This comes as good news following the announcement of flu vaccine production delays this season, which has caused health officials to urge healthy people to postpone their flu shots until December, so that the elderly, immune-system-suppressed persons and pregnant women would be ensured of getting their shots first. The vaccine is now being shipped, and enough doses are reported to be available.

Tamiflu, manufactured by New Jersey-based Hoffman-La Roche, currently is used as a treatment that shortens effects of the flu by about a day, if taken right after symptoms emerge. But yesterday officials noted that if taken every day during a flu outbreak, persons over age 13 will reduce their chances of getting sick in the first place. The drug works by inhibiting a protein that enables the flu virus to infect cells.But Tamiflu is not as cheap as simply getting a flu shot. Many Americans, including Medicare patients, typically get flu shots free through insurers or employers, or for less than $20 during public vaccine campaigns. A10-day supply of Tamiflu, by contrast, costs about $49 wholesale. And patients must take the pill every day during outbreaks, which have lasted up to 42 days.

Roche is trying to persuade insurance companies to cover Tamiflu for flu prevention, but that will not help the elderly because Medicare does not pay for prescription drugs.

Study results show that only 1.2 percent of unvaccinated people who took Tamiflu during a flu outbreak got sick, vs. 4.8 percent of people who took a placebo. More important, nursing home studies found that less than half a percent of elderly residents who took Tamiflu got sick, vs. 4.4 percent who took a dummy pill. Most of the nursing home residents had already been vaccinated, but Tamiflu offered additional protection.

Influenza typically sickens 20 million Americans per year, kills 20,000 and hospitalizes many more. The elderly and frail persons are the most at risk during outbreaks.

Source: The Washington Post, Nov. 21, 2000

Set to take effect in January 2002, the new rules are designed to streamline the claims process by requiring health plans to give patients decisions on claims within 30 days, with a possible 15-day extension, and decisions on appeals of denied claims within 60 days.

The new regulations are the first changes to the claims and appeals process since the Employee Retirement Income Security Act, which covers employer health plans, was passed in 1974.

Clinton approved the rules after Congress failed to act on proposed Patients' Bill of Rights legislation that would have given patients the right to sue their managed-care plans.

According to the Labor Department, the only time a patient can sue a health plan is if it does not comply with the regulations. Legislation allowing patients to sue their health plans for inadequate care was passed by the House earlier this year, but Senate Republicans, prompted by appeals from industry lobbyists, contend that it would raise health care premiums and lead to a flurry of new lawsuits.

The new rules specify that for initial claims, plans must render a decision within three days for urgent care claims, 15 days on pre-service claims and 30 days on post-service claims. One 15-day extension will be allowed on pre- and post-service claims.

Appeals have a 30-day limit on pre-service claims, a 60-day limit on post-service claims and a three-day limit on urgent care decisions. Claimants have 180 days to file appeals, up from the current 60-day limit.

In addition, health plans are mandated to reveal the names of any health care professionals consulted in conjunction with the claims process, and appealed claims must be decided by someone other than the official who rendered the claim denial.

Source: The Washington Post, Nov. 21, 2000

Peter Budetti, M.D, J.D was the keynote speaker for the event. As one of the authors of the original Health Quality Improvement Act, Budetti shared the legislative and political history of the NPDB and provided insight into future needs related to the NPDB.

In addition to administering the NPDB, the Division of Quality Assurance also administers the Healthcare Integrity Protection Data Bank and the Federal Credentialing Program. Other federal agencies which maintain data banks on adverse incidents, health consumers or other health information include the Department of Veterans Affairs, the Agency for Healthcare Research and Quality , and the Department of Defense.

The Office of Inspector General discussed how they used information maintained in the database, problems associated with reporting to the database, and discussed experimental efforts to address the primary intent of the database, to assure competency and safe care. The OIG discussed the Citizens Advisory Committee effort to address quality care.

Presentations also were made by researchers from the University of Virginia, University of Tennessee and the University of Michigan.

The moderator for the day was Mary Wakefield, PhD, RN ,who discussed her work on the IOM report in relation to the mandate of the NPDB.

(Contact Winifred Carson at x7061 or wcarson@ana.org)

(ANA Contact Winifred Carson at wcarson@ana.org)

The visits--to every family that asks for one--are to help at-risk families learn how to give the best health care and nutrition to babies, said Marilyn Seabrooks, the city's maternal and child health officer.

Nine D.C. hospitals with obstetric units and five Medicaid health maintenance organizations are participating in the initiative, which officials say will cost about $750,000--most of it in federal funds.

Each mother will be given a gift basket with a baby T-shirt, a rattle with the District logo, a bib and a letter from Mayor Anthony A. Williams (D), while in the hospital, inviting her to schedule a home visit.

The basket will also have information on preventive steps against lead poisoning and on immunization, and it will include a refrigerator magnet with useful phone numbers. The baskets contain no commercial or marketing materials, Seabrooks said.

The service will be offered to the estimated 8,000 women a year who deliver babies at District birthing centers and live in the city. Of those new mothers, about half are expected to invite a city nurse to visit for a few hours to discuss child care. Members of Medicaid HMOs will be visited by nurses provided by their city-paid health plan, Seabrooks said.

"It's the first tangible thing that goes directly at infant mortality," Walks said. "There are a lot of horrible children's deaths in D.C., and this is the best public health intervention to get at those things and help us make healthier children."

The city's infant mortality rate has fallen steadily from record levels 10 years ago.

The concept of home visits has worked well in other cities because women may feel less threatened if they receive the information on their own turf.

For information, call 800-MOM-BABY. Spanish-speaking nurses are available.

Source: The Washington Post, Nov. 17, 2000

The expanded list opens up a host of new possibilities for Internet addresses, providing a boon to name-hungry Web site operators and the companies that hand them out.

But the new domains also promise to make hunting for Web addresses that much more complicated. No longer are the most common choices limited to .com, .org, .gov or .net.

The Internet Corporation for Assigned Names and Numbers (ICANN) approved the new domain names yesterday during its annual meeting in Marina Del Ray, Calif. President Clinton authorized the private nonprofit organization to oversee address policy in 1998.

Source: The Washington Post, Nov. 17, 2000

On Friday, ANA President Mary Foley, MS, RN, and UAN Chair Cheryl Johnson, RN, joined with labor leaders in blocking the entrance of the Washington Hospital Center, and were arrested for their actions. Also arrested were American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) President John Sweeney; American Federation of Teachers (AFT) President Sandra Feldman; AFL-CIO Metropolitan Council President Joslyn Williams; and other religious and community leaders.

At the same time, five WHC nurses began a "Fasting and Prayer Vigil" to protest the hospital center's actions. And a lawsuit was filed against U.S. Nursing Corp. by DCNA, the AFL-CIO, a hospital center patient and two other plaintiffs. U.S. Nursing, the suit claims, has not registered as a foreign corporation in the District and does not have a license as a temporary employment agency in DC. The suit also alleges that the replacement nurses have been improperly certified and should not be working in the hospital.

The house took important action on nurse staffing issues, including directing ANA to support and participate in efforts to identify adequate and appropriate registered nurse staffing levels where health care services are delivered and strong opposition to mandatory overtime. The house also acted upon several important proposals in the patient safety/advocacy and workplace rights arenas, two of ANA’s core issues.

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