This Week in Managed Care: June 2, 2017

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This week, the top managed care stories include an announcement that CMS will take Social Security numbers off Medicare cards; a national plan to combat chronic obstructive pulmonary disease was released; and a nutrition advocacy group calls on FDA to stick with the schedule for a new nutrition facts label.


CMS takes aim at Medicare fraud, the nation gets an action plan to fight COPD, and oncologists gather this week in Chicago for the annual meeting of ASCO.

Welcome to This Week in Managed Care, I’m Laura Joszt.

New Medicare Cards

Starting in April 2018, CMS will take Social Security numbers off Medicare cards to combat fraud and protect seniors from identity theft. The new cards meet a requirement Congress set when it passed the Medicare Access and CHIP Reauthorization Act.

However, physician groups, led by the American Medical Association, worry that providers have no way to obtain the new M-B-I number if seniors lose or forget their card, and they had sought a formal rulemaking process to come up with a plan. Other fraud prevention steps could create confusion, the groups warned in a recent letter: “CMS has said that, for security purposes, it will not provide information on when the new identification cards will be sent to beneficiaries, which means practices will not know when to ask their patients for their new card.”

CMS said the changeover to the new cards will take a full year.

National Plan for COPD

Chronic obstructive pulmonary disease, better known as COPD, is the third-leading cause of death in the United States, and a new partnership has formed to end the disease.

The National Heart, Lung and Blood Institute has released the first COPD National Action Plan, which was presented at the recent meeting of the American Thoracic Society International Conference.

The 5 goals for the COPD Action Plan are:

  • Empower patients, families, and caregivers to recognize and reduce the burden
  • Improve diagnosis, treatment, and management by improving quality of care
  • Collect, analyze, and share public health data
  • Increase research to better understand COPD
  • Translate policy recommendations into better research and public healthcare actions.

For more, visit the COPD compendium.

Waste of Direct-to-Consumer Tests

Direct-to-consumer genetic tests will lead to low-value, wasteful medical care, according to a new commentary appearing in JAMA. Kimberly Lovett Rockwell, MD, JD, who is also a lawyer, writes that the direct-to-consumer market runs counter to efforts to contain healthcare costs and improve quality.

Her viewpoint responds to FDA’s April decision to allow the genetic testing company 23andMe to directly sell testing kits to consumers that let them test for DNA mutations linked to conditions such as Alzheimer’s and Parkinson’s disease.

Rockwell said the direct-to-consumer tests are not developed using evidence-based guidelines, and are advertised in ways that attract consumers who may not be good candidates for the tests. She calls for state lawmakers to ensure that tests are only performed under supervision from doctors and medical boards. Rockwell concluded: “These interventions would serve to increase accountability for preserving scarce healthcare resources and also protect patients from untoward downstream consequences of follow-up testing and procedures.”

Food Labels

A nutrition advocacy group has called on FDA to stick with the schedule for updating the Nutrition Facts label, which has not been changed in 20 years.

The Center for Science in the Public Interest, alarmed with changes to rules for school lunches and a delay for food labeling rules for restaurant meals, said the long-awaited food label is needed to give consumers clear information about calorie counts and added sugar.

The new label is set to take effect starting in July 2018 and will reflect the most recent changes to the Dietary Guidelines for Americans, which call for limiting added sugar to 10 percent of daily calories and limiting sodium to 2300 milligrams per day.

In a letter to FDA and HHS, the group said, “Americans consume added sugars, especially sugar-sweetened beverages, in amounts that are linked to a higher risk of heart disease, type 2 diabetes, obesity, tooth decay, and nutrient poor diets.”

ASCO 2017

A study to be presented this weekend at the American Society for Clinical Oncology has found that patients with colorectal cancer who have more active lifestyles have a lower risk of death. Those with a healthy body weight, regular physical activity, and a diet rich in fruits, vegetables and whole grains had a longer period of disease-free survival and overall survival, according to the study.

The study followed 992 patients who received chemotherapy for stage 3 colon cancer between 1999 and 2001.

Read more about the study.

AJMC will have full coverage of the ASCO annual meeting in Chicago, which begins Friday. Visit our conference page.

For all of us at the Managed Markets News Network, I’m Laura Joszt. Thanks for joining us.