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In This Issue January 16, 2014

Vitamin E Slows Alzheimer's in VA Trial

CMS Proposes to Strip Mental Health Drugs of Protected Status

Is the Pentagon Getting Soft?

Big Year for VA Loans

January is Cervical Cancer Screening Month

Caregiver Action Network Seeking Your Stories

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Vitamin E Slows Alzheimer's in VA Trial

Holiday Stress

From the Veterans Health Administration Update on January 6:  Vitamin E, known for its antioxidant power, helped slow the progression of Alzheimer’s disease in veterans with mild to moderate symptoms in a Veterans Administration trial. 

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From the National Council on Behavioral Health

CMS Proposes to Strip Mental Health Drugs of Protected Status in Part D

On January 6, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would eliminate protected status for antidepressants and antipsychotics in Medicare Part D prescription drug plans. The proposed rule revises prior agency policy that required Part D plans to include on their formularies “all or substantially all” drugs within six classes: antidepressants, antipsychotics, anticonvulsants, anti-neoplastics, and immune-suppressants. This policy, known as the “six protected classes” policy, has been in effect since the inception of Part D and has enjoyed strong bipartisan support in Congress. The Affordable Care Act strengthened this policy by codifying it in federal statute, while granting CMS the authority to specify what criteria it would use to identify protected classes.

In this proposed rule, CMS laid out its new criteria for deciding whether a class of drugs should have protected status: 1) failure to receive the drug would result in the patient’s hospitalization within 7 days (the timeframe for the appeals process); and 2) drugs in that class are not interchangeable. The new criteria exclude antidepressants and immune-suppressants from protected status beginning in 2015. CMS argued that many of the drugs within these classes are interchangeable and will not cause hospitalization if patients do not immediately take them upon receiving a prescription. CMS determined that antipsychotics also fail to meet the new criteria; however, they will not immediately be excluded from protected status. CMS is soliciting comments on whether a transitional policy for antipsychotics is needed and will preserve their protected. The public comment period is open through March 7.

Although drug costs are not part of the formal criteria, CMS openly and extensively discussed its concerns about pricing in the proposed rule, noting that the “six protected classes” policy “substantially limits Part D sponsors’ ability to negotiate price concessions in exchange for formulary placement of drugs in these categories or classes.” Mental-health providers and advocates expressed concern that drug prices were the primary driver of the new rule, with the two criteria developed only so as to be able to selectively exclude several costly drug classes from protected status.  

As Reported in The Fiscal Times 

Is the Pentagon Getting Soft?

Holiday Stress

In a January 8 article in The Fiscal Times, David Francis reports on  U.S. Army Chief Ray Odierno’s presentation at the National Press Club on January 7, where the general talked about his opposition to sending troops to Iraq to how the Army would execute the planned withdrawal from Afghanistan. But during the hour-long discussion, Odierno spent more time addressing issues that have nothing to do with combat.  

Read the complete article >>

As Reported in The New York Times

Big Year for VA Loans

In a NewYork Times article on Jan 12 by Lisa Prevost, the number of loans guaranteed by the VA reached a record high in 2013, perhaps marking the peak of an upward trajectory that began after the housing market collapse. The department guaranteed nearly 630,000 mortgage loans in fiscal year 2013, setting a new high just as the program enters its 70th year, said Mike Frueh, the director of the VA’s Loan Guaranty Program. The average loan was about $225,000, an amount that reflects the program’s value to “working-class America,” he said. Calling the program’s growth “pretty incredible,” Chris Birk, the executive editor at Veterans United Home Loans, an online broker of VA loans, estimated that total loan volume has risen 372 percent since fiscal 2007. 

Read the complete article >>

From the Maryland VA Health Care System

January is Cervical Cancer Screening Month

Attention all women! You may want to consider scheduling a pap smear as part of your New Year’s resolutions. A pap smear can find abnormal cells that may indicate cervical cancer. Screening for cervical cancer using the pap test has decreased the number of new cases of cervical cancer and the number of deaths due to cervical cancer since 1950. All women veterans enrolled in VA health care are urged to get tested for cervical cancer. Women aged 21 to 65, as well as those at high risk, are candidates for a cervical pap smear screening every one to three years. Detecting cervical cancer in its earliest stages greatly improves survival rates. More than 90 percent of women can survive cervical cancer when it is localized and caught early.

From the Veterans Health Council

Caregiver Action Network Seeking Your Stories

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The Caregiver Action Network is exploring the full spectrum of family caregiving and wants to hear from you. From bathing and hygiene, toileting and incontinence, home healthcare and cleanup, to staying organized and getting the support you need, you've done it all.

Share the wisdom and insight you've gathered along your caregiving journey:

  1. Do you remember the moment you realized you became a family caregiver?
  2. What do you know now that you wish you knew then?
  3. What advice would you give to others on balancing your personal and professional life with caregiving responsibilities?
  4. What helped you the most in dealing with an emergency situation?
  5. If you're living with your parent(s) again, how does this affect your relationships with other family members, romantic partners, and employers?
  6. What are the pros and cons of a multi-generational household?
  7. Can you recount a memorable moment when your loved one made you smile?
  8. What is special about the history of you and your loved one that makes you want to be there for them?
This is your chance to tell your story of what's worked for you and what keeps you going as a family caregiver. Email your responses to info@caregiveraction.org
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