Tag Archives for Lt. Gov. Charles J. Fogarty

Drug Company CEOs Receive Plea  for Lower Drug Costs

Published in Pawtucket Times on March 15, 2004

Seniors can only hope the pen is mightier than the sword as senior advocates send correspondence to CEOs of major drug companies, urging them to take more responsibility in putting the brakes on skyrocketing pharmaceutical drug costs.

Last Monday, AARP CEO William D. Novelli drafted a letter challenging 16 CEOs of major drug companies to lower the nation’s spiraling drug costs.

AARP’s CEO charged in this correspondence -which has been obtained by All About Seniors – that even with last year’s newly enacted Medicare prescription drug law, high drug prices are still a very serious issue for the nation’s seniors.

“Too many people cannot afford the drugs they need,” Novellis said, resulting in a “very substantial non-compliance with physicians’ recommendations.

Also contributing to higher drug prices, said AARP’s top official, is that seniors do not use geriatrics despite their “comparable effectiveness and lower cost.”

Novelli called on each drug company CEO to limit their company’s price increases to no greater than the level of inflation for current drug products. Additionally, he requested they stop price increases of new drugs, asking them to use their influence to stop drug mark-ups throughout the drug distribution chain.

Novelli urged the drug company CEOs to support drug-importation legislation, subject to proper FDA oversight to ensure safety of the imported medications. (Currently there is legislation being considered by Rhode Island lawmakers to allow drug importation from Canada).

Furthermore, Novelli asked CEOs for their drug companies’ strong endorsement of federal and state funding “to support clinically based, comparative effectiveness research that will permit objective, scientific comparisons of specific drugs in the same therapeutic class.”

Novell even urged the CEOs not to oppose any federal legislation introduced that would provide the Secretary of Health and Human Services with appropriate negotiating authority in the event the competitive private purchasing system does not produce the anticipated cost savings for the Medicare program.

The Republican-crafted Medicare law does not allow the federal government to negotiate for lower drug prices – a move that’s been opposed by the Democrats.

To put the brakes on rising out-of-pocket costs for seniors, Novelli also asked the CEOs to support a disclosure of pricing information by pharmaceutical benefits managers to their payer clients. This would assure that those enrolled in the Medicare program will receive full advantage of negotiated discounts and rebates.

Better displays of drug information regarding the risks, side effects and proven effectiveness of their consumer advertising is needed, Novelli told the CEOs. He also called for generics to be quickly moved into the marketplace when the patent has expired for brand name drugs.

In his correspondence, Novelli called on the CEOs to follow the ethics guidelines of the American Medical Association when it comes to giving gifts to physicians and sponsorships of educational meetings.

Last month, Lt. Gov. Charles J. Fogarty, chairman of the state’s Long-Term Care Coordinating Council, in Feb. 19 correspondence, called on Alan F. Holmer, president and CEO of PhRMA, to join the lead of drug manufacturer Merck in providing medication at no cost to low-income Medicare beneficiaries who participate in the new federal Medicare prescription drug discount card program.

Low-income seniors would be eligible for the Merck benefit once they use up their $ 600 federal allotment on their cards. Fogarty said in his written statement.

The Medicare drug discount cards are an interim measure put in place by the federal government until 2006, when newly passed Medicare changes will take affect, said Fogarty. The lieutenant governor, along with many of the state’s senior advocacy groups and the state’s Congressional delegation, have given their thumbs-down to the Republican-backed enacted Medicare revisions and have urged Congress to scrap the law and “to back to the drawing table.”

By accepting his invitation to help lower the cost of pharmaceutical rugs, Fogarty believes, “This will give the industry the opportunity to partner with the government and make a significant difference for those in need.”

The seniors’ battle to slash the out-of-pocket costs of pharmaceuticals must take place both on Capitol Hill, inside the Washington, D.C. Beltway, and at the Rhode Island Statehouse in Providence.  Novelli and Fogarty are now taking the fight to the boardrooms of major drug manufacturers across the nation.

Seniors may well hope that the pen is indeed mightier than the corporate sword.

Home Care Quality Data Not Always Easy to Interpret

Published in Pawtucket Times on November 10, 2003

A 70-year-old widow was recently discharged from a local hospital after surgery for cancer. Her daughter has agreed to take on caregiving duties, but because of her demanding job, there will be frequent periods of time that the elderly woman will be left home alone.

To keep this elderly woman at home after her hospital stay, her physician has referred her to a home health agency that will provide skilled nursing services for wound care and medication management.

Additionally, physical therapy has been ordered for rehabilitation. By being eligible for skilled nursing care, Medicare will also pay for a certified nursing assistant for five weekly visits to provide personal care services.

Although fictional, this situation is very typical of the care provided by 21 Medicare-certified home care agencies to 12,000 older Rhode Islanders who have a medical need for skilled care.

These agencies offer an array of health care (i.e. skilled nursing care, physical, occupational, respiratory and speech therapies, social services, psychiatric nursing and palliative care) and personal care services to patients in their own homes.

Federal and state officials, home care agency providers and Rhode Island Partnership for Home Care recently gathered at the Quality Partners of Rhode Island offices to unveil the Centers for Medicare & Medicaid Service’s (CMS) new quality improvement initiative.

CMS’s quality data will allow consumers to evaluate Medicare certified home care agencies on 11 quality measures. They include four measures related to improvements in getting around, four measures related  to improvement in meeting basic daily needs, two measures related to medical emergencies and one measure related to mental health improvements.

Quality Partners has been involved in the state’s public reporting program, which is designed to facilitate consumer choice and promote quality improvement in health care. The Providence-based independent quality improvement organization, under contract with CMS, is working with local home health agencies to improve the quality of care and inform consumers about the availability of the federal agency’s recently released quality performance data.

CMS’s new initiative is a “key step toward improving quality in getting consumers the information they need to make informed health care choices,” said CMS Administrator Tom Scully in a written statement. “By generating and publishing quality data, we are helping consumers make decisions that best meet their needs and are creating incentives for home health agencies to further improve quality.

“These quality measures should be used as an additional resource when making decisions about a home health agency or addressing the quality of care that a loved one is receiving,” said Scully. “Use these measures as an opportunity to discuss the care provided by the home health agency and address not only the areas of care covered by the quality measures, but all services as well.”

Lt. Gov. Charles j. Fogarty, who chairs the state’s Long-Term Care Coordinating Council, added, {CMS’] rating system for home health agencies fits in nicely with what we are doing here in Rhode Island. Having this information will help foster quality among the rated agencies. It will create an environment for home health care agencies to continue to improve on their quality of care.”

“Most home care agency providers embrace this quality initiative as an opportunity for agencies to focus more resources on quality for all agencies to achieve the highest standards of care which will result in an informed pubic,” noted Paula Parker, executive di rector of the Rhode Island Partnership for Home Care.

“Consumers can e confident that their home care provider has practices and policies in place to measure quality indicators. This will empower consumers to discuss quality with their providers,” she says.

While recognizing the merits to this initiative, Maria Barros, clinical director of the Pawtucket-based Nursing Placement and Saranna Home Care, is concerned that consumers may have difficulty in interpreting the quality data.

“The Home Health Quality Initiative does not really measure the agencies’ performances (in some situations),” says Barros, especially when agencies take care of patients who have chronic disabling or terminal conditions. “The patients do not improve and the quality measurers reflect this, ultimately giving a false impression that quality care is not being provided,” she says.

“Not all of our patients with diseases get better or are cured,” Barros adds. “We help them to manage their disease processes, keep them at home and enhance their quality of life until they are ready to enter into hospice care.”

Moreover, Barros said some agencies that take care of younger patients with acute medical conditions that only require short-term home health services will have better outcome data when compared to agencies that care for sicker patients’

“The intensity of the medical care is not always reflected in these 11 quality indicators,” she said.

Parker agreed, stressing that it is important for consumer to interpret the numbers released by the CMS in the context in which home care is provided.

For Medicare certified home health agencies, CMS has published advertisements in local newspapers that will include three of the quality indicators. The complete listing of quality data along with  other consumer information on home health care agencies in Rhode Island, is available at Home Health Compare located on Medicare website, www.medicare.gov and throughout Medicare’s 24-hour help line at 1-800-MEDICARE (1-800-633-4227).

For those 5,000 Rhode Islanders who receive home care through programs other than Medicare quality of care is measured by the R.I. Department of Health through their performance measurement and reporting program, mandated by legislation introduced by then-state Senator Charles Fogarty and passed by the General Assembly in 1998. Signed by the governor, this law is designed to provide consumers with published reports of quality measures for every segment of Rhode Island’s health care system.