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Just over $7 billion was provided for community health centers and Medicare’s therapy caps were repealed.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

Compulsive video-game playing could be mental health problem

Drotumdi O

June 18, 2018 by Jamey Keaten And Maria Cheng
Compulsive video-game playing now new mental health problem
In this Friday, Nov. 3, 2017 file photo, a man plays a game at the Paris Games Week in Paris. The World Health Organization says that compulsively playing video games now qualifies as a new mental health condition, in a move that some …more

Obsessive video gamers know how to anticipate dangers in virtual worlds. The World Health Organization says they now should be on guard for a danger in the real world: spending too much time playing.

In its latest revision to a disease classification manual, the U.N. health agency said Monday that compulsively playing video games now qualifies as a mental health condition. The statement confirmed the fears of some parents but led critics to warn that it may risk stigmatizing too many young video players.

WHO said classifying "gaming disorder" as a separate addiction will help governments, families and health care workers be more vigilant and prepared to identify the risks. The agency and other experts were quick to note that cases of the condition are still very rare, with no more than up to 3 percent of all gamers believed to be affected.

Dr. Shekhar Saxena, director of WHO's department for mental health and substance abuse, said the agency accepted the proposal that gaming disorder should be listed as a new problem based on scientific evidence, in addition to "the need and the demand for treatment in many parts of the world."

Dr. Joan Harvey, a spokeswoman for the British Psychological Society, warned that the new designation might cause unnecessary concern among parents.

"People need to understand this doesn't mean every child who spends hours in their room playing games is an addict, otherwise medics are going to be flooded with requests for help," she said.

Others welcomed WHO's new classification, saying it was critical to identify people hooked on video games quickly because they are usually teenagers or young adults who don't seek help themselves.

"We come across parents who are distraught, not only because they're seeing their child drop out of school, but because they're seeing an entire family structure fall apart," said Dr. Henrietta Bowden-Jones, a spokeswoman for behavioral addictions at Britain's Royal College of Psychiatrists. She was not connected to WHO's decision.

Bowden-Jones said gaming addictions were usually best treated with psychological therapies but that some medicines might also work.

The American Psychiatric Association has not yet deemed gaming disorder to be a new mental health problem. In a 2013 statement, the association said it's "a condition warranting more clinical research and experience before it might be considered for inclusion" in its own diagnostic manual.

The group noted that much of the scientific literature about compulsive gamers is based on evidence from young men in Asia.

"The studies suggest that when these individuals are engrossed in Internet games, certain pathways in their brains are triggered in the same direct and intense way that a drug addict's brain is affected by a particular substance," the association said in that statement. "The gaming prompts a neurological response that influences feelings of pleasure and reward, and the result, in the extreme, is manifested as addictive behavior."

Dr. Mark Griffiths, who has been researching the concept of video gaming disorder for 30 years, said the new classification would help legitimize the problem and strengthen treatment strategies.

"Video gaming is like a non-financial kind of gambling from a psychological point of view," said Griffiths, a distinguished professor of behavioral addiction at Nottingham Trent University. "Gamblers use money as a way of keeping score whereas gamers use points."

He guessed that the percentage of video game players with a compulsive problem was likely to be extremely small—much less than 1 percent—and that many such people would likely have other underlying problems, like depression, bipolar disorder or autism.

WHO's Saxena, however, estimated that 2 to 3 percent of gamers might be affected.

Griffiths said playing video games, for the vast majority of people, is more about entertainment and novelty, citing the overwhelming popularity of games like "Pokemon Go."

"You have these short, obsessive bursts and yes, people are playing a lot, but it's not an addiction," he said.

Saxena said parents and friends of video game enthusiasts should still be mindful of a potentially harmful problem.

"Be on the lookout," he said, noting that concerns should be raised if the gaming habit appears to be taking over.

"If (video games) are interfering with the expected functions of the person—whether it is studies, whether it's socialization, whether it's work—then you need to be cautious and perhaps seek help," he said.

Explore further: WHO gaming addiction classification an important step for treatment, says expert