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HEALTH CARE NEWS

US Congress extends CHIP, funds opioid crisis response following temporary shutdown

Publish date: February 9, 2018

By 

Gregory Twachtman 

Oncology Practice

 

 

 

 

 

 

 

 

 

Congress, despite a second shutdown in less than a month, was able to pass a number of financial extenders to fund key health care programs.

The bipartisan spending bill (H.R. 1892), passed in the early morning hours on Feb. 9 by a 71-28 vote in the Senate (16 Republicans and 12 Democrats voted against it, and Sen. John McCain [R-Ariz.] was not present) and a 240-186 vote in the House (67 Republicans and 119 Democrats voted against and 5 representatives did not vote). President Trump signed the bill later that morning.

 

The spending bill and continuing resolution to fund the government through March 23 includes $6 billion to fund treatment for opioid addiction and other mental health issues, $2 billion in additional funding for the National Institutes of Health, and 4 additional years of funding for the Children’s Health Insurance Program. The additional CHIP funding extends the program for a total of 10 years.

The funding bill also made a technical correction to the Merit-based Incentive Payment System (MIPS) track of the Medicare Quality Payment Program. It removes Part B drug reimbursement from the MIPS payment adjustment, so any positive or negative change to physician payments based on the MIPS score will only be applied to physician fee schedule payments.

The bill also repeals the Independent Payment Advisory Board, a panel created by the Affordable Care Act that would have the power to slash Medicare spending under certain budget circumstances. That board was never convened.

The funding legislation also accelerates closure of the Medicare Part D “donut hole,” the coverage gap in which beneficiaries must pay 100% of medication costs prior to entering catastrophic coverage.

Just over $7 billion was provided for community health centers and Medicare’s therapy caps were repealed.

While the funding bill was written in the Senate with bipartisan input and received bipartisan support, Sen. Rand Paul (R-Ky.) held up votes over objections to the more than $1 trillion it will add to the nation’s debt, as well as for the fact that there was no opportunity to introduce and vote on amendments, leading to an hours-long government shutdown.

There also were concerns about two issues that could have derailed the vote in the House. Democrats wanted to add language to address immigrants brought to this nation illegally as children, while some Republicans did not want to increase the federal debt. However, there were enough votes to pass the funding legislation.

gtwachtman@frontlinemedcom.com

Mediterranean Diet Boosts Beneficial Bacteria

Drotumdi O

In the pre-clinical study, non-human primates were randomized to either Western or Mediterranean diet groups and studied for 30 months. The Western diet consisted of lard, beef tallow, butter, eggs, cholesterol, high-fructose corn syrup and sucrose, while the Mediterranean diet consisted of fish oil, olive oil, fish meal, butter, eggs, black and garbanzo bean flour, wheat flour, vegetable juice, fruit puree and sucrose. The diets had the same number of calories.

At the end of the 30 months, Yadav’s team analyzed the gut microbiome – the good and bad bacteria that live in the gastrointestinal tract – in both diet groups through fecal samples. They found the gut bacteria diversity in the Mediterranean diet group was significantly higher than in the group that ate the Western diet.

“We have about 2 billion good and bad bacteria living in our gut,” Yadav said. “If the bacteria are of a certain type and not properly balanced, our health can suffer.

“Our study showed that the good bacteria, primarily Lactobacillus, most of which are probiotic, were significantly increased in the Mediterranean diet group.”

The data revealed in this study should be useful for further studies aimed at understanding the diet-microbiome-health interactions in humans, including obesity, type 2 diabetes, cardiovascular disease and psychiatric disorders, Yadav said.

This work was supported by National Institutes of Health grant R01 HL087103 (CAS), R01 HL122393 (TCR), and the Pepper Older Americans for Independence Center (P30 AG21332), as well funds and services provided by the Center for Diabetes, Obesity and Metabolism, at Wake Forest Baptist and the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health-funded Wake Forest Clinical and Translational Science Institute (WF CTSI) through Grant Award Number UL1TR001420.

Co-authors are: Ravinder Nagpal, Ph.D., Carol A. Shively, Ph.D., Susan A. Appt, D.V.M, Thomas C. Register, Ph.D., Kristofer T. Michalson, D.V.M., and Mara Z. Vitolins, Ph.D., of Wake Forest Baptist.