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What Happened To Our Health Care System?

Conversations about health care reform are heard everywhere these days. Our Government officials debate it regularly, the media discusses every different version of it, and the American public wonders if it will ever actually happen. With all these different ideas on how to reform the health care system, it’s easy to get confused and overwhelmed. And, frankly, it all starts to sound a little stale after a while. But, every once in a while, you come across an intriguing and thought-provoking article that really makes sense, like this one. We just happened to stumble across this article written by Atul Gawande of The New Yorker, and honestly believe it’s one of the best articles we’ve ever read on controlling health care costs and health care reform.

“The Cost Conundrum” is a long and detailed article, but it’s extremely interesting. Instead of writing a dry, humorless critique of the health care system, the author instead provides us with fascinating statistics, real-life examples, and even a bit of humor. Yet, through it all, Gawande makes his point clear: “we took a wrong turn when doctors stopped being doctors and became businessmen.”

To start, the article comments on how high our nation’s health care costs have become. Our country’s health care is by far the most expensive in the world. Money spent on doctors, hospitals, drugs, and other medical costs now accounts for more than one of every six dollars we earn. Health care costs have caused millions of families to file bankruptcy, and it has hurt our country’s global competitiveness. In fact, President Obama even acknowledged its effects in a March speech: “The greatest threat to America’s fiscal health is not Social Security. It’s not investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing costs of health care. It’s not even close.”

The article introduces the little town of McAllen, Texas. McAllen is located in Hidalgo Country, which has the lowest household income in the country. Yet surprisingly, McAllen is one of the most expensive health care markets in the country. Miami is the only other city that spends more per person on health care than McAllen – and Miami has much higher labor and living costs. In 2006, Medicare spent $15,000 per enrollee in McAllen – that’s almost twice the national average!

What’s the reason for these high health care costs? Unfortunately, it’s hard to say for sure. El Paso County is about 800 miles up the border from McAllen. Both have essentially the same demographics, a population of roughly 700,000, and similar public health statistics. The treatments and technologies offered in McAllen were comparable to those offered in El Paso. Public statistics show no drastic difference in the supply of doctors. But health care costs in El Paso are much lower than those in McAllen. In 2006, Medicare only spent $7,504 per enrollee in El Paso – that’s half as much as they spent in McAllen!

So, you would assume that the quality of health care must be the big difference between the two cities, right? If everything else is the same, yet McAllen has such high health costs, the quality of care offered there must be better. Right? Not according to statistics! Medicare ranks hospitals on 25 metrics of care. On all but 2 of these, McAllen’s five largest hospitals performed worse, on average, that the hospitals in El Paso. So, if it’s not quality of care they’re paying for, what exactly is it?

To put it simply, it seems that the doctors in McAllen are more revenue-focused than most other doctors. They find ways to increase their high-margin work and decrease their low-margin work. They order expensive tests and rely on surgery even when it’s not necessary. In fact, one hospital executive in McAllen accounts several cases of outright fraud: “I’ve had doctors here come up to me and say, ‘You want me to admit patients to your hospital, you’re going to have to pay me.’” He said they always requested over $100,000 per year – and sometimes as much as $500,000 per year. And although he stressed that this was only a few doctors, he also acknowledged that he had never been asked for a kickback until he came to McAllen.

On the other end of the spectrum is the Mayo Clinic, one of the highest-quality, lowest-cost health care systems in our country. The basic view of the Mayo Clinic is: “The needs of the patients come first” – not the convenience of the doctors or the revenues. A few decades ago, the Mayo Clinic decided to work on eliminating as many financial barriers as possible. They pooled all the money the doctors and hospital system received, and they started paying everyone a salary. This way, the doctors wouldn’t focus on trying to make more money by ordering unnecessary tests and medical procedures. Instead, they simply focus on what is medically best for the patient.

When you contrast and compare these different hospital systems: McAllen, El Paso, and the Mayo Clinic, it’s easy to see why our nation’s health care system has become so uncontrolled. Health care reform is absolutely vital for the financial stability of our country and the overall well-being of our people. If you get a chance, read through Gawande’s article in The New Yorker. It’s absolutely astounding, riveting, and inspiring.

As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don’t, McAllen won’t be an outlier. It will be our future.

- Atul Gawande

via Annals of Medicine: The Cost Conundrum: Reporting & Essays: The New Yorker.

Students Need More Health Insurance Information and Education

University Student Insurance

We’ve discussed the importance of health insurance many times before. And as the summer season rolls around every year, we try to encourage college graduates to research their health insurance options and establish a good quality, affordable health insurance plan as they begin the next phase of their life. We often think that college students either don’t care about health insurance or consider it an unnecessary expense, because so few college graduates actually take the steps to obtain health insurance after graduation.

However, United Health Care has discovered something completely different. According to a recent study done by UnitedHealthCare, 82% of young adults actually do believe that health insurance is a necessity that they cannot ignore. However, more than 50% of them feel that they lack the information needed to make good decisions about their health care coverage. Even though they fully understand the importance of health insurance, they don’t know how to research their choices and find a suitable health plan.

An online poll was conducted among 1,000 students between the ages of 18 and 21. And while an overwhelming majority of them ranked health benefits equally as important as salary in their job search, an astounding 67% had not made any plans for health insurance coverage after graduation. This number jumped to 72% among students who were currently covered by their parent’s health insurance plan.

  • 69% of students currently covered under their parent’s health insurance plan didn’t really understand the details of their current health coverage
  • 26% had no idea when their health insurance coverage would end
  • 55% of students surveyed felt that their parents had not shared enough health insurance information with them
  • 87% strongly believe that schools and educational institutions should be doing more to communicate the basics of health insurance to students, in an effort to prepare them for graduation
  • Overall, 83% of the students said they had no idea about the kinds of health insurance policies that exist for young adults between jobs.

Short-term health insurance plans are designed with college graduates in mind. These health insurance plans aim to fill in the coverage gap while the graduates are transitioning from school to work. These health plans are quite affordable for college graduates, and provide a certain sense of security as graduates begin their new lives. Yet surprisingly, 83% of the students surveyed in the poll had never even heard of short term health insurance.

United Health Care offers a short-term health insurance plan through their Golden Rule Insurance Company. These short term health plans offer coverage for one to six months, with a range of deductibles and payment options available. The short term health plans are easy to understand and only require a simple and quick application process. When the health plan expires, the customer can reapply for a new plan if health insurance coverage is still needed. Additionally, these health plans provide flexibility, allowing customers to drop the health insurance plan at any time without penalty.

Young adults recognize the importance of having health insurance coverage but are ill-prepared to make good decisions about it when they leave school. Graduates are entering the real world without a sense of what to look for in a health plan and how to find coverage that is right for their needs.

- Richard A. Collins, President of UnitedHealthCare’s individual line of business and CEO of United Health Care’s Golden Rule Insurance Company

via UnitedHealthCare: Study Reveals Lack of Information, Not “Invincible” Mindset, Stands Between Young Adults and Health Insurance

Bloggers Debate Health Insurance & Health Care Reform

  • Could the U.S. pay for a Government sponsored health care system?
  • Should the U.S. Government run the health care industry?
  • Universal health care or health care reform?
  • Should health care be mandated?

Bloggers are weighing in on the ever-touchy health care debate. CNN asked a host of bloggers some important questions regarding health insurance and health care. Some of the top questions included: Should health insurance be geared towards only the privileged (people that can afford coverage or are covered under a group health insurance policy)? Should the United States Government sponsor a health insurance plan that is made to be affordable for all individuals and families? Watch the health care debate unfold in this CNN Health video.

Health Insurance & Health Care Get Overhauled

Sen-Edward-kennedy

Senator Ted Kennedy has been a steadfast supporter of health care reform. And even with his own personal obstacles to overcome, health care reform still remains one of Kennedy’s top priorities. Yesterday, Senator Kennedy released his health care plan. The plan is both innovative and extensive, extending to both the health care and health insurance industries. Unfortunately, there will likely be critics of the plan. Take a look at this excerpt from the LA times, and let us know what you think. We’re quite impressed with Senator Kennedy’s strong will and motivation in these times of uncertainty. If we had more Ted Kennedy’s in the government arena, we may actually get a lot more accomplished.

Kennedy, whose fight to reshape the healthcare system spans more than 40 years, would require all Americans to get medical insurance, establish complex new insurance exchanges to facilitate near-universal coverage, and dramatically step up government oversight of the insurance industry. Among other things, private insurers would be required to cover people with preexisting conditions, co-payments for preventive care would be limited, and doctors and hospitals that provided high-quality care would be rewarded.

But reaction to the 615-page bill — written with little GOP involvement — was an ominous preview of the potential for a return to the kind of partisan conflict that sank previous efforts to reshape the troubled medical system.

via MSNBC: Congress: Health-Care Bills Cometh

Diabetic Health Insurance Plans

Millions of people in the United States have diabetes, which has become the largest and fastest-growing chronic disease in the nation. According to the Centers for Disease Control and Prevention (CDC), diabetes was the country’s seventh leading cause of death by disease in 2006. Diabetes is also a leading cause of blindness, kidney disease, heart disease, and amputations.

Although there is no “cure” for diabetes, various treatments and lifestyle changes can be made to help diabetics live a stable, normal life. Early screening, diagnosis, and treatment are absolutely crucial in preventing or reducing more serious forms of the disease.

Once you have been diagnosed with diabetes, self-management becomes critical. You must test and monitor your blood glucose levels regularly, and adjust your lifestyle habits accordingly. Diabetes treatment requires patient education, special equipment, and diabetes supplies – which can become quite costly for the diabetic. For the typical diabetic, the following supplies are needed: test strips, glucose meters, and insulin.

Many states have recognized the impact of diabetes, and have enacted laws that require health insurance policies to cover diabetes treatment. There are only four states that do not have a mandate or insurance requirement: Alabama, Idaho, North Dakota, and Ohio. However, most states do require private health insurance coverage options for people diagnosed with diabetes. While some states only cover diabetes education or diabetic testing supplies, other states will also cover diabetes equipment.

Some states may turn you down because they consider diabetes a “pre-existing condition.” Although there are not many other options available, you may sill be able to find diabetic health coverage. If you’re having difficulty obtaining an individual health insurance plan because of your diabetes, your best option may be through an employer-sponsored health insurance plan. It is illegal for any employer-based health plan to discriminate based on diabetes, and most plans will cover your diabetes equipment and diabetes testing supplies. If you are self-employed, check into starting your own health plan.

Naturally, the laws in each state differ, and the health insurance options that exist in one state may not exist in another. The American Diabetes Association has gathered information on the various health insurance options available in each state. You can Select Your State to see a listing of the diabetes health insurance options available to you.

We understand how difficult it may be for diabetics to obtain health insurance, and we urge you to e-mail us with any questions or concerns you may have regarding a health insurance policy for diabetics. We hope that one day our health insurance system will provide equal coverage to all people, regardless of their health status. Until then, keep searching around for the best health insurance plan for your needs.

UnitedHealth Group Releases Health Care Savings Suggestions

If you remember, President Obama handed out an assignment to health care industry groups several weeks ago. For the means of health care reform, Obama asked these health care groups to submit plans on how they intend to reduce health care spending growth by $2 trillion over the next decade. It’s quite a big task, but the health care industry groups are taking it seriously.

In fact, United Health Group has just released a report of 15 suggestions that could be taken to save $540 billion in federal health care costs over the next 10 years. UnitedHealth Group’s Center for Health Reform and Modernization has been working diligently to make a contribution to health care reform. “We are issuing (the recommendations) as a constructive contribution to the debate on how national health care reform can proceed . . . What we know is there is a huge variation in cost and quality across the health care system, and (the suggested steps) are some of the practical techniques that help us get a grip on that.” – Simon Stevens, head of United Health Group’s Center for Health Reform and Modernization

We’ve included a brief summary of the suggested health care cost saving options:

  • Provide incentives for patients to use high quality health care providers.
  • Utilize cancer support programs – including guidance on proper cancer treatment, patient options, and adequate case management to prevent hospital readmission between therapy sessions.
  • Provide more guidance for transplant patients. Provide voluntary guidance to patients on selecting the best transplant options and the best transplant centers in the nation, for their unique condition.
  • More Nurse Practitioners at nursing homes and other skilled nursing facilities – to manage patient illnesses and prevent avoidable hospitalizations.
  • Provide better follow-up care to patients leaving the hospital. By checking on the recovery process and ensuring adherence to discharge plans and recommended medical care, hospital readmissions could decline greatly.
  • Better advanced illness programs – provide information and guidance to patients and their families about their condition and further treatment options, including palliative care at the end of life.
  • Disease management programs for patients with Congestive Heart Failure – provide coaching for patients and family members to ensure proper treatment and lifestyle changes.
  • Eliminate gaps in health care treatment, by ensuring that members with chronic illnesses are receiving the care they need to maintain good health.
  • Promote integrated medical management – by combining clinical-based care management with targeted preventative care and patient education, hospital admission rates could reduce drastically.
  • Establish a primary care physician as the central coordinator of patient care. Having one main point of health care contact could reduce inappropriate or duplicate treatments.
  • Reward physicians for providing comprehensive medical care and utilizing health care resources appropriately.
  • Share comparative quality and effectiveness data with physicians.
  • Use clinical evidence to determine when diagnostic radiology studies are clinically appropriate.
  • Analyze appropriateness of situation for radiology therapy – aim to reduce radiology therapy treatments when not necessary.
  • Analyze all claims thoroughly – before they are paid – to prevent duplicate billing and other administrative errors.

via Federal Health Care Cost Containment: How In Practice Can It Be Done?

We think United Health Group has a decent grasp on the changes that need to be made. Granted, health care reform will take quite a bit more than this, but it’s definitely a step in the right direction. We’re interested to hear what you think? Are there any ideas you have, or anything that you’ve heard, that could potentially reduce health care spending? Even if you’re not part of a health care industry group, your opinion is still important, and it should be heard. Because, at the end of the day, you’re the patient, patient care is most important.

Maryland Insurers Promote Use Of Electronic Health Records

The state of Maryland has jumped on the bandwagon for electronic health records – and they are asking their physicians to do the same. In fact, Governor Martin O’Malley just recently signed a bill intended to persuade doctors into using the electronic medical records. How? By requiring private health insurance companies to provide incentives for physicians who adopt the electronic records. According to the bill, insurers will have to provide some sort of financial motivation for adopting electronic health records. Insurers will be able to choose with incentive to provide: higher reimbursements, single-sum payments, or any in-kind service that has a monetary value. And according to the Baltimore Sun, doctors who do not utilize electronic health records by 2015 could even face penalties.

This new bill also requires the state to develop a health information exchange – a computer network that links all of Maryland’s physicians, hospitals, medical laboratories, and pharmacies. This type of health information exchange has been discussed before – both by former President George W. Bush, and current President Barack Obama. Ideally, they would have each state create a health information network, and then all the state networks would be linked together. This national health information exchange could be used to provide more quality health care, in a more patient-based environment.

Maryland’s health information network has actually been in the works since last summer, when the Maryland Health Care Commission asked two different physician groups to develop pilot programs for the network. These two groups encompass a wide variety of health care entities:

The Chesapeake Regional Information System for our Patients (CRISP)

  • John Hopkins Medicine
  • MedStar Health
  • Erickson Retirement Communities
  • And several other large Baltimore medical institutions

The Montgomery Country Health Information Exchange

  • Community Hospitals
  • County Health Department
  • Health clinics that serve the poor and uninsured

One Maryland pilot projects currently link 10 community clinics with the Montgomery Country General Hospital emergency room. When a patient arrives at the ER, the physician can quickly access their medical history, including medications, allergies, lab results, and previous medical visits. The emergency room can then send information to the patient’s clinic, which might not otherwise know about the visit. Although this group doesn’t plan to bid on the statewide information exchange project, they hope that the pilot program will provide vital information for the statewide network.

The ultimate goal of both the Electronic Health Record system and the Health Information Network are quite simple: to bring individual patients’ data together in one place. Many people receive care from a wide variety of medical facilities, and those health records are often not combined. These new technologies would allow for improved access to patient data, improved patient safety, lower health care costs, and an overall enhanced patient experience.

Drug Recycling Programs Provide Medication To Uninsured Patients

Have you heard about these prescription drug donation and recycling programs? 37 different states currently have programs that allow people or medical facilities to donate unused prescription medications. The medicines are then redistributed to patients who have no health insurance and cannot afford their prescribed medications.

Most drug recycling programs have only been in effect for two years or less, so it’s still a bit too early to know the overall impact these programs might have on health care reform. However, the statistics are looking good. For example, Iowa’s drug recycling program collected over 300,000 dosage units between March and December 2007 – that’s an estimated $292,000 worth of prescription medication. Now, this certainly won’t be the magic answer for health care reform – but it may certainly help. The cost of providing health care to the poor and uninsured is steadily increasing every year. And those costs tend to get passed on to the patients with health insurance – which leaves them with drastic medical expenses. But a program like this could really help out the situation, and provide patients with necessary medications, when they can’t afford them on their own. We encourage you to check with your state health department to learn about any drug recycling programs in your area.

Of course, every state has certain restrictions in place to assure that the donated medicines are pure, safe, and fresh. The individual state regulations vary by state, but these general rules apply to all state drug donation programs:

  • All donated medications must not be expired and must have a verified future expiration date
  • Controlled substances, as defined by the Federal Drug Enforcement Administration (DEA) are usually excluded and prohibited from the programs
  • A state-licensed pharmacist or pharmacy must be part of the verification and distribution process
  • Each patient who receives the donated drug must have a valid prescription form in his or her own name

The National Conference of State Legislatures (NCSL) has a detailed listing of all the individual state drug recycling programs available. We have listed them below, along with some regulations for the programs. Please note: some of these programs may not be available yet, while others may have ceased operations. It’s important to contact your state’s department of health for additional information on prescription drug recycling programs that are available.

Arizona

  • What Rx: Only accepts medications in original sealed & tamper-evident unit dose packaging. Rx Board will issue list of un-acceptable products.
  • Who can donate: Person, manufacturer or health care institution.
  • Who accepts: Pharmacy, hospital, nonprofit clinic that volunteers to participate.
  • Donated to: Only state residents who meet eligibility standards set by Board.
  • Restrictions: Expiration must be more than 6 months from donation date.  Recipient must sign waiver form about the source and non-liability.

Arkansas

  • What Rx: Accepts drugs only in their original sealed and tamper-evident packaging.
  • Who can donate: Nursing facility by the clinic pharmacy.
  • Who accepts: Charitable clinic pharmacies.
  • Donated to: Appropriately screened and qualified indigent patients who are not eligible for Medicaid but cannot afford private health insurance.
  • Restrictions: The charitable clinic pharmacy cannot accept controlled substances.  No product of which the integrity cannot be assured is accepted for re-dispensing.

California

  • What Rx: Will only accept drugs in their unopened, tamper-evident packaging.
  • Who can donate: Licensed health facilities, licensed pharmacies, and drug manufacturers that are legally authorized under federal law to manufacture and sell pharmaceutical drugs.
  • Who accepts: Local ordinances established by counties that elect to create such a repository and distribution program.
  • Donated to: Persons in need of financial assistance to ensure access to necessary pharmaceutical therapies.
  • Restrictions: Must be ensured that drugs received have not been in the possession of any individual member of the public.

Colorado

  • What Rx: Only accepts unused cancer drugs or medical devices.
  • Who can donate: Cancer patients or the patients’ family.
  • Who accepts: Health care facilities, medical clinics or pharmacies that elect to participate in the program.
  • Donated to: Eligible health care facilities, medical clinics or pharmacies for use under the program as well as eligible patients.
  • Restrictions: Cancer drugs or medical devices needs to be prescribed by a practitioner, as defined in section 12-22-102 (27), C.R.S., for use by an eligible patient and is dispensed by a pharmacist.

Connecticut

  • What Rx: Accepts all drug products sealed in individually packaged units.
  • Who can donate: Long-term care facilities.
  • Who accepts:  Vendor pharmacy or the Department of Social services for drug repackaging and reimbursement.
  • Donated to: Eligible patients.
  • Restrictions: Prescription drug products that are not controlled substances, sealed in individually packaged units, returned to the vendor pharmacy within the recommended period of shelf life for the purpose of re-dispensing such drug products, determined to be of acceptable integrity by a licensed pharmacist.

Florida

  • What Rx: Willl accept only unused cancer drugs or supplies in its original, unopened, sealed and tamper-evident unit dose packaging.
  • Who can donate: A person, health care facility, hospital, pharmacy, drug manufacturer, medical device manufacturer or supplier, wholesaler of drugs or supplies, or any other entity may donate.
  • Who accepts:  A physician’s office, pharmacy, hospital, hospice, or health care clinic that participates in the program.
  • Donated to: Residents, except those Medicaid-eligible or under any other prescription drug program funded in whole or in part by the state are ineligible to participate.
  • Restrictions: All drugs submitted to the program will be administered by a pharmacist to determine the drugs and supplies are not adulterated or misbranded. Additionally a cancer drug may not be accepted or dispensed under the program if such drug bears an expiration date that is less than six months after the date the drug was donated.

Georgia

  • What Rx: Accepts unused prescription drugs, but not those defined as controlled substances.
  • Who can donate: Any person, including a drug manufacturer or any health care facility, may donate prescription drugs to the drug repository program.
  • Who accepts: Any pharmacy, hospital, or nonprofit clinic that elects to participate in the drug repository program and meets criteria for participation in the program.
  • Donated to: Medically indigent persons who are residents of Georgia.
  • Restrictions: Only drugs in their original sealed and tamper-evident unit dose packaging may be accepted and dispensed. The packaging must be unopened, except that drugs packaged in single unit doses may be accepted and dispensed when the outside packaging is opened if the single unit dose packaging is undisturbed. Drugs donated by individuals must have an expiration date that is more than six months from the date the drug is donated.

Hawaii

  • What Rx: Prescription drugs previously dispensed or distributed by a pharmacy for administration to patients in an institutional facility by personnel of the institutional facility may be returned to the pharmacist.
  • Who can donate: Patients or personnel of an institutional facility with unused drugs.
  • Who accepts: Institutional facilities or repositories of the state of Hawaii.
  • Donated to: Pharmacists.
  • Restrictions: The prescription drugs should be returned only to the original dispensing pharmacy. Also, prescription drugs from individual members of the public are not accepted for reuse.

Indiana

  • What Rx: Unused medications.
  • Who can donate: Health facilities with unused drugs.
  • Who accepts: Pharmacy or pharmacist who initially dispensed the medication.Donated to: Pharmacists, hospitals, health care facilities or practitioners.
  • Restrictions: Requires the office of Medicaid policy and planning (office) to review the process of returning unused medication.

Iowa

  • What Rx: Prescription drugs and supplies.
  • Who can donate: Any person may donate prescription drugs and supplies.
  • Who accepts: Medical facilities or pharmacies that elect to participate in the program and meet the requirements established by the department. Donated to: Drugs may be donated to individuals or may be distributed to another eligible medical facility or pharmacy for use.
  • Restrictions: Must be inspected to assure the prescription drug or supplies have not been adulterated or misbranded. The drug must be in its original sealed and tamper-evident packaging.

Kansas

  • What Rx: Unused medications; excludes controlled substances.
  • Who can donate: Residents of adult care homes and donating entities that volunteer to participate in the program.
  • Who accepts: A qualifying center or clinic in consultation with a pharmacist.
  • Donated to: Medically indigent residents of Kansas.
  • Restrictions: The medications must come from a controlled storage unit of a donating entity and be in its original packaging or tamper-evident packaging. Drugs purchased under Medicaid or SCHIP do not apply.

Kentucky

  • What Rx: Prescription “Legend” drugs or supplies needed to administer such drugs.
  • Who can donate: Health facilities and pharmacies.
  • Who accepts: Donations can be made on the premises of a health facility or pharmacy that elects to participate in the program and meets requirements specified by the cabinet by an administrative regulation promulgated by the cabinet.
  • Donated to: Individuals who meet the eligibility criteria specified by an administrative regulation promulgated by the cabinet or eligible health facility or pharmacy for use under the program.
  • Restrictions: The legend drug cannot be classified as a controlled substance. Upon inspection, the  drug must be in its original, unopened, sealed, and tamper-evident unit dose packaging. In addition, the legend drug or supplies must be prescribed by a physician, advanced registered nurse practitioner, or physician assistant and dispensed by a pharmacist.

Louisiana (2 programs)

  • What Rx: Prescription drugs.
  • Who can donate: Any person, including a drug manufacturer, hospital, health care facility, or governmental entity.
  • Who accepts: Charitable pharmacies.
  • Donated to: Appropriately screened and qualified patients.
  • Restrictions: Drugs must be in their original sealed and tamper-evident packaging. In addition, donor shall execute a form stating the donation of the drugs. The pharmacy should retain that form along with other acquisition records.
  • What Rx: Unused portions of or surplus prescription drugs that are within the expiration date.
  • Who can donate: A hospital, health care facility, or governmental entity enrolled in the Medicaid program.
  • Who accepts: Charitable pharmacies.
  • Donated to: Medically indigent residents of Louisiana.
  • Restrictions: Drugs must be in their original sealed and tamper-evident packaging. Pharmacists of the charitable pharmacies should determine if the drug is not adulterated or misbranded and is safe to dispense.

Maine

  • What Rx: Unused prescription drugs.
  • Who can donate: Drug manufacturers, drug wholesale or terminal distributors, hospitals, health clinics, federally qualified health centers, Indian health centers and rural health centers and assisted living facilities licensed by the department.
  • Who accepts: Pharmacies, hospitals, health clinics and federally qualified health centers, Indian health centers and rural health centers. Donated to: Qualified residents of Maine, which include family income below 350% of the federal non-farm income official poverty level and not receiving benefits from Mainecare.
  • Restrictions: The program will only accept prescription drugs that are unopened and packaged in tamper-evident unit dose packages or that are unopened injectable, aerosol or topical medications.

Maryland

  • What Rx: Prescription drugs or medical supplies.
  • Who can donate: Any person.
  • Who accepts: Certain drop-off sites which meets specified criteria, a repository, the board and pharmacists.
  • Donated to: A needy patient who is a resident of Maryland.
  • Restrictions: The drugs must be packaged in tamper-evident unit dose packaging and unadulterated. The donor must sign a statement that indicates the donor is the owner of the drugs and are voluntarily offering them to the program.

Massachusetts

  • What Rx: Unused medications.
  • Who can donate: Residents or consultant pharmacist in a health care facility.
  • Who accepts: Health care facilities.
  • Donated to: Eligible residents of Massachusetts.
  • Restrictions: The donated medication should be sealed in unopened, individually packaged units and within the recommended period of shelf life. Excluded are schedule I or II controlled substances as defined in MA chapter ninety-four C.

Minnesota

  • What Rx: Cancer drugs or supplies.
  • Who can donate: A pharmacy, medical facility, drug manufacturer, or wholesale drug distributor, can donate if the donated drugs have not been previously dispensed. In addition, any individual over the age of 18 may donate.
  • Who accepts: Pharmacies or medical facilities on the premises that volunteer to participate in the program. The medical facilities or pharmacies need to be licensed and in compliance with all applicable federal and state laws and administrative rules.
  • Donated to: Any Minnesota resident who is diagnosed with cancer is eligible to receive drugs or supplies. The drugs will be distributed upon a priority base.
  • Restrictions: Drugs must be in its original, unopened, tamper-evident unit dose packaging and not adulterated or misbranded. The donation must also be accompanied by a cancer drug repository donor form that is signed by the person making the donation or that person’s authorized representative.

Mississippi

  • What Rx: Prescription drugs.
  • Who can donate: The State Board of Pharmacy; the State Department of Health; the Division of Medicaid; any person, including a drug manufacturer, or health care facility or government entity.
  • Who accepts: Any pharmacy, hospital, nonprofit clinic or health care professional.
  • Donated to: Individuals who meet the eligibility standards or to other government entities and nonprofit private entities to be dispensed to individuals who meet the eligibility standards.
  • Restrictions: Only drugs in their original sealed and tamper-evident packaging may be accepted and dispensed.

Missouri (2 programs)

  • What Rx: Sealed and unopened prescription drugs.
  • Who can donate: Any person or entity may donate prescription drugs.
  • Who accepts: Any pharmacy, hospital, or non-profit clinic that elects to participate in the program.
  • Donated to: Eligible Missouri residents.
  • Restrictions: Prescription drugs must be in their original sealed and tamper-evident unit dose packaging. Prescription drugs donated by individuals should bear the manufacturer’s lot number and an expiration date that is more than six months from the date the prescription drug is donated.
  • What Rx: Prescription drugs.
  • Who can donate: Any person, including but not limited to a prescription drug manufacturer or health care facility, may donate prescription drugs to the prescription drug repository program.
  • Who accepts: Any pharmacy, hospital, or nonprofit clinic that elects to participate in the prescription drug repository program and meets the criteria for participation established by rule of the department pursuant to section 196.984.
  • Donated to: People who are residents of Missouri and who meet the eligibility requirements of the program, or to other governmental entities and nonprofit private entities to be dispensed to persons who meet the eligibility requirements of the program.

Montana

  • What Rx: Unused prescription drugs.
  • Who can donate: Long-term care facilities.
  • Who accepts: Provisional community pharmacies.
  • Donated to: Qualified patients for transfer free of charge or at a reduced charge to those individuals.
  • Restrictions: Drugs defined as a dangerous drug or a drug designated as a precursor to a controlled substance cannot be accepted.

Nebraska

  • What Rx: Cancer drugs.
  • Who can donate: Any person or entity, including, but not limited to, a cancer drug manufacturer or health care facility.
  • Who accepts: Any physician’s office, pharmacy, hospital, or health clinic that elects to participate in the program and meets criteria established by the department for such participation.
  • Donated to: Eligible Nebraska residents.
  • Restrictions: The drug needs to be in its original, unopened, sealed, and tamper-evident unit dose packaging, except that a cancer drug packaged in single unit doses may be accepted and dispensed if the outside packaging is opened but the single-unit-dose packaging is unopened.

Nevada

  • What Rx: Prescription drugs.
  • Who can donate: A public or private mental health facility may return a prescription drug that is dispensed to a patient of the facility, but will not be used by that patient.
  • Who accepts: A dispensing pharmacy.
  • Donated to: The drug will be used to fill other prescriptions for patients in the pharmacy facility.
  • Restrictions: The drug cannot be a schedule II drug specified in or pursuant to chapter 453 of NRS. The drug must be dispensed in a unit dose, in individually sealed doses or in a bottle that is sealed by the manufacturer of the drug.

New Jersey

  • What Rx: Prescription drugs.
  • Who can donate: Unopened, unexpired prescription drugs dispensed to, but not used by, a patient within a licensed health care facility, may be reused at the facility in accordance with regulations issued by the State Board of Pharmacy.
  • Restrictions: Must be unopened and unexpired.

New Mexico

  • What Rx: Unused medication
  • Who can donate: a corrections facility that has a registered or licensed nurse.
  • Who accepts: a pharmacy operated by, or under contract with, the Corrections Department .
  • Restrictions:  product has not been altered, defaced or tampered with and include the identity, strength, expiration date and lot number of the prescription drug; and the prescription drug was dispensed in a unit-dose package or unit-of-issue package.

New York

  • What Rx: Unused medication.
  • Who can donate: A resident or consultant pharmacist or his designee in a residential health care facility.
  • Who accepts: The pharmacy  from which the medication was purchased.
  • Donated to: Eligible New York residents.
  • Restrictions: The medication must be unopened in the original manufacturer’s packaging and must be in tamper evident packaging.

North Dakota

  • What Rx: Legend drugs, devices, or supplies.
  • Who can donate: Any person or entity.
  • Who accepts: Practitioners or pharmacies that meets the criteria established for participation in the program.
  • Donated to: Eligible patients.
  • Restrictions: A drug donated, prescribed, or dispensed under the program must be in the original, unopened, sealed, and tamper-evident unit dose packaging, except a drug packaged in single-unit doses may be accepted and dispensed if the outside packaging has been opened and the single-unit-dose package is unopened.

Ohio

  • What Rx: Prescription drugs.
  • Who can donate: Any person, including a drug manufacturer or health care facility.
  • Who accepts: Any pharmacy, hospital, or nonprofit clinic that has elected to participate in the program and meets certain eligibility requirements established in rules adopted by the Board.
  • Donated to: Individuals with a prescription issued by a health care professional authorized to prescribe drugs.
  • Restrictions: Drugs must be in their original sealed and tamper-evident unit dose packaging.

Oklahoma

  • What Rx: Unused prescription drugs.
  • Who can donate: Drugs may be transferred from residential care homes, nursing facilities, assisted living centers, public intermediate care facilities for people with mental retardation (ICF/MR) or pharmaceutical manufacturers.
  • Who accepts: Any pharmacies operated by a county, pharmacy operated by a city-county health department or a pharmacy under contract with a city-county health department, a pharmacy operated by the Department of Mental Health and Substance Abuse Services or a charitable clinic for the purpose of distributing the unused prescription medications.
  • Donated to: Oklahoma residents who are medically indigent.
  • Restrictions: Prescription drugs defined as controlled substances will not be accepted.

Pennsylvania

  • What Rx: Unused cancer drugs
  • Who can donate: health care facility, health clinic, hospital, pharmacy or physician’s office.
  • Who accepts: Authorized participating pharmacies, designated by the Cancer Drug Repository Program of the State Board of Pharmacy.
  • Donated to: Needy residents, as dedfined in “Income eligibility criteria and other standards and procedures for individuals participating in the program, determined by the Department of Public Welfare and the Pharmacy Board.
  • Restrictions:  Unit dose medication must be maintained by a health care facility, health clinic, hospital, pharmacy or physician’s office rather than an individual patient, as “part of a closed drug delivery system.” Expiration date must be at least six months in the future. A pharmacy ”may charge a handling fee”, to be determined by the Board of Pharmacy. Regulations to be drafted within 90days of effective date.

Rhode Island

  • What Rx: Unused prescription medication.
  • Who can donate: Nursing homes, assisted living centers and prescription drug manufacturers.
  • Who accepts: Authorized participating pharmacies.
  • Donated to: Medically indigent Rhode Island residents.
  • Restrictions: The packaging of the medication should not be opened, except cancer drugs packaged in single-unit doses.

South Dakota

  • What Rx: Unused unit dose drugs.
  • Who can donate: Patients in hospice programs, nursing facilities, or assisted living facilities.
  • Who accepts: Hospice programs, nursing facilities, or assisted living facilities.
  • Donated to: Eligible patients.
  • Restrictions: The drugs are provided in the manufacturer’s unit dose packaging or are repackaged by the pharmacy in a hermetically sealed single unit dose container.

Tennessee

  • What Rx: Unused prescription medications; controlled substances are excluded.
  • Who can donate: Nursing homes or hospice services programs.
  • Who accepts: Charitable clinic pharmacies.
  • Donated to: Tennessee residents who are indigent.
  • Restrictions: Drugs only in their original sealed and tamper-evident packaging should be accepted.

Texas

  • What Rx: Unused drugs; controlled substances are excluded.
  • Who can donate: A pharmacist who practices in or serves as a consultant for a health care facility or a licensed health care professional responsible for administration of drugs in a penal institution.
  • Who accepts: Pharmacies.
  • Donated to: Eligible patients.
  • Restrictions: Drugs must be sealed in unopened tamper-evident packaging and either individually packaged or packaged in unit-dose packaging.

Utah

  • What Rx: Unused drugs.
  • Who can donate: A pharmacist may accept back and redistribute any unused drug, or a part of it, after it has left the premises of the pharmacy.
  • Restrictions: The drug must have been prescribed to a patient in a nursing care facility, an ICFMR, or state prison facility, county jail, or state hospital; the drug must have been stored under the supervision of a licensed health care provider according to manufacturer recommendations; the drug should be in a unit pack or in the manufacturer’s sealed container; the drug should have been returned to the original dispensing pharmacy; the drug should have initially dispensed by a licensed pharmacist or licensed pharmacy intern; and back and redistribution of the drug complies with Federal Food and Drug Administration and Drug Enforcement Administration regulations.

Vermont

  • What Rx: Any unsold or unused prescription drugs and medical supplies that the facility or distributor cannot sell or otherwise use.
  • Who can donate: Any health care facility and wholesale drug distributor.
  • Who accepts: Any participating pharmacy, hospital, or nonprofit clinic.
  • Donated to: Vermont residents who meet the eligibility standards.
  • Restrictions: Drugs or medical supplies must be in their original sealed and tamper-evident unit dose packaging to be accepted and dispensed, except for drugs packaged in single unit doses when the outside packaging is opened if the single unit dose packaging is undisturbed.  The board of pharmacy shall allow donation of only those drugs bearing an expiration date that is less than six months beyond the date the drug is donated and shall allow drugs to be dispensed only when the expiration date is more than one month from the date of dispensing.

Virginia

  • What Rx: Prescription drugs.
  • Who can donate: Hospitals are authorized to donate drugs that were originally dispensed to hospital patients, but have been returned.
  • Who accepts: Pharmacies.  May be redispensed by clinics (2005) and hositals (as of 2009 law)
  • Donated to: Indigent patients, without charge.
  • Restrictions: The pharmacist-in-charge at the pharmacy shall be responsible for determining the suitability of the product for re-dispensing. A re-dispensed prescription shall not be assigned an expiration date beyond the expiration date or beyond-use date on the label from the first dispensing and no product shall be re-dispensed more than one time. No product shall be accepted for re-dispensing by the pharmacist where integrity cannot be assured.

Wisconsin (2 programs)

  • What Rx: Prescription drugs.
  • Who can donate: State prison pharmacies.
  • Who accepts: State prison pharmacies.
  • Donated to: Any patients in any state prison.
  • Restrictions: The prescription drug should never have been  in the possession of the patient to whom it was originally prescribed. The prescription drug is returned in its original container. A pharmacist determines that the prescription drug has not been adulterated or misbranded.
  • What Rx: Cancer drugs or supplies.
  • Who can donate: Any person or entity.
  • Who accepts: Medical facilities or pharmacies that elects to participate in the program and meets requirements specified by rule by the department.
  • Donated to: Individuals who meets eligibility criteria or to another eligible medical facility or pharmacy for use under the program.
  • Restrictions: The cancer drug or supplies needed to administer a cancer drug must be in its original, unopened, sealed, and tamper-evident unit dose packaging or, if packaged in single-unit doses, the single-unit-dose packaging must be unopened.

Wyoming

  • What Rx: Prescription drugs.
  • Who can donate: Any person or entity, including but not limited to a drug manufacturer, physician or health care facility.
  • Who accepts: Any physician’s office, a pharmacy or health care facility that elects to participate in the program and meets criteria established by the department.
  • Donated to: Wyoming residents.
  • Restrictions: Drugs shall be accepted or dispensed under the drug donation program only if they are in their original, unopened, sealed packaging or, if the outside packaging is opened, the contents are single unit doses that are individually contained in unopened, tamper evident packaging.

via National Conference of State Legislatures: State Prescription Drug Return, Reuse and Reclycling Laws

Health Savings Acount Enrollment Reaches Eight Million Americans

According to a new census by America’s Health Insurance Plans (AHIP), the number of Americans covered by a Health Savings Account (HAS) has increased by more than 31 percent since last year. Ever since the concept of Health Savings Accounts was authorized in 2004, AHIP has conducted a periodic census of its members participating in the HSA/high deductible health plan market. Their most recent census has returned with many interesting findings:

  • There are currently 8 million Americans enrolled in a Health Savings Account. This number has increased steadily since the inception of the HSA plans in 2004. There were 1 million people enrolled in 2005, 3.2 million in 2006, 4.5 million in 2007, and 6.1 million in 2008.
  • 47 percent of individuals covered by a Health Savings Account are in the large group market, while only 30 percent are in the small group market. The remaining 23 percent of members are in the individual market.
  • Most HSA members are covered by a Preferred Provider Organization (PPO), while a small number of members are covered by a Health Maintenance Organization (HMO).
  • Almost half of all Health Savings Account members live in neighborhoods with median incomes under $50,000
  • The average total deposits (including personal deposits, employer contributions, and interest) were $1,634.
  • The average total withdrawals (including associated fees) were $1,063.
  • The states with the highest levels of HSA/HDHP enrollment are California, Florida, Illinois, Texas, Ohio, and Minnesota

via America’s Health Insurance Plans

A Health Savings Account is essentially a tax-favored insurance savings account, combined with a high deductible health insurance plan. An HSA allows you to set aside money in a tax-free, interest-earning account. These funds can then be used to pay medical expenses and health care costs. Typically, a Health Savings Account is used in conjunction with a qualifying high deductible health plan.

Although a Health Savings Account may not be right for everyone, it could be a great way to save money for some people. High deductible health plans tend to have lower health insurance premiums, yet they still provide a decent amount of  health insurance coverage. If you’re considering a Health Savings Account, feel free to research the plans and get a free HSA health quote here at RxHealthQuotes.com!

FDA vs. General Mills : Is Cheerios Really A Drug?

There’s no better way to start out your day than by having a delicious breakfast – and it’s even better when that breakfast happens to be healthy. For millions of people across the United States, Cheerios has become the most favored breakfast – the cereal is both delicious and healthy. What health benefits does it provide? The Cheerios label claims that in just six weeks, eating the cereal can help lower bad cholesterol, a risk factor associated with coronary heart disease, by four percent. The label then goes on to cite a clinical study that proved that eating two servings of Cheerios a day could help to reduce your bad cholesterol levels.

And ever since General Mills made these statistics available, the popularity of the cereal has skyrocketed. Nobody has been able to find any fault with the cereal…until now.

By now, you’ve probably heard of this bizarre controversy between the Food and Drug Administration (FDA) and General Mills. Apparently, the FDA has contacted General Mills, claiming that they are “in serious violation” of federal rules. The letter goes on to read:

Based on claims made on your product’s label, we have determined that your Cheerios® Toasted Whole Grain Oat Cereal is promoted for conditions that cause it to be a drug because the product is intended for use in the prevention, mitigation, and treatment of disease.

via the Food and Drug Administration – View a full copy of the Warning letter sent to General Mills

The FDA also claims that Cheerios is a new drug, because it has not yet been “recognized as safe and effective for use in preventing or treating hypercholesterolemia or coronary heart disease.” Which means that General Mills may not legally market Cheerios unless General Mills either applies for approval as a new drug, or changes the way it labels the cereal.

General Mills doesn’t seem to be too concerned about the situation. In fact, they’re defending the claim quite calmly, explaining that Cheerios’ soluble fiber heart healthy claim has been FDA-approved for 12 years, and that its claim to “lower your cholesterol four percent in six weeks” has been featured on the box for more than two years, without any problems. General Mills has yet to make any changes to their packaging, and they seemed quite unconcerned in the letter they sent to Dow Jones Newswires:

The science is not in question … the clinical study supporting Cheerios’ cholesterol-lowering benefit is very strong. The FDA is interested in how the Cheerios cholesterol-lowering information is presented on the Cheerios package and website. We look forward to discussing this with FDA and to reaching a resolution.”

via the Wall Street Journal Health Blog

We’re really interested to see how this debate plays out. The FDA has threatened to remove the cereal from supermarket and wholesaler shelves if General Mills fails to correct its supposed violations. What do you think? Should Cheerios be considered a drug, just because it makes certain health claims?

If so, should all healthy foods be considered drugs – like carrots, milk, and whole grains?