HC Reform Update by Mark Sanna: Middle-aged smokers are far more likely than nonsmokers to develop dementia later in life, and heavy smokers — those who go through more than two packs a day — are at more than double the risk, a new study reports. After adjusting for other factors, the researchers that pack-a-day smokers were 37% more likely than nonsmokers to develop dementia, and the risks went up sharply with increased smoking; 44% for one to two packs a day; and twice the risk for more than two packs.

HC Reform Update from Mark Sanna: With the elections less than one week away, ads making claims about the health law are flooding the airwaves. Many Democrats continue to not mention health reform, while Republicans criticize the law as too large, too expensive and intrusive into Americans’ lives. But President Barack Obama and some Democrats are promoting the law’s immediate consumer benefits and say it will improve the quality of health care for all Americans.

HC Reform Update from Mark Sanna: This election season, spending on anti-health reform ads has outpaced spending on pro-reform ads more than five to one. On the federal campaign level, candidates and outside groups have spent nearly $92 million on ads attacking reform, while voices in favor of reform have spent just over $19 million, according to Evan Tracey of the Campaign Media Analysis Group.

HC Reform Update from Mark Sanna: Nursing mothers will not be allowed to use their tax-sheltered health care accounts to pay for breast pumps and other supplies. That is because the IRS has ruled that breast-feeding does not have enough health benefits to quality as a form of medical care. With all the changes the health care overhaul will bring in the coming years, it nonetheless will leave those regulations intact when new rules for flexible spending accounts go into effect in January. Those allow millions of Americans to set aside part of their pretax earnings to pay for unreimbursed medical expenses.

HC Reform Update from Mark Sanna: Some of the sickest patients can run up hospital charges as high as $18,000 a day, with average stays of almost three weeks, according to a new government report on the cost of hospital care. The report, from the Agency for Healthcare Research and Quality, used data from a nationwide sampling of patients in 2008 to analyze the two million most expensive stays.

HC Reform Update from Mark Sanna: November 15 marks the beginning of the open enrollment season for private Medicare plans, including Part D, the prescription drug plan. Officials at the Centers for Medicare and Medicaid Services say they have taken steps to streamline this year’s plan options – including eliminating some plans they consider duplicative. The changes, officials say, were part of an effort to ease seniors’ confusion.

HC Reform Update from Mark Sanna: The Obama administration will not be compiling a federal health record on all citizens, including each individual’s body mass index, as some candidates are claiming. The administration is offering incentives to doctors to record various vital statistics in electronic medical records and report the data in the aggregate, to help understand national health trends.

HC Reform Update from Mark Sanna: As many as 1 in 3 American adults could have diabetes by 2050, federal officials said Friday in a new projection that represents a threefold increase. The CDC estimates that 1 in 10 have diabetes now, but the number could grow to 1 in 5 or even 1 in 3 by midcentury if current trends continue. The last estimate put the number at 39 million in 2050. The new estimate takes it to the range of 76 million to 100 million.

HC Reform Update from Mark Sanna: Insurance regulators unanimously approved controversial rules Thursday governing how much insurers must spend on patients’ medical care – without adopting any of several last-minute amendments some consumer advocates had feared would gut key provisions. The recommendations will now go to HHS Secretary Kathleen Sebelius, who has final say.

HC Reform Update from Mark Sanna: All eyes will be on this week’s annual meeting of the National Association of Insurance Commissioners, which is taking place in Orlando. When the state insurance regulators are expected to unveil their final recommendations later this week on how the nation’s health insurers will have to meet new spending standards under the new health care law.

HC Reform Update from Mark Sanna: The Food and Drug Administration issued a warning this week linking long-term use of popular osteoporosis drugs to an unusual fracture of the thigh bone. The agency asked patients taking the drugs, known as bisphosphonates, to report any thigh or groin pain to their doctors. At the same time, the F.D.A. safety announcement emphasized that people should continue taking the drugs unless their doctors advise otherwise.

HC Reform Update from Mark Sanna: Health insurers can't have different rules for when individual policies are sold for children with medical problems than for healthy kids, HHS Secretary Kathleen Sebelius said in a letter to the National Association of Insurance Commissioners. Some insurers want to allow healthy children to enroll year-round but only have a limited "open season" for ones with pre-existing conditions. Such an approach is legally questionable and "inconsistent with the language and intent" of the health care law, Sebelius wrote.

HC Reform Update from Mark Sanna: In a foreboding ruling for the Obama administration, a federal judge in Florida decreed Thursday that a legal challenge to the new health care law by officials from 20 states could move forward and warned that he would have to be persuaded that its keystone provision — a requirement that most Americans obtain insurance — is constitutional.

HC Reform Update from Mark Sanna: By inventing 118 bogus health clinics in 25 states, prosecutors said, a band of Armenian-American gangsters billed Medicare for more than $100 million, and managed to collect $35 million over at least four years. The US attorney in Manhattan, called it the “single largest Medicare fraud ever perpetrated by a single criminal enterprise.” Eighteen people were charged in the Medicare indictment unsealed on Wednesday, part of a larger ring of 44 people prosecutors said had engaged in a variety of swindles, including bilking auto insurance companies by falsifying, staging or exaggerating the severity of fender-benders. Charges included racketeering, health care fraud, identity theft, money laundering and bank fraud. Forty-one of the defendants had been arrested as of Wednesday afternoon.

HC Reform Update from Mark Sanna: The Obama administration announced Tuesday it will delay for one year a provision of the health law that requires employers to report the value of an employee's health plan on tax forms. The White House says the extra time is necessary to give employers time to prepare to comply with the requirement. Instead of a mandatory reporting requirement, the IRS' draft 2011 W-2 tax form includes an optional line for employers to report the cost of employer-sponsored health insurance coverage.

HC Reform Update from Mark Sanna: The safety of vaccines is at the heart of a case expected to be heard on Tuesday by the United States Supreme Court, one that could have implications for hundreds of lawsuits that contend there is a link between vaccines and autism. At issue is whether a no-fault system established by Congress about 25 years ago to compensate children and others injured by commonly used vaccines should protect manufacturers from virtually all product liability lawsuits.

HC Reform Update from Mark Sanna: The global drug market will grow 5 to 7% in 2011, to $880 billion, as higher spending in nations like China, Brazil and India makes up for slow growth and patent losses in the United States, according to a forecast released last week by IMS Health, an industry data company.

HC Reform Update from Mark Sanna: Republicans think they have a winning issue in health care reform, calling for its repeal and slamming the new law as big government gone haywire—even before most of its provisions have taken effect. A new poll suggests it's not so clear-cut, and some Democrats seem to agree.

HC Reform Update from Mark Sanna: This week, FTC Chairman Jon Leibowitz told a meeting of health industry representatives that his agency would explore an "expedited review process" for hospitals and doctors looking to determine if new partnerships they form to provide care would violate antitrust laws. A key part of the new health law encourages the development of "accountable care organizations" that would allow doctors to team up with each other and with hospitals, in new ways, to provide medical services. Health care providers want to make sure their ACOs won’t be accused of stifling competition or trying to fix prices when they bargain with insurance companies. Insurers, meanwhile, are expressing concern that providers could use the leverage of ACOs to demand higher prices.

HC Reform Update from Mark Sanna: A federal judge in Michigan on Thursday dismissed one of more than 15 legal challenges to the new health care law, becoming the first to rule that the law is constitutional. Two other cases with higher profiles, one in Florida and one in Virginia, are headed toward hearings on the issues that were decided in Michigan. The central question, which may ultimately fall to the Supreme Court, is whether the Commerce Clause of the Constitution gives Congress the authority to require citizens to obtain a commercial product, namely health insurance.

HC Reform Update from Mark Sanna: The Obama administration is granting companies like McDonald’s and some insurers waivers to maintain even minimal coverage far below the new law’s standards. About 30 insurers, employers and union plans, responsible for covering about one million people, were given one-year waivers on the new rules that phase out annual limits on coverage for limited-benefit plans, also known as “mini-meds.”

HC Reform Update from Mark Sanna: A new report from The Institute of Medicine released today may give nurses with advanced degrees a potent weapon in their perennial battle to get the authority to practice without a doctor's oversight. The report says nurses should take on a larger and more independent role in providing health care in America. It calls for the elimination of "regulatory and institutional obstacles" including limits on nurses "scope of practice".

HC Reform Update from Mark Sanna: Healthcare.gov, the website created by the new health law to be a one-stop consumer resource, unveiled detailed cost and benefits information about health plans available in the individual insurance market. It's the first time such data have been made public - either by the government or industry. The site will also list the percentage of applications turned down and of people who are charged more than that health plan’s advertised price.

HC Reform Update from Mark Sanna: Since January, the nation's five largest insurers and the industry's Washington-based lobbying arm have given three times more money to Republican lawmakers and political action committees than to Democrats." In 2009, the industry was largely split in its donations to Democrats and Republicans.

HC Reform Update by Mark Sanna: Medicare enrollment season is approaching, and many experts say they believe it promises to be a turbulent one — “a perfect storm.” In some areas, there will be dozens, even hundreds, of coverage options. The choices must be reviewed not just by current enrollees and a crush of baby boomers newly eligible for the government-run insurance program.

HC Reform Update by Mark Sanna: A group of Texas pharmacies has filed a lawsuit against CVS Caremark, the nation’s largest pharmacy health care provider, saying it violates racketeering and privacy laws. The Texas lawsuit accuses CVS Caremark of gaining too much control over patient information, including files from the independent pharmacies that have to hand over patient information for insurance disputes. The lawsuit also says CVS uses that information for direct marketing to patients and doctors at the behest of pharmaceutical companies.

HC Reform Update from Mark Sanna: The Principal Financial Group announced on Thursday that it planned to stop selling health insurance, another sign of upheaval emerging among insurers as the new federal health law starts to take effect. Principal’s decision closely tracks moves by other insurers that have indicated in recent weeks that they plan to drop out of certain segments of the market, like the business of selling child-only policies. State regulators say some insurance companies are already threatening to leave particular markets because of the new law.