LeadingAgeLINK - Vol. 19 Issue 11
Budget Update, Feb. 15 – Wednesday, the Senate Appropriations Committee took up all 25 of the budget bills. After a nearly two-hour debate over a minor education budget issue, the committee got down to business and passed all bills of concern to LeadingAge Florida.
The overall Senate budget is $70.8 billion, whereas the House is more than one billion lower. Some of the differences are due to some technical issues, but still significant differences on substantive issues remain that will have to be resolved by the various conference committees after the Senate passes the bills next week.
The following brief summary highlights the differences between House and Senate versions of the budget. For more details, please look for our communications on the budget during the last two weeks of session. These are located on the legislative updates section of the LeadingAge Florida website.
Home and Community-Based Services
- 2,415 additional Long-Term Care Diversion Waiver slots
- 150 new PACE slots in DeSoto, Manatee, and Sarasota counties
- 150 new PACE slots in Alachua, Clay, and Duval counties
- 207 additional Assistant Living for the Elderly Waiver slots
- 187 additional Community Care for the Elderly slots
- Expands the ALE waiver to 19-59 year olds
- 1,762 additional Long-Term Care Diversion Waiver slots
- 100 additional PACE slots in Broward County
Nursing Homes and Hospice
- Price level increase for institutional providers, including nursing homes is authorized
- Reduces nursing home budget by 2.5%
- Price level increase for institutional providers, including nursing homes is authorized
Services to Individuals
- Emergency room visits for non-pregnant adults is limited to 12 visits per year
- Adult Podiatric and Chiropractic care eliminated
- Emergency room visits for non-pregnant adults is limited to 6 visits per year
If we assume that during conference committee meetings no new nursing home budget cuts appear, then the worst-case scenario for nursing home members is a 2.5% budget cut. This cut, however, would be offset by the price level increase, that is likely to represent more than a 2.5% increase. The net affect of these two factors is virtually no change to nursing home per diems.
The picture is actually a little better. Because the federal matching percentage (FMAP) has increased for FY 2012-13, the dollars generated through the Nursing Facility Quality Assessment will bring in more matching funds and will reduce the impact of previous years’ budget cuts. All in all, we conservatively estimate that the average nursing home rate will increase about $5 on July 1, 2012.
We will not know until late June the exact per day amount of the Quality Assessment for July 1, 2012. We do not expect any significant changes. Florida is already collecting the maximum allowable by federal law (6% of revenues). Any increase in the daily rate will depend entirely on how much nursing home revenues in the aggregate increased during the last year. Please note, President Obama’s recommended budget proposes to reduce the allowable level of provider taxes (which is what the Quality Assessment is) to 4.5% in 2015, 4% in 2016, and 3.5% in 2017 and beyond. If the President’s proposal is adopted by Congress, the nursing home budget will lose approximately $375 million by 2017. These funds will have to be replaced in part by Florida general revenue dollars or the nursing home budget will have to incur unacceptable reductions.
Weekly Legislative Advocacy Briefings – Get involved every Friday, at 10:00 a.m. EST, with LeadingAge Florida’s weekly Legislative Advocacy Briefing Conference Calls during the 2012 Legislative Session. You will hear from Larry Overton, Larry Overton and Associates, Erwin Bodo, LeadingAge Florida’s Legislative Consultant, Mary Ellen Early, Public Policy Liaison, along with the LeadingAge Florida public policy staff. Remaining schedule of calls: Feb. 24 and March 2. On March 12 at 2:00 p.m. we will hold our Post Session Call. Click here to register for the conference calls.
The 2012 Weekly Legislative Update publication is also available online. The publication, which is published weekly, provides an overview of what happened during that week of the Florida Legislature Session. Please feel free to share the document with your staff, board members and friends.
Assisted Living News
Florida Supreme Court Requested to Hear ALF Case – This week the Agency for Health Care Administration (AHCA) petitioned the Florida Supreme Court to hear a case on whether two Orlando assisted-living facilities should lose their licenses. In late November 2011, a ruling by the 1st District Court of Appeal sided with ALF firms Avalon's Assisted Living, LLC, and Avalon's Assisted Living II, LLC. When AHCA sought to revoke the ALF licenses, at least in part because of allegations that they had operated another unlicensed ALF, the 1st District Court of Appeal ruled that AHCA based its decision on "uncorroborated hearsay."
However, in a document submitted this week asking Florida's highest court to hear the case, AHCA said it provided sufficient evidence to justify taking action against the firms. "Because the owners/administrators invoked their Fifth Amendment right against self-incrimination, all other staff for the unlicensed facility had disbanded and because the facility's alleged residents were of fragile physical and mental status, AHCA's ability to produce direct evidence of the unlicensed activity at the hearing was limited,' the document said. "This is a problem AHCA commonly faces in unlicensed activity cases."
MOR Training Available – Join us for this unique educational opportunity. Learn how to prepare and receive superior scores on your next Management and Occupancy Review (MOR) by attending this ‘Hands-On’ MOR Training conducted by representatives from the North Tampa Housing Development Corporation.
This workshop will be highly interactive and “hands-on” and is a cost-effective way for you and your staff to receive the most up-to-date important training available.
8:45 a.m. Registration
9:00 a.m. Welcome & Introductions
9:05 a.m. Presentation
11:00 a.m. Roundtable and Wrap Up
12:00 p.m. Adjourn
At the end of this meeting, you will be able to:
- To understand Housing Programs as described in the US Housing Act of 1937 and the Multifamily Assisted Housing Reform and Affordability Act of 1997.
- To understand the capabilities of all HUD secure systems.
- To apply the principles of HUD Handbooks 4350.1, 4350.3 and the Section 8 Renewal Policy Guidebook.
- To understand all HUD multifamily housing notices and regulations pertaining to the Multifamily Section 8 Program.
- To understand policies and procedures as dictated by the Annual Contributions Contract.
Offered in three locations near you:
Tuesday, March 13
Stanley Axlrod UTD Towers • 1809 Brickell Avenue • Miami 33129
Wednesday, March 14
Acorn Trace • 11115 N Nebraska Ave • Tampa 33612
Thursday, March 15
Hurley Manor • 3335 University Drive • Jacksonville 32810
To register please click onto the date you desire above.
Agency for Health Care Administration Offers Joint Training for Assisted Living Facilities – Florida Health Care Association, Florida Assisted Living Association, and LeadingAge Florida (formerly FAHSA) bring you this first-ever one-day joint training designed especially for ALFs – and in numerous cities to make the training convenient and accessible. This training will equip ALF providers with the latest, most authoritative information for maintaining successful operations, strong resident services, and safety in a changing environment. Training dates and locations are:
- Wednesday, March 28 – Tampa
- Friday, March 30 – Orlando
- Wednesday, April 4 – Weston
- Wednesday, April 11 – Tallahassee
Agency for Health Care Administration experts Polly Weaver, Kim Smoak, and Catherine Anne Cone will provide insights on the following critical areas:
- 2012 legislative focuses including new legislation proposals, broader implementation of a new survey process, and an updated and streamlined regulation set
- Regulatory expectations across a broad spectrum of areas including managing adverse behaviors, crisis intervention, appropriate placement, training requirements, and state training responsibilities
- Review of the Agency’s background screening results database and the Agency’s efforts with other groups to improve resident outcomes for the assisted living community
- Industry trends including the new resident-focused survey process, abbreviated survey thresholds and tasks, modified regulation set categorization, and the Z-tags
- Criminal history screening developments and resources
- Florida’s ALF Medicaid Waiver Program status update
This program is targeted to assisted living facility executive directors, administrators, nurse leaders, charge nurses, social workers, therapists, activity directors, consultants, ARNPs, Physician Assistants, Medical Directors, dietary staff, and representatives of long-term care ombudsmen and state surveyors. Register today to attend this informative training and earn 6 hours of continuing education. Visit the Events Calendar at Florida Health Care Association for online registration and the full training brochure.
Agency for Health Care Administration Joint Training for Nursing Homes – Florida Health Care Association and LeadingAge Florida (formerly FAHSA) bring you this one-day joint training to highlight major areas of change and provide supportive information to take back to your facility for training and education. Training, in various locations throughout Florida, will take place on the following dates:
- Tuesday, March 27 – Tampa
- Thursday, March 29 – Orlando
- Tuesday, April 3 – Weston
- Tuesday, April 10 – Tallahassee
Agency for Health Care Administration experts Polly Weaver, Kim Smoak, and Patricia McIntire will present hot topics in long term care including:
- Florida’s top 10 deficiencies with best practice information to assist in compliance and improved culture change/quality outcomes
- Recent CMS regulatory guidance changes to the State Operations Manual and major goals for 2012
- Best practices guidelines on the prevention of abuse/neglect/adverse incidents and crimes against residents, as well as immediate jeopardy situations
- Updates on discharge and appeals, background screening, the Independent Informal Dispute Resolution process, and the Elder Justice Act
Dr. Chuck Gokoo with American Medical Technologies will also share his expertise on:
- Infection control, pressure ulcer reduction, and readmissions to hospitals from skilled nursing facilities
This program is appropriate for nursing home administrators, nurse leaders, charge nurses, social workers, therapists, activity directors, consultants, ARNPs, Physician Assistants, Medical Directors, dietary staff, and representatives of long-term care ombudsmen and state surveyors. Register today to attend this informative training and earn 6 hours of continuing education. Visit the Events Calendar at Florida Health Care Association for online registration and the full brochure.
Upstairs Solutions Offers Free Quality Assurance Training to LeadingAge Members – Upstairs Solutions, a provider of online training for senior care, is offering its Quality Assessment and Assurance e-learning training module at no charge for LeadingAge members through Feb. 29, 2012. Go to module (login to My.LeadingAge). The course, approved for administrator and nursing CEUs, offers guidance on preventing falls, identifying trends in weight loss, and establishing a quality assessment program in your organization.
If you are not a member of LeadingAge and want to take advantage of this free CEU module, register here.
- March 13, 14, 15 – HUD/MOR Training (Miami, Tampa, Jacksonville)
- March 27, 29; April 3, 10 – Joint Training for Nursing Homes (various locations)
- March 28, 30; April 4, 11 – Joint Training for Assisted Living Facilities (various locations)
- May 23 – CFO Conference (tbd)
- July 22 – Preceptor Refresher Course (JW Marriott Grande Lakes)
- July 22 – Preceptor Training Workshop (JW Marriott Grande Lakes)
- July 22-25 – 49th Annual Convention and Exposition (JW Marriott Grande Lakes)
- Sept. 12-14 – LeadingAge Florida’s Affordable Housing Conference (Jacksonville)
AHCA: Background Screening System Upgrade – The Agency for Health Care Administration’s (AHCA’s) Background Screening Unit was awarded a federal grant through the Centers for Medicare and Medicaid Services to enhance their background screening system (BGS). They have completed the first phase of enhancements and are set to go live on Wednesday, Feb. 29.
In order to complete the upgrade, the current BGS system will be offline from Friday, Feb. 24 at 5:00 p.m. through Tuesday, Feb. 28. During this time, providers will not be able to access screening results. Email notifications and letters highlighting the changes to the system were sent out recently to Background Screening Results Website registered users and all licensed providers.
If you currently have access to the Agency’s Background Screening Results Website, your user code and password will remain the same. You will need to complete an online form to capture additional information to assist in resetting future passwords. If you are not enrolled, you will need to create an account and submit a User Agreement. Registration for the Portal will be available at the following link beginning Feb. 29. For instructions on how to register with the Portal, please visit the Background Screening website.
Tips from CMS Webinar on Bundled Medicare Payment Programs – On Feb. 14, the CMS Innovation Center held a webinar for organizations interested in learning about the core competencies needed for implementing bundled payment programs. Speakers discussed strategies, tactics, and lessons learned from their own efforts to transform care with the goals of improving the health of target populations, enhancing the patient experience of care, and controlling healthcare costs. One of the three speakers was Cheryl Phillips, MD, AGSF, Senior Vice President of Policy and Advocacy for LeadingAge. For those of you who did not participate in the webinar, the following points were made:
- Creating an integrated delivery health care system is a multiyear journey and a learning experience.
- You must have the right skills and the right people on board to transform an organization to participate in emerging health care models such as medical homes, bundled payments, and accountable care organizations.
- You must be prepared to demonstrate better care and better health outcomes at a reduced cost.
- Most existing and emerging health systems do not have a skilled nursing component. The speaker from Aurora, a 25-year-old integrated health system, noted that his organization is seeking skilled nursing partners.
- Partners must have a way of measuring performance, managing patient data, and aligning interventions that are designed to avoid re-hospitalization.
- Health systems that are undertaking care redesign efforts must have electronic health records, performance measures and other data that help them understand the patient population and how patients transition through various levels of care.
- Health systems are likely to begin the transformation by focusing on a specific area of practice that lends itself to bundled payments such as orthopedic care.
- Patient satisfaction and family involvement are important.
- An integrated model of care avoids the “discharge concept” and, instead, focuses on the next level of care.
- Many hospital readmissions are due to the absence of off-hour alternatives for patients to use when faced with a problem. Patient self-management and instructions for after-hour care are important.
- Quality care must be measurable. There are a number of established quality measures that can be used as a starting point.
- A universal assessment instrument is also important. CMS will soon be releasing one.
- Extended care pathways or glide paths are needed to link interventions across healthcare settings.
- Bundling is about payment reform. Some of the challenges include patient choice and assessment of quality in all settings that are part of the continuum.
- Dr. Phillips suggested that collaboration can and should extend beyond the health care system, possibly to senior housing and continuing care communities. She gave an example of a health system that placed a case manager in a senior housing project.
The major point made by speakers is that good care by itself is not enough to compete in this changing healthcare environment. In order to become partners and players in integrated health systems, providers must be able to distinguish themselves. The way to do that is to demonstrate through data that a provider has effective clinical pathways that result in positive patient outcomes and fewer hospital readmissions.
The third and final webinar on this topic is scheduled for Friday, Feb. 24.
Affordable Housing News
FY 2013 Budget – The proposed budget for FY2013 was released on Monday, Feb. 13. We are in the process of analyzing the budget and its impact on our Affordable Housing members. To read the latest update, please click here. Please make sure to watch your inbox and the Housing News section of our website for the most up-to-date information.
Below is a chart with an overview of the section 202 funding proposed in the FY 2013 budget. (Thank you to LeadingAge for the chart.) As with everything, there is good news and there is bad news. The good news is the administration requested funding for new development, but the bad news is it may be difficult to access the funds if appropriated because it would require changes in legislative authority.
If you have any questions or if you have not been receiving the housing updates this week, please contact Casey Stoutamire, Director of Housing and Membership, at firstname.lastname@example.org.
Affordable Housing Trust Funds Swept by Florida Senate in 2012 General Appropriations Act – Late on Friday, Feb. 10, the Senate released its 2012 General Appropriations Act. In it, the Senate swept the affordable housing trust funds. The final decision will be made by the full Senate budget committee at its meeting this week, so there is still a chance this decision could be reversed. Watch your inbox and check the Affordable Housing news section of the LeadingAge Florida website for the latest updates. You can access the full General Appropriations Act here. The document is located under the Transportation and Economic Development Appropriations pull down.
Section 8 Reform Bill Marked Up By House Financial Services Subcommittee – As alerted by LeadingAge, the U.S. House of Representatives Financial Services Committee Subcommittee on Insurance, Housing and Community Opportunity marked up the Section 8 Reform Bill on Feb. 7. The subcommittee moved forward in the legislative process for the most recent version of the Section 8 reform legislation, the Affordable Housing and Self Sufficiency Improvement Act of 2012 (AHSSIA).
The legislation includes a number of provisions intended to streamline the housing choice voucher program by eliminating duplicative and burdensome requirements that will apply to the Section 8 voucher program. It also includes provisions that impact all federally-assisted housing, including senior housing requirements, Limited English Proficiency, the project-based voucher program, and mark to market.
Increased Standard Deduction, Increased Rent
If this bill is enacted, the standard deduction for seniors will be $525, an increase from $400. At the same time, the deduction for unreimbursed medical expenses in determining rent will be decreased from those above 3% of a senior's income to those above 10% of a senior's income.
For those with high medical expenses, this provision will mean a rent increase. LeadingAge is concerned that for those with very low incomes and high medical expenses, the increase may be too burdensome. We will work with congressional staff to mitigate negative impacts on vulnerable seniors. The bill also increases the minimum rent from $50 to $69.45 indexed in the future.
The hardship exemptions remain in place and providers should be sure to advise residents that they may be eligible for such exemptions.
The legislation also changes the recertification requirements so that those on fixed incomes like social security and SSDI will have their incomes recertified every three years instead of every year.
The bill also changes the asset definitions to deny eligibility to anyone with net family assets exceeding $100,000, as adjusted annually by an inflationary factor, or to anyone who has a present ownership interest in and an ability to sell a home that is suitable for occupancy by the individual applying for assistance.
Limited English Proficiency
The bill also includes provisions that will impact all managers and their ability to serve residents and potential residents of Limited English Proficiency by providing for translation of required documents and for a toll-free telephone line to provide translation services if necessary.
Project-based Voucher Program
The project-based voucher program is also reformed in this legislation to increase the percentage of vouchers that a housing authority can project base from 20% to 25% for projects that serve seniors and provide supportive services -- good news for new development and preservation of senior housing that needs rental subsidy.
Mark to market Program Extended
Finally, the legislation extends through Sept. 30, 2015, the mark to market program authorization, which will extend authorities that help preservation of certain subsidized housing.
LeadingAge Would Like Your Feedback – LeadingAge recently sent out an email via its listserv with the following information: The recently marked-up Section 8 reform legislation, the Affordable Housing and Self-Sufficiency Improvement Act of 2012 (AHSSIA), includes a new definition of income for eligibility for seniors, raising the standard deduction for seniors from $400 to $525. At the same time, for purposes of rent calculation, the bill raises the threshold for unreimbursed medical expenses as deductible. Currently, unreimbursed medical expenses that exceed 3% of income are deductible for rent calculations. Under AHSSIA, only unreimbursed medical expenses that exceed 10% of income are deductible. We are concerned that for seniors with very high unreimbursed medical expenses, there will be an unreasonable rent increase. We would welcome your feedback on this issue, including any concerns you have, actual cases that show impact, and possible solutions. You can email Casey Stoutamire, Director of Housing and Membership, at email@example.com or Nancy Libson with LeadingAge at nlibson@LeadingAge.org.
LeadingAge Supports Reauthorization of Older Americans Act – As alerted by LeadingAge, on Jan. 26, Sen. Bernard Sanders (I-VT) introduced S. 2037, legislation to reauthorize the Older Americans Act (OAA). The bill includes provisions to improve the calculation of inflation for the elderly to more accurately reflect out-of-pocket expenses for health care and prescription drugs. It would clarify the legal definition of “economic security” to encompass the income necessary to pay for:
- Health care
- Long-term services and supports
- Other basic needs.
The measure would streamline and strengthen the meals programs, authorizing a 50% boost in funding. In addition, the bill would help modernize senior centers by creating a pilot program and community planning grant program.
LeadingAge strongly supports this legislation and will work with its sponsors to include provisions for combining supportive services with affordable housing.
Nursing Home News
CMS: Preparing for the Version 5010 Upgrade: Questions to Ask Your Vendor – The compliance deadline to upgrade to Version 5010 from Version 4010/4010A was Sunday, Jan 1, 2012. CMS announced an enforcement discretion period for 90 days until Saturday, March 31, during which it would not initiate enforcement action with respect to any HIPAA-covered entity that is non-compliant with Version 5010. However, you should continue to upgrade your systems as promptly as possible in order to meet this deadline.
In order to ensure a smooth upgrade prior to April, you will need to complete both Phase I Internal and Phase II External testing of Version 5010 transactions. As part of your external testing, you will need to conduct tests with outside trading partners, which include vendors, clearinghouses, billing services, and payers. Your vendor is a critical partner in achieving Version 5010 compliance.
You should take the following steps to evaluate your vendor and vendor products to ensure a timely Version 5010 upgrade:
- Establish a tracking system and timeline for milestones
- Review existing and new contractual obligations with vendors
- Coordinate vendor capabilities with your practice needs and expectations
- Evaluate ease of use of vendor products
You also might want to ask your vendor some of the following questions about the Version 5010 upgrade to help assess your readiness for this upgrade:
- Have they upgraded their systems to meet Version 5010 standards?
- If they have not yet upgraded, when will they do so?
- What will be the cost for each upgrade?
- What versions of their software will be upgraded, and will these upgrades require any additional hardware upgrades?
- How often will updates occur and what is the delivery method?
- How are issues logged and how will they be addressed?
- Is there training available for new system changes and/or functionalities?
AHCA Provider Training: Top Findings from the AHCA review of submitted claims for physician services in Nursing Facilities – AHCA Provider training on the Top Findings from the AHCA review of submitted claims for physician services in Nursing Facilities will be held in February 2012. AHCA will show how claims submitted were not in compliance, provide key policy reminders, and help providers to increase compliance with Medicaid policy.
The training will be held during the following dates. All times are Eastern Standard Time.
|Thursday, Feb. 23, 2012||12:30 p.m. - 1:30 p.m.|
|Tuesday, Feb. 28, 2012||12:30 p.m. - 1:30 p.m.|
|Wednesday, Feb. 29, 2012||12:30 p.m. - 1:30 p.m.|
Medicaid providers are invited to participate. The training will be performed via teleconference. To join the teleconference training, please dial 1 (888) 808-6959 and at the prompt enter the conference code: 3054466900. You don’t need to register or reserve space. Just call at the designated time. If the session is full when you call, please plan to participate in any of the other sessions.
The training will follow a PowerPoint presentation. To download the presentation to view during the teleconference, click on the “Upcoming Training and Schedules” tab, then right click on the picture of the presentation, choose “Save Target As…” and save a copy of the presentation to your computer. You may also click on the picture of the presentation and view it online. Please have a copy of the PowerPoint presentation available before the teleconference so you can follow along.
Any questions can be emailed prior to or during the teleconference to: firstname.lastname@example.org. If you have any questions about the teleconferences, please contact email@example.com.
Five Ways Not-for-Profit Nursing Homes are Different (by Geralyn Magan, published Feb. 6, 2012) – A new report from LeadingAge New York suggests that not-for-profit nursing homes in the Empire State distinguish themselves from for-profit facilities in five major areas:
- Lower hospitalization rates. In 2009, hospitalization rates were considerably higher in for-profit facilities than in not-for-profit facilities, according to New York State Nursing Homes: Sponsorship as a Defining Factor in Outcomes. The rate of hospitalization was 34% higher for short-stay residents of for-profit facilities and 28% higher for long-stay residents of for-profit facilities. These findings are significant, says the report, because “avoiding unnecessary hospitalizations is a policy imperative of government, payers and advocates due to the associated clinical, cost and quality implications.”
- Fewer deficiencies. A typical for-profit facility had 16% more deficiencies per 100 beds than a not-for-profit home in 2009. This finding is consistent with a 2011 study from the Government Accountability Office, which found that nursing homes owned by private investment companies and other for-profit operators had higher numbers of survey deficiencies than not-for-profit facilities, notes the report.
- Higher staffing levels. The average number of registered nurse (RN) hours per resident day was 27% higher in not-for-profit homes than in for-profit homes. In addition, says the report, spending per day in nursing costs was 15% higher in not-for-profit nursing homes.
- Lower patient acuity. For-profit homes reported patient acuity that was 6.6% higher than in not-for-profit homes. However, for-profit homes did not report commensurately higher staffing levels. “If a facility’s case-mix index accurately measures resident care needs, homes with higher acuity levels should have higher staff hours,” says the report.
- More discharges back to home. A greater proportion of residents were discharged back to home from not-for-profit nursing homes than from for-profit facilities. Data from 2009 show that 49.7% of total discharges from not-for-profit nursing homes were to home versus 41.3% from for-profit facilities, which amounted to a 20% difference, according to the report. “Discharges to home are typically indicative of resident improvement in condition and are considered a positive outcome of care,” it says.
The LeadingAge-New York report is based on an analysis of state and federal data sources containing resident assessment, survey, staffing, financial and other facility information for 2009. Citing a move away from fee-for-service reimbursement to capitated managed-care arrangements in New York, the report underscores the importance of recognizing differences among facility structures, processes and outcome dimensions of care.
“If, in fact, the form of ownership of a nursing home affects quality of care and quality of life, this information should influence the development and administration of payment and regulatory policies and be of great interest to consumers and payers,” the report concludes.
Don’t Miss out!! 2012 Joint Training at Four Locations and Two Days: Day One, Nursing Homes & Day Two, ALFs
- March 27 & 28 – Tampa, Double Tree Tampa Airport, Westshore 4500 West Cypress Street
- March 29 & 30 – Orlando, Hyatt Regency Grand Cypress, 1 Grand Cypress Blvd.
- April 3 & 4 – Ft. Lauderdale, Hyatt Regency Bonaventure, 250 Racquet Club Road
- April 10 & 11 – Tallahassee, Holiday Inn/Monroe Street Conference Center, 2714 Graves Road
Victrelis (boceprevir) and Ritonavir-Boosted Human Immunodeficiency Virus (HIV) Protease Inhibitor Drugs: Drug Safety Communication - Drug Interactions – FDA notified healthcare professionals and patients that drug interactions between the hepatitis C virus (HCV) protease inhibitor Victrelis (boceprevir) and certain ritonavir-boosted human immunodeficiency virus (HIV) protease inhibitors (atazanavir, lopinavir, darunavir) can potentially reduce the effectiveness of these medicines when they are used together.
A drug interaction study showed that taking boceprevir (Victrelis) with ritonavir (Norvir) in combination with atazanavir (Reyataz) or darunavir (Prezista), or with Kaletra (lopinavir/ritonavir), reduced the blood levels of the HIV medicines and boceprevir in the body. FDA will be updating the Victrelis drug label to include information about these drug interactions.
Background: Victrelis is a hepatitis C virus (HCV) protease inhibitor used with the medicines peginterferon alfa and ribavirin to treat chronic (long-lasting) hepatitis C infection in adults. HIV protease inhibitors are a class of anti-viral drugs used to treat HIV infection. Ritonavir is an HIV protease inhibitor used to “boost” other HIV protease inhibitors, increasing their levels in the blood and making them more effective.
Recommendation: Patients should not stop taking any of their medicines without talking to their healthcare professional. Patients should contact their healthcare professional if they have any questions or concerns. Healthcare professionals who have started patients infected with both chronic HCV and HIV on Victrelis and antiretroviral therapy containing a ritonavir-boosted protease inhibitor should closely monitor patients for HCV treatment response and for potential HCV and HIV virologic rebound.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program.
Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178.
CMS Webinar on Bundled Payments for Care Improvement Initiative scheduled for Feb. 14 – Although we have known for nearly a week that the Centers for Medicare and Medicaid was planning a webinar on bundled payments for care, the details were not released until this morning. We apologize for any inconvenience that this last-minute notice may cause you and your staff. Our public policy staff will monitor the webinar in the event that any of the information presented by speakers should be shared with members. Please click here for more information.
Return Your Forms To Receive Nationally Negotiated Pricing Through Value 1st GPO – Don’t forget to sign up to receive first-rate pricing through Value First, an option for our members to purchase a wide array of supplies and services, with no cost to enroll and no obligation to purchase. Members can enroll in Value First and participate in other Group Purchasing Organizations at the same time.
Value First is owned by LeadingAge Florida along with LeadingAge and 24 other state associations, and is partnered with national group purchasing specialist MedAssets. The portfolio of more than 400 vendors includes food distributors, medical supplies, therapy, facility operations, furniture, equipment, technology, and construction services.
LeadingAge Florida-member communities received customized enrollment packets in May 2011, so be sure to sign and return the forms to start receiving national first-rate pricing today! By doing so, LeadingAge Florida will receive credit for your orders, which will help enable us bring you even more member services.
Copyright 2012 – Publication of the LeadingAge Florida (formerly FAHSA).
LeadingAge Florida Chair: Brian L. Robare
LeadingAge Florida President/CEO: Janegale Boyd
Managing Editor: Casey Stoutamire
Copyright Information: Copies of the articles and other information in this publication may be noncommercially reproduced for the purpose of educational or scientific advancement. Otherwise, no part of this publication may be reproduced or utilized in any form or by any means, mechanical or electronic, including photocopying, microfilm and recording, or by any information storage and retrieval system, without the written permission of the editor.
Correspondence: Should be addressed to: Editor, 1812 Riggins Road, Tallahassee, FL 32308. For telephone inquiries, call (850) 671-3700. Or email LeadingAge Florida at info@LeadingAgeFlorida.org. © 2012 LeadingAge Florida. All rights reserved.
Disclaimer: The information contained in this correspondence is not intended as a substitute for legal advice. Please discuss any information gathered from this or any other LeadingAge Florida publications with your legal counsel in the context of your particular situation before implementing any new policies or procedures.