Health Reform Implementation Timeline
Implementation update: On July 19, 2010, the Office of Consumer Information and Insurance Oversight (OCIIO) issued regulations on the new preventive benefits coverage requirements. These rules apply to new plans established on or after September 23, 2010. On August 1, 2010, the U.S. Preventative Services Task Force released its recommendations. On July 19, 2011, the Institute of Medicine released a report that recommended several women’s preventive services that should be included in health plans with no cost-sharing. On August 1, 2011, HHS issued interim final regulations on preventive services, including requirements that insurers cover birth control with no cost-sharing. On August 3, 2011, HHS issued an amendment to the final regulations. On February 15, 2012, HHS issued final rules “authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services.” Also on February 15, 2012, HHS issued an issue brief estimating that 54 million Americans had received preventive benefits without cost-sharing. On August 1, 2012, HHS began requiring most new and renewing health plans to provide women’s preventive health services, including contraception, with no cost-sharing. HHS issued a brief estimating that 47 million women will receive coverage for these services without cost sharing.”
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The GAO has released what’s being called a “scathing” report on cybersecurity readiness and threats in health IT. The agency says HHS’ investigations often result in technical advice that is not pertinent and that the agency doesn’t always follow up to ensure corrective actions have been taken.
Vital Signs: Central Line
Because efforts to improve central line insertion might have limited impact in non-ICU settings, in which central lines are less frequently inserted, additional prevention strategies must be developed. For example, S. aureus more commonly inhabits the skin and thus might be a more common cause of insertion-related infections; therefore, the smaller reduction among other pathogens suggests a need for improved implementation of post-insertion line-maintenance practices and strategies to ensure prompt removal of unneeded central lines. In addition, reductions in S. aureus CLABSIs likely were enhanced by widespread efforts to interrupt transmission of methicillin-resistant S. aureus. Implementation of CDC-recommendations to maintain central lines, remove them promptly when they are no longer needed, and interrupt transmission of resistant bacteria (16,17) will reduce CLABSIs further. Focusing on antibiotic-resistant pathogens can be especially important given the increased risk for mortality associated with these pathogens (18). Slower declines in non–S. aureus CLABSIs also suggest the need to research methods for preventing infections that meet the surveillance definition for a CLABSI but clinically might be related to another cause (e.g., infections caused by translocation of bacteria from the intestine). The variation in reductions among different organisms underscores the importance of collecting pathogen and susceptibility information as part of CLABSI surveillance. Microbiologic information will be critical in helping direct future CLABSI prevention efforts at pathogens that have been reduced less markedly.
Consumer Information and Insurance Oversight