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Just over $7 billion was provided for community health centers and Medicare’s therapy caps were repealed.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

Race, Pre-Pregnancy BMI May Help Predict Maternal Weight Gain

Drotumdi O

Race, Pre-Pregnancy BMI May Help Predict Maternal Weight Gain

Article ID: 691287

Released: 16-Mar-2018 1:05 PM EDT

Source Newsroom: Endocrine Society

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CITATIONS

ENDO 2018, Mar-2018

CHANNELS

Obesity, OBGYN, Women's Health, Local - DC, Local - DC Metro, Medical Meetings

KEYWORDS

 

Newswise — CHICAGO—Race and pre-pregnancy body mass index (BMI) both affect leptin and adiponectin levels, and leptin levels in mid-pregnancy may be an important predictor of weight gain during pregnancy, new research suggests. The results will be presented on in a poster on Sunday, March 18 at ENDO 2018, the 100th annual meeting of the Endocrine Society in Chicago, Ill.

"Gaining too much or too little weight during pregnancy poses potential health risks. Leptin and adiponectin, hormones released primarily from fat cells, are known to play roles in appetite regulation, insulin resistance, lipid metabolism, blood pressure and the development of metabolic syndrome. During pregnancy, lower levels of adiponectin are associated with higher risk of gestational diabetes and higher leptin levels are observed in women who develop pre-eclampsia," said lead study author Adam Jara, D.O., Ph.D., a clinical instructor at Ohio State University in Columbus, Ohio.

Jara and his co-authors at Ohio State investigated the effects of race and pre-pregnancy BMI on serum adiponectin, leptin, the leptin-to-adiponectin ratio (LAR) throughout pregnancy and postpartum, and their effects on weight gain during pregnancy.

The research team recruited 80 pregnant women—38 African-American and 42 Caucasian women—from the Ohio State University Medical Center Prenatal Clinic. The authors measured adiponectin and leptin levels 3 times during pregnancy—early, middle and late—and again after delivery.

Both race and pre-pregnancy BMI appeared to affect adiponectin and leptin levels during pregnancy and after birth.

After controlling for race and pre-pregnancy BMI, serum levels of adiponectin, leptin and the LAR during pregnancy predicted total maternal weight gain. Leptin levels in mid-pregnancy were the most predictive of weight gain during pregnancy.

Among African-American women with obesity, the LAR increased significantly from early to mid-pregnancy, stayed high in late pregnancy and decreased after birth. By contrast, among Caucasian women with obesity, the LAR did not change significantly over time.

Overall, adiponectin levels decreased from early to late pregnancy, with an increasing trend after birth. Higher pre-pregnancy BMI was associated with lower levels of adiponectin. African-American women had lower serum adiponectin at each time point they were tested, compared to Caucasian women with equivalent pre-pregnancy BMIs.

Overall, serum leptin increased throughout pregnancy and declined after birth. Lower leptin levels were associated with lower pre-pregnancy BMIs.

The National Institute of Nursing Research (NINR), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Center for Advancing Translational Sciences (NCATS), and an Ohio University Transition to Research Independence Award supported the study.

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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

 

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