HCR Update from Mark Sanna: Know someone who drowned from jumping off burning water skis? Well, there’s a new medical billing code for that. Been injured in a spacecraft? There’s a new code for that, too. Roughed up by an Orca whale? It’s on the list. Next fall, a transformation is coming to the arcane world of medical billing. Overnight, virtually the entire health care system — Medicare, Medicaid, private insurers, hospitals, doctors and various middlemen — will switch to a new set of computerized codes used for determining what ailments patients have and how much they and their insurers should pay. Technology specialists fear major disruptions to health care delivery if the new coding system — heavily computer-reliant — isn’t put in place properly.

HCR Update from Mark Sanna: More than 975,000 people signed up for health insurance through the federal exchange between Dec. 1 and Dec. 24, the deadline to enrollment to be covered by Jan. 1, the administrator for the Centers for Medicare and Medicaid Services said in a blog item posted today. Marilynn Tavenner, the CMS administrator, wrote that 1.1 million Americans have enrolled in insurance through the exchange since it opened Oct. 1.

HCR Update from Mark Sanna: The chocolate-chip cookie celebrated its 75th birthday this year. ... The beauty of the chocolate-chip cookie—and no small part of its enduring popularity—is its flexibility. You can make it with shortening, margarine, or butter; you can make big cookies or small cookies; you can use pecans or walnuts or M. & M.’s or peanut butter; you can use more brown sugar or less; ... It doesn't matter. What comes out will still be recognizable as a chocolate-chip cookie and, most likely, it will taste good.

HCR Update from Mark Sanna: He won't use it, and he didn't actually sign up for it himself, but President Barack Obama has enrolled for health coverage through the new insurance exchanges. Announcing his enrollment Monday, the White House called it a symbolic show of Obama's support for the fledgling exchanges where millions of Americans must buy insurance or face a penalty.

HCR Update from Mark Sanna: A record-setting crush of last-minute shoppers descended on HealthCare.gov on Monday, creating long wait times for users and putting new stress on the government’s much-maligned health portal as they raced against a midnight deadline to sign up for coverage that will go into effect on Jan. 1. 

HCR Update from Mark Sanna: Kurt DelBene, who previously was president of the Microsoft Office Division, was named by President Barack Obama to replace Jeffrey D. Zients and oversee efforts to rescue the federal government's health care website.

HCR Update from Mark Sanna: Americans who already have health insurance are blaming President Barack Obama's health care overhaul for their rising premiums and deductibles, and overall 3 in 4 say the rollout of coverage for the uninsured has gone poorly. An AP poll finds that health care remains politically charged going into next year's congressional elections. ... In the survey, nearly half of those with job-based or other private coverage say their policies will be changing next year — mostly for the worse.

HCR Update from Mark Sanna: The Food and Drug Administration on Wednesday put in place a major new policy to phase out the indiscriminate use of antibiotics in cows, pigs and chickens raised for meat, a practice that experts say has endangered human health by fueling the growing epidemic of antibiotic resistance. This is the agency’s first serious attempt in decades to curb what experts have long regarded as the systematic overuse of antibiotics in healthy farm animals, with the drugs typically added directly into their feed and water. 

HCR Update from Mark Sanna: Lawmakers have all but given up on efforts to permanently replace the Medicare physician payment formula this year and have refocused their effort on getting it done in 2014. Both the Senate Finance and the House Ways and Means committees are expected to vote next week on a proposal that would permanently repeal the Sustainable Growth Rate and establish a new formula for paying doctors and hospitals that treat Medicare patients. It's a rare bipartisan, bicameral approach that would forever eliminate the need for the universally hated annual "doc fix".

HCR Update from Mark Sanna: HealthCare.gov web pages now load in less than a second, down from eight seconds in late October. The system now operates more than 90% of the time. For some weeks in October, the site was up for only 40% of the time. And the average rate of time-outs or other Web-page failures on the site has dropped to around three-quarters of a percent. It was as high as 6% in October.

HCR Update from Mark Sanna: Time's up. It’s deadline day for the repair of HealthCare.gov, a psychological milestone that could revive confidence in the embattled health law or send it into a political tailspin. The administration is taking pains to not characterize Saturday as a deadline. The site, officials acknowledge, will still struggle at times. Repairs and upgrades will go on for months.

HCR Update from Mark Sanna: The Obama administration is delaying yet another aspect of the health care law, putting off until next November the launch of an online portal to the health insurance marketplace for small businesses. The move, announced Wednesday, was needed because repairs are still underway to the troubled HealthCare.gov website, which is the primary way for individuals to apply for insurance.

HCR Update from Mark Sanna: White House officials, fearful that the federal health care website may again be overwhelmed this weekend, have urged their allies to hold back enrollment efforts so the insurance marketplace does not collapse under a crush of new users. At the same time, administration officials said Tuesday that they had decided not to inaugurate a big health care marketing campaign planned for December out of concern that it might drive too many people to the still-fragile HealthCare.gov

HCR Update from Mark Sanna: HealthCare.gov experienced an "unscheduled outage" for about an hour Monday morning, an Obama administration official confirmed Monday, but the administration maintains that the federal website, which serves as the portal for the Obamacare marketplaces in 36 states, will work for the "vast majority" of users by next week.

HCR Update from Mark Sanna: The Affordable Care Act is good for young adults because it’ll save them money on health care, leaving them more to spend on liquor and birth control. That’s one way to interpret the message from a provocative new ad campaign in Colorado. Not everyone is thrilled with it. One of the ads shows a college student doing a keg stand with a pretty big picture of a keg. Alcohol features prominently in several ads in the campaign. They all encourage young people to learn more about the federal health care law.  Two nonprofit groups in Denver put them together, ProgressNow Colorado Education and Colorado Consumer Health Initiative. They say they only had about $5,000 to spend and wanted to grab some eyeballs on social media.

HCR Update from Mark Sanna: The Obama administration said Friday that it would give people eight more days, until Dec. 23, to sign up for health insurance coverage that takes effect on Jan. 1 under the new health care law. The administration also said it would delay the 2015 insurance enrollment period for the Affordable Care Act by a month, pushing it beyond the 2014 elections.

HCR Update from Mark Sanna: Last week, the nation’s leading heart organizations released a sweeping new set of guidelines for lowering cholesterol, along with an online calculator meant to help doctors assess risks and treatment options. But, in a major embarrassment to the health groups, the calculator appears to greatly overestimate risk, so much so that it could mistakenly suggest that millions more people are candidates for statin drugs.

HCR Update from Mark Sanna: Remember when President Obama said, "If you like your health plan you can keep it?" Now it's more like, "If you like your health plan you can keep it — for another year, and only if your insurance company says it's OK." It's not clear whether the administration's proposal to let insurers extend the policies they've been cancelling for the past couple of months will solve the president's political problem. But it's sure not going over very well with the insurance industry.

HCR Update from Mark Sanna: Bowing to pressure, President Barack Obama on Thursday announced changes to his health care law to give insurance companies the option to keep offering consumers plans that would otherwise be canceled. The administrative changes are good for just one year, though senior administration officials said they could be extended if problems with the law persist. Obama announced the changes at the White House.

HCR Update from Mark Sanna: Facing dissent from his own party and growing pressure from anxious Congressional Democrats, President Obama is to propose an administrative fix today to a central element of his signature health care law, allowing Americans who are losing their health insurance coverage because of the Affordable Care Act to retain it.

HCR Update from Mark Sanna: The Obama administration has ruled that neither the Affordable Care Act federal insurance exchange nor the federal subsidies paid to insurance companies on behalf of low-income people are “federal health care programs.” The surprise decision exempts subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare.

HCR Update from Mark Sanna: Today marks one month since the disastrous start of Healthcare.gov, the seriously impaired federal health insurance marketplace. And what a month it's been!

HCR Update from Mark Sanna: A new rule will now permit employers to let Flexible Spending Account plan participants roll over up to $500, the Treasury Department said Thursday. Some plan sponsors may be eligible to start letting workers carry over the money at the end of this year. Others may have to wait until next year to start offering the feature.

HCR Update from Mark Sanna: President Barack Obama’s advisers deliberately crafted his signature health-care law to fulfill his oft-repeated promise: if you like your insurance, you can keep it. Even with that provision, Obama administration officials knew by June 2010 that as many as 10 million people with individual insurance probably would be thrown off existing plans anyway.

HCR Update from Mark Sanna: Millions of Americans are getting their health insurance cancelled under the Affordable Care Act and the Obama administration has known for about three years that this would happen, NBC News is reporting. Between half and three quarters of 14 million consumers who buy health insurance individually will receive a cancellation letter or its equivalent in the next year because their current policies don't meet the standards laid out by the new law.

HCR Update from Mark Sanna: The rocky debut of the insurance exchanges at the heart of President Barack Obama’s health-care law poses risks to his political agenda and the activist role for government that he has championed for his second term.White House officials say they expect a surge in online enrollment to begin in mid-November, meaning the administration may have only about three weeks to fix the flaws before negative public perceptions about the new program begin to harden.

HCR Update from Mark Sanna: The Obama administration said Friday that it would fix problems in the federal health insurance marketplace by Nov. 30, just two weeks before the deadline to sign up for coverage to replace health insurance policies being canceled because they do not meet new federal standards.

HCR Update from Mark Sanna: In the face of projected doctor shortages and debate about the future of medicine, a record number of students applied to, and started, medical school this year. About 20,000 students enrolled in medical school in 2013, around 2.8% more than the year before, according to the data distributed by the Association of American Medical Colleges on Thursday. First-time applications were also up by almost 6%. Osteopathic medical schools saw a continued surge in their new student pool, with an 11.1% growth in enrollment, according to the Association of American Colleges of Osteopathic Medicine. What is the trend in enrollment in Chiropractic Colleges?

HCR Update from Mark Sanna: The Obama administration said Wednesday night that it will give Americans who buy health insurance through the new online marketplaces an extra six weeks to obtain coverage before they incur a penalty. The announcement means that those who buy coverage through the exchange will have until March 31 to sign up for a plan.

HCR Update from Mark Sanna: Health and Human Services Secretary Kathleen Sebelius said delaying the launch of the insurance exchanges was "not really an option" — even though those building the federal website knew about major problems days in advance. "There are people in this country who have waited decades for affordable health coverage, people who are so eager for this to happen."

HCR Update from Mark Sanna: Days before the launch of President Obama’s online health insurance marketplace, government officials and contractors tested a key part of the Web site to see whether it could handle tens of thousands of consumers at the same time. It crashed after a simulation in which just a few hundred people tried to log on simultaneously. Despite the failed test, federal health officials plowed ahead.

HCR Update from Mark Sanna: Federal contractors have identified most of the main problems crippling President Obama’s online health insurance marketplace, but the administration has been slow to issue orders for fixing those flaws, and some contractors worry that the system may be weeks away from operating smoothly, people close to the project say.

HCR Update from Mark Sanna: Republican foes of the overhaul came out of the confrontation with only a tweak to income verification rules for those seeking subsidies to buy coverage on the new health insurance exchanges. The agreement created a new budget deadline, however, requiring lawmakers to return to the table to reach a long term deficit reduction agreement by Dec. 13.

HCR Update from Mark Sanna: Rank-and-file senators on Wednesday morning will review a deal to reopen the government and extend its borrowing authority. Aides to the Democratic and Republican Senate leaders worked on the proposal through the night. The only concession to the movement to gut President Obama’s health care law is a mild tightening of income verification rules for people obtaining subsidized health insurance on the new insurance exchanges. Even any alteration of the law’s tax on medical devices, hated by members of both parties, was removed from the final deal.

HCR Update from Mark Sanna: The technical problems that have hampered enrollment in the online health insurance exchanges resulted from the failure of a major software component, designed by private contractors, that crashed under the weight of millions of users last week, federal officials said Monday.

HCR Update from Mark Sanna: Consumers trying to price health insurance in the new federally run health marketplaces may have been having trouble getting through the government’s main web site, healthcare.gov, but there’s a backdoor way to see the plans that are being offered in 36 states. The Department of Health and Human Services has posted premiums for more than 17,000 plans on its website. The data lists each plan by insurer and the plan name and the monthly premium rate for a child, a 27-year-old,a family with 30-year-old parents and two kids, a single-parent family with two 30-year-olds, and a 40-year-old couple without children. The plans are also listed by the metal tier (platinum, gold, silver or bronze) that details how comprehensive the coverage is, and what kind of plan it is (HMO, PPO, etc.). You can also search for plans by state and county.One spreadsheet shows premiums for health insurance and a second shows premiums for stand-alone dental plans. Also for small businesses, there are health premium rates and rates for stand-alone dental plans. https://www.healthcare.gov/health-plan-information/

HCR Update from Mark Sanna: It's Oct. 1 and the Affordable Care Act is finally getting its rollout, but President Barack Obama's health-care law looks a lot different from the one he signed 31/2 years ago. Thanks to a Supreme Court ruling, about half the states aren't participating in a Medicaid expansion that was a core part of the legislation. The federal government is running the bulk of new marketplaces for health insurance, not the states as originally envisioned. And some of the key provisions are delayed, including one that makes larger businesses pay a fine if they don't offer coverage.

HCR Update from Mark Sanna: Tomorrow is the long-awaited kickoff for President Obama's signature health care law, when millions of Americans can start signing up for new insurance options. Yet across the country, officials are issuing warnings that despite fevered efforts, their new insurance exchanges — online markets where people can shop for health plans and see if they qualify for federal subsidies — will not be fully operational for weeks or even months.

HCR Update from Mark Sanna: Two-thirds of the public are not aware when the new online marketplaces open to allow people without employer coverage to shop and purchase their own health policies, according to a poll by the Kaiser Family Foundation. These exchanges open Tuesday. Despite outreach efforts by the Obama administration and supporters of the law, the poll found the number of uninsured unaware of the opening date is even greater than the public at large, with three out of every four not knowing the marketplaces are supposed to open in October.

HCR Update from Mark Sanna: According to a report in ProPublica, during the last decade, more than 1,500 Americans died after accidentally taking too much of a drug renowned for its safety: acetaminophen, one of the nation's most popular pain relievers. Acetaminophen – the active ingredient in Tylenol – is considered safe when taken at recommended doses. Tens of millions of people use it weekly with no ill effect. But in larger amounts, especially in combination with alcohol, the drug can damage or even destroy the liver.

HCR Update from Mark Sanna: Injecting steroids into the area around the spinal cord, known as an epidural, is the most commonly used treatment for back pain, but a new review of studies suggests that injecting any liquid, even plain saline solution, works just as well. Researchers pooled the results of 43 studies involving more than 3,600 patients who got various kinds of injections for back pain. The study, published online in Anesthesiology, found that there was little difference between the amount of relief provided by steroidal and nonsteroidal epidural injections.

HCR Update from Mark Sanna: Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers. From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.

HCR Update from Mark Sanna: A group seeking to persuade young people to "opt out" of President Obama’s health care law posted videos on YouTube Thursday that show young patients on exam tables recoiling in fear as a character the group is calling "Creepy Uncle Sam" appears out of nowhere and looms over them. The group, Generation Opportunity, said in a news release that the videos were part of a new, six-figure campaign to educate people between the ages of 18 and 29 about "alternatives to expensive and creepy Obamacare exchanges".

HCR Update from Mark Sanna: A new study published on Thursday in The New England Journal of Medicine provides the best evidence yet that wearing a back brace will slow the progression of the most common form of scoliosis in adolescents, helping them avoid painful spine surgery. Researchers analyzed data on 242 patients at 25 sites across the United States and Canada. The children were all aged 10 to 15 and still growing, and they all had a spinal curvature of 20 to 40 degrees. The rate of treatment success was 72% among children with bracing. The benefit increased the longer bracing was worn. More than 90% of the children who were successfully treated wore their braces more than 13 hours a day.

HCR Update from Mark Sanna: The White House warned consumers on Wednesday to beware of possible fraud by con artists taking advantage of the new insurance marketplaces being set up under President Obama’s health care law. White House officials said that consumers should be suspicious if anyone asked them for money to enroll in a health plan offered through an insurance exchange. Legitimate insurance counselors and “enrollment assisters” will not ask for money, they said.

HCR Update from Mark Sanna: Federal health officials reported Monday that at least two million Americans fall ill from antibiotic-resistant bacteria every year and that at least 23,000 die from those infections, putting a hard number on a growing public health threat. It was the first time that federal authorities quantified the effects of organisms that many antibiotics are powerless to fight.

HCR Update from Mark Sanna: The case for regulating electronic cigarettes grew even stronger this month when the Centers for Disease Control and Prevention reported a notable increase in their use by high school and middle school students. A national survey found that the percentage of high school students who had ever smoked e-cigarettes jumped to 10% in 2012 from 4.7 percent in 2011; for middle school students (grades six to eight), the figure rose to 2.7% from 1.4%.

HCR Update from Mark Sanna: This week JAMA Pediatrics published the results of the first home-based study to address key household routines related to obesity risk among preschool-aged children. Families in the study were taught to increase their children’s sleep duration and reduce their children’s TV viewing on weekends. The result? Children who participated in the study decreased their BMI a key measure of obesity.

HCR Update from Mark Sanna: Bearing a child is still one of the most dangerous things a woman can do. It's the sixth most common cause of death among women age 20 to 34 in the United States. If you look at the black-box warning on a packet of birth control pills, you'll notice that at most ages the risk of death from taking the pills is less than if you don't take them—that's because they're so good at preventing pregnancy, and pregnancy kills. ... In the United States today, about 15 women die in pregnancy or childbirth per 100,000 live births.

HCR Update from Mark Sanna: No one joins Facebook to be sad and lonely. But a new study from the University of Michigan psychologist Ethan Kross argues that that's exactly how it makes us feel. Over 2 weeks, researchers sent text messages to 82 Ann Arbor residents 5 times per day. The researchers wanted to know a few things: how their subjects felt overall, how worried and lonely they were, how much they had used Facebook, and how often they had had direct interaction with others since the previous text message. They found that the more people used Facebook in the time between the two texts, the less happy they felt—and the more their overall satisfaction declined from the beginning of the study until its end. The data, they argue, shows that Facebook was making them unhappy.

HCR Update from Mark Sanna: Small business owners who thought they were off the hook for ObamaCare regulations until 2015 may be in for an expensive wake-up call next month. Beginning Oct. 1, any business with at least one employee and $500,000 in annual revenue must notify all employees by letter about the Affordable Care Act’s health-care exchanges, or face up to a $100-per-day fine. The requirement applies to any business regulated under the Fair Labor Standards Act, regardless of size. Going forward, letters are to be distributed to any new hires within 14 days of their starting date, according to the Department of Labor.

HCR Update from Mark Sanna: The promise from President Obama was straightforward enough: "If you like your health care plan, you can keep your health care plan. Period. No one will take it away," he said. That was four years ago, during the build-up to the passage of the Affordable Care Act. Just months before several major provisions of the law take full-effect, many Americans still aren't sure whether to believe him. And for good reason. Wildly conflicting predictions are being reported almost daily.

HCR Update from Mark Sanna: The FDA announced Friday that it had found no evidence that current levels of arsenic in rice pose an immediate health risk. The finding comes 2 months after the agency proposed new limits on arsenic in apple juice. The agency tested more than 1,300 types of rice and rice products, like rice cakes and infant cereals, and found that arsenic levels ranged from 3 to 7 micrograms per serving, amounts that the agency said were not hazardous to human health in the short term. Arsenic is a carcinogen when consumed in large enough quantities. It occurs naturally in the environment, but it can also be an effect of industrial contamination.

HCR Update from Mark Sanna: Something unusual happened just before Congress left for its summer break. The House Energy and Commerce Committee voted 51-0 for a bill that would overhaul the way Medicare pays doctors. The bill would, among other things, repeal something called the sustainable growth rate formula, or SGR, and eventually replace it with a system that would pay doctors based on how healthy they keep their patients.

HCR Update from Mark Sanna: The number of physicians accepting new Medicare patients rose by 1/3 between 2007 and 2011 and is now higher than the number of physicians accepting new private insurance patients, according to a Department of Health and Human Services report. In 2007, about 925,000 doctors billed Medicare for their services. In 2011, that number had risen to 1.25 million, according to the report.

HCR Update from Mark Sanna: The National Football League has agreed to pay $765 million to settle a lawsuit brought by more than 4,500 players and their families, largely closing the legal front in the league’s battle against accusations that it concealed what it knew about the dangers of repeated hits to the head. The settlement, announced Thursday, will be seen as a victory for the league, which has nearly $10 billion in annual revenue and faced the possibility of billions of dollars in liability payments and a discovery phase that could have proved damaging if the case had moved forward.

HCR Update from Mark Sanna: The percentage of newborn boys who are circumcised in the United States declined to 58.3% in 2010 from 64.5% in 1979, according to a new from the National Center for Health Statistics. The report is based on annual surveys of about 450 hospitals nationwide. There are regional variations as well. In 2010, about 71% of babies in the Midwest were circumcised, 66.3% in the Northeast, 58.4% in the South, and 40.2% in the West.

HCR Update from Mark Sanna: As the clock ticks down to the launch of President Barack Obama's healthcare reform, hundreds of businesses, unions and advocacy groups are still pushing to win concessions on the far-reaching law. Restaurants want to increase the number of hours that define a full-time worker. Unionized electrical workers are seeking to change the treatment of health plans offered by multiple employers.

HCR Update from Mark Sanna: Joint pain and swelling in postmenopausal women is common, and some studies have suggested that low vitamin D and calcium levels may be one cause. But a randomized clinical trial found that vitamin D and calcium supplements are no better than a placebo for relieving joint problems. The analysis is posted online in The Journal of the Academy of Nutrition and Dietetics.

HCR Update from Mark Sanna: Nationwide, roughly 1/3 of all visits to emergency rooms for injuries are alcohol related. Now a new study suggests that certain beverages may be more likely to be involved than others. The study, carried out over the course of a year at the Johns Hopkins Hospital in Baltimore, found that five beer brands were consumed most often by people who ended up in the emergency room. They were Budweiser, Steel Reserve, Colt 45, Bud Ice and Bud Light.

HCR Update from Mark Sanna: Over the past two decades, the use of antidepressants has skyrocketed. One in 10 Americans now takes an antidepressant medication; among women in their 40s and 50s, the figure is one in four. The study, published in the journal Psychotherapy and Psychosomatics, found that nearly two-thirds of a sample of more than 5,000 patients who had been given a diagnosis of depression within the previous 12 months did not meet the criteria for major depressive episode as described by the psychiatrists’ bible, the Diagnostic and Statistical Manual of Mental Disorders.

HCR Update from Mark Sanna: With the new health law's enrollment period set to open in just a little more than six weeks, President Barack Obama's administration announced $67 million in awards Thursday to organizations that will help people understand their new insurance opportunities and get signed up. Health and Human Services Secretary Kathleen Sebelius announced the Navigator grant awards to 105 groups in states where the federal government will run online insurance marketplaces. Sebelius said consumers are "hungry for information".

HCR Update from Mark Sanna: In an effort to address what many predict will be increased Affordable Care Act-related costs, employers that sponsor their own health insurance plans will shift costs to employees and expand wellness and value-based health care initiatives. According to a new survey by the International Foundation of Employee Benefits, 53% of employers are shifting costs and 36% are boosting wellness and value-based health care initiatives.

HCR Update from Mark Sanna: People can only handle so much complexity. And few things in life seem more complex than the American health-care system. How complex? A new paper suggests that even those who have health insurance have a poor understanding of their coverage. Researchers commissioned two surveys of covered Americans and found that only 14% could explain all four key health insurance concepts: deductible, copay, coinsurance and out-of-pocket maximum. Only 11%, given all the necessary information, could calculate the cost of a four-day hospital stay to within $1,000.

HCR Update from Mark Sanna: Researchers studying two seemingly unrelated conditions — autism and cancer — have unexpectedly converged on a surprising discovery. Some people with autism have mutated cancer or tumor genes that apparently caused their brain disorder. 10% of children with mutations in a gene called PTEN, which causes cancers of the breast, colon, thyroid and other organs, have autism. So do about half of children with gene mutations that can lead to some kinds of brain and kidney cancer and large tumors in several organs, including the brain. That is many times the rate of autism in the general population.

HCR Update from Mark Sanna: While many residents in New York and California may see sizable decreases in their premiums, Americans in many places could face significant increases if they buy insurance through state-based exchanges next year. That's because these people live in states where insurers were allowed to sell bare-bones plans and exclude the sick, which has kept costs down. Under Obamacare, insurers must offer a package of essential benefits -- including maternity, mental health and medications -- and must cover all who apply. But more comprehensive coverage may lead to more expensive insurance plans.

HCR Update from Mark Sanna: A study that analyzed articles published in just one prominent medical journal over a period of 10 years has found that newly established medical practices — even ones in wide use — are often reversed by subsequent evidence-based research. The finding, which was published online this month in the journal Mayo Clinic Proceedings, belies the common assumption that the very latest screening technology, medication or surgical technique is an improvement on care.

HCR Update from Mark Sanna: The biggest overhaul of the U.S. health-care system in 50 years has spawned one of the most complex computer projects in the government's history. Dubbed the Hub, the $267 million computer system built by a unit of UnitedHealth Group Inc. is one of the most important determiners of whether the Affordable Care Act succeeds. The hub ties together the databases of seven U.S. agencies, ranging from the Internal Revenue Service to the Peace Corps, to determine which Americans can buy medical coverage and get U.S. subsidies through the new government-run insurance exchanges.

HCR Update from Mark Sanna: It will make you stronger. It will give you peace of mind and make you feel like a winner. Health insurance is what the country is talking about, so don't be left out. Sound like a sales pitch? Get ready for more. As President Obama's health care law moves from theory to reality in coming months, its success may hinge on whether the best minds in advertising can reach one of the hardest-to-find parts of the population: people without health coverage.

HCR Update from Mark Sanna: A Texas Republican is seeking to change the new Medicare reimbursement system that has different payment categories for a turkey bite and a turkey peck. An international coding system, ICD10, which medical professionals must adopt by October of next year, has at least nine reimbursement codes for treating "turkey contact" injuries.

HCR Update from Mark Sanna: Individuals buying health insurance on their own will see their premiums tumble next year in New York State as changes under the federal health care law take effect, state officials are to announce on Wednesday. State insurance regulators say they have approved rates for 2014 that are at least 50% lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.

HCR Update from Mark Sanna:

HCR Update from Mark Sanna: In an effort to put President Obama’s health care program back on track, the White House has recruited Chris Jennings, a respected veteran of the Clinton administration, to join the Obama team as a health policy coordinator and strategist, the White House said on Sunday night.

HCR Update from Mark Sanna:

HCR Update from Mark Sanna: Racing to meet an October deadline, Obama administration officials said Thursday that they had awarded a contract worth as much as $1.2 billion to a British company, Serco, to help them sift applications for health insurance and tax credits under the new health care law. Serco will help the Obama administration and states determine who is eligible for insurance subsidies, in the form of tax credits, and who might qualify for Medicaid.

HCR Update from Mark Sanna:

HCR Update from Mark Sanna: In a significant setback for President Obama’s signature domestic initiative, the administration on Tuesday abruptly announced a one-year delay, until 2015, in his health care law’s mandate that larger employers provide coverage for their workers or pay penalties. The decision postpones the effective date beyond next year’s midterm elections.

HCR Update from Mark Sanna:

HCR Update from Mark Sanna: The Medicare system may never collect more than $543 million in overpayments made in 2010, a federal inspector general's report released Tuesday shows, because Medicare entered only a summary of each bill in its new system. The new accounting system for the Center for Medicare Services (CMS) and systems used by Medicare contractors did not extract data automatically, the report said, so information about providers and contractors was lost.

HCR Update from Mark Sanna:

The Obama administration issued final rules Friday governing contraception coverage in the sweeping 2010 health care law. Nonprofit religious organizations will not have to contract, arrange, pay for or refer contraceptive coverage if they object on religious grounds, but that coverage would be provided separately to women enrolled in their health plans at no cost. HHS received more than 400,000 comments on the proposed rules.

HCR Update from Mark Sanna:

The Obama administration issued final rules Friday governing contraception coverage in the sweeping 2010 health care law. Nonprofit religious organizations will not have to contract, arrange, pay for or refer contraceptive coverage if they object on religious grounds, but that coverage would be provided separately to women enrolled in their health plans at no cost. HHS received more than 400,000 comments on the proposed rules.

HCR Update from Mark Sanna:

The Obama administration issued final rules Friday governing contraception coverage in the sweeping 2010 health care law. Nonprofit religious organizations will not have to contract, arrange, pay for or refer contraceptive coverage if they object on religious grounds, but that coverage would be provided separately to women enrolled in their health plans at no cost. HHS received more than 400,000 comments on the proposed rules.

HCR Update from Mark Sanna: This week F4CP released its newest report, “Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care,” which highlights the role and ability of Doctors of Chiropractic to generate better patient outcomes, higher satisfaction scores and lower care costs for advanced delivery models. To download the report, visit:www.F4CP.com/accountablecareorganizations.

HCR Update from Mark Sanna: The Obama administration announced that it is establishing a Web site and a telephone call center to provide information to consumers in preparation for what the government anticipates will be a flood of people buying health insurance starting Oct. 1. The call center will be in operation 24 hours a day. The phone number is 800-318-2596. The Web site, www.healthcare.gov, provides information promoting the 2010 health care law and describing new insurance options. The Web site and call center currently have only general information about coverage.

HCR Update from Mark Sanna: According to HHS, Insurers will rebate $500 million to consumers who purchased health insurance under a provision in the new health-care law that requires companies to spend a certain portion on premiums on consumers or refund the money. About 8.5 million Americans will receive the rebates with an average rebate of about $100 per family.

This week, the American Medical Association has officially recognized obesity as a disease, a move that could induce physicians to pay more attention to the condition and spur more insurers to pay for treatments. In making the decision, delegates at the association’s annual meeting in Chicago overrode a recommendation against doing so by a committee that had studied the matter.

HCR Update from Mark Sanna: With the deadline for states to implement Affordable Care Act-mandated health insurance exchanges less than four months away, state governments will need to move fast. States are having to reevaluate their existing health insurance infrastructures to meet the act's requirements. They have already received nearly $4 billion in funding for the effort thus far and can access more dollars through 2014.

HCR Update from Mark Sanna: It is time to get ready to buy insurance. The biggest part of the health-care law—online exchanges that offer insurance to individuals—kicks in next year. And beginning this October, states will start selling those health-care plans, which adhere to a new set of standards, though online marketplaces. But there already are many ways that you can start investigating options ahead of the roll out. This summer is prime time to educate yourself about your options, say health-insurance experts.

HCR Update from Mark Sanna: It’s a life or death matter: Who gets the next scarce donated organ? In an unprecedented challenge to the nation's transplant system, this week a federal judge allowed one dying child - and a day later another - to essentially jump the transplant waiting list in rulings that could have ramifications for thousands of people awaiting new organs.

HCR Update from Mark Sanna: Teams of technology experts are racing to finish building government websites that will allow people to shop and sign up for health insurance this October. People involved in the effort say to expect some problems, at least initially. The functioning of the websites will play a major role in determining whether the Affordable Care Act is deemed a success or failure.

HCR Update from Mark Sanna: More than 70 medical, research and advocacy organizations active in 41 countries and including the National Institutes of Health announced Wednesday that they had agreed to create an organized way to share genetic and clinical information. Their aim is to put the vast and growing trove of data on genetic variations and health into databases — with the consent of the study subjects — that would be open to researchers and doctors all over the world, not just to those who created them.

HCR Update from Mark Sanna: HHS Secretary Sebelius said she only discussed funding to support the new health care law with the tax-preparation firm H&R Block and the Robert Wood Johnson Foundation, two organizations that are not regulated by HHS. HHS acknowledged seeking funds from the two entities last month and has said the secretary hasn’t asked for any money from companies or entities the HHS regulates.

HCR Update from Mark Sanna: Government officials, drug companies and medical experts, faced with outbreaks of antibiotic-resistant “superbugs,” are pushing to speed up the approval of new antibiotics, a move that is raising safety concerns among some critics. The Health and Human Services Department last month announced an agreement under which it will pay $40 million to a major drug maker, GlaxoSmithKline, to help it develop medications to combat antibiotic resistance.

HCR Update from Mark Sanna: House Republicans were so opposed to forcing people to buy health insurance that they fought Obamacare all the way to the Supreme Court. But now they may be okay with an individual mandate — if it's for illegal immigrants. Members of a House immigration group are considering a rule that would force immigrants to buy their own health insurance while they wait for citizenship.

HCR Update from Mark Sanna: While most of the attention on the Obama administration’s health care law has been on providing coverage to tens of millions of uninsured Americans by 2014, workers with employer-paid health insurance are also beginning to feel the effects. Companies hoping to avoid the "Cadillac" tax are beginning to scale back the more generous health benefits they have traditionally offered and to look harder for ways to bring down the overall cost of care.

HCR Update from Mark Sanna: The monthly cost for policies sold on California's state-run health insurance exchange came in lower than the 30% rate increases some had anticipated, though some consumers will still experience sharply higher premiums. Blue Shield of California estimated that current customers would see rate increases of about 13%.

HCR Update from Mark Sanna: More than half of doctors' offices and 80 percent of hospitals that provide Medicare or Medicaid will have electronic health records by the end of the year, the Department of Health and Human Services announced this week.

HCR Update from Mark Sanna: The Obama administration’s efforts to raise private money to carry out the president’s health care law have provoked such a strong partisan uproar that potential donors have become skittish about contributing, according to several people involved in the fund-raising program.

HCR Update from Mark Sanna: Conservative lawmakers and tea party advocates Thursday sought to link the IRS scandal to efforts to repeal Obamacare, even acknowledging the potential of impeachment. Rep. Michele Bachmann made the leap from Benghazi to the IRS scandal to Obamacare, a progression she said was all related.

HCR Update from Mark Sanna: Kathleen Sebelius, the secretary of health and human services, has solicited sizable donations from the Robert Wood Johnson Foundation and H&R Block, the tax preparation service, as part of a multimillion-dollar campaign to ensure the success of President Obama’s health care law, even as a leading Senate Republican raised questions about the legality of her efforts. The foundation is expected to contribute as much as $10 million, while H&R Block is expected to make a smaller donation of about $500,000.

HCR Update from Mark Sanna: The nation’s largest cardiovascular health organization has a new message for Americans: Owning a dog may protect you from heart disease. The unusual message was contained in a scientific statement published on Thursday by the American Heart Association, which convened a panel of experts to review years of data on the cardiovascular benefits of owning a pet. The group concluded that owning a dog, in particular, was probably associated with a reduced risk of heart disease.

HCR Update from Mark Sanna: Data being released for the first time by the government today shows that hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure, raising questions about how hospitals determine prices and why they differ so widely. The data for 3,300 hospitals, released by CMS, shows wide variations not only regionally but among hospitals in the same area or city.

HCR Update from Mark Sanna: For the third time, Republicans are trying to make the new health care law perhaps the biggest issue of the elections, and are preparing to exploit every problem that arises. After many unsuccessful efforts to repeal the law, the Republican-led House plans another vote soon. And Republican governors or legislatures in many states are balking at participating, leaving Washington responsible for the marketplaces.

HCR Update from Mark Sanna: In a study published today in the journal Pediatrics, scientists report that infants whose parents sucked on their pacifiers to clean them developed fewer allergies than children whose parents typically rinsed or boiled them. They also had lower rates of eczema, fewer signs of asthma and smaller amounts of a type of white blood cell that rises in response to allergies and other disorders.

HCR Update from Mark Sanna: The nation's largest health insurers are far from leaping at the chance to join new state health insurance exchanges under President Barack Obama's reform law, making it likely that some markets will have little or no competition next year. … But health insurers, some of whom fought the law before it was passed and continue to lobby to reverse parts of it, are wary.

HCR Update from Mark Sanna: Scientists have discovered that the most dangerous cancer of the uterine lining closely resembles the worst ovarian and breast cancers, providing the most telling evidence yet that cancer will increasingly be seen as a disease defined primarily by its genetic fingerprint rather than just by the organ where it originated. The study of endometrial cancer and another of acute myeloid leukemia were published simultaneously on Wednesday by Nature and The New England Journal of Medicine.

HCR Update from Mark Sanna: Yesterday, federal officials released simplified application forms to be used by people seeking health insurance, tax credits and other government subsidies under the law, which Mr. Obama signed 3 years ago. The new application forms — one for individuals is 3 pages long, and another for families is 7 pages — are significantly shorter than a 21-page draft that the administration circulated earlier this year. Major provisions of the law take effect next Jan. 1, when most Americans will be required to have health insurance.

HCR Update from Mark Sanna: The lack of competition in nearly a dozen states could present problems when the insurance exchanges that are part of the Affordable Care Act launch in October. The exchanges are supposed to give Americans who do not get health insurance from their employers the opportunity to choose from an array of private insurance plans. The idea is to generate competition between insurers that will lead to lower premiums. But in states with a dominant insurance carrier, competition and lower prices may not arrive for quite some time.

HCR Update from Mark Sanna: A new study published in the journal Biological Psychiatry  raises the possibility that analyzing the placenta after birth may provide clues to a child’s risk for developing autism. The study, which analyzed placentas from 217 births, found that in families at high genetic risk for having an autistic child, placentas were significantly more likely to have abnormal folds and creases.

HCR Update from Mark Sanna: Those who lost limbs in the Boston Marathon bombings now need care to learn to navigate the world in a new way and navigate a thorny area of health care coverage, too. In the case of the Boston bombings, pledges and offers of support have poured in to help with the health care costs of the 14 people who lost all or part of a limb. But for some amputees, covering the staggering cost for prosthetics care could be a struggle. Even those with health insurance may find that their plan places limits on specific services, like physical therapy or psychological counseling.

HCR Update from Mark Sanna: Law enforcement agencies are reporting an increase in these sorts of health insurance scams across the country. Many of the fraudsters seem to be preying on the public's confusion over the massive changes taking place in the nation's health care system.

HCR Update from Mark Sanna: This week, Senate Finance Committee Chairman Max Baucus accused the Obama administration of failing to educate Americans about the health care reform law, a situation he said could lead to "a huge train wreck" and disrupt its implementation. He said, "The administration's public information campaign on the benefits of the Affordable Care Act, I think, deserves a failing grade."

HCR Update from Mark Sanna: A study, which was published Tuesday in The Journal of the American Medical Association, found that hospitals earned 330% higher profit margins on surgeries with one or more complications, because private insurers pay them for longer stays and extra care.

HCR Update from Mark Sanna: For decades, pharmaceutical companies have deployed an array of tactics aimed at preventing low-cost copies of their drugs from entering the marketplace. The new approach is almost elegant in its simplicity: brand-name drug makers are refusing to sell their products to generic companies, which need to analyze them so they can create the copycat versions. Traditionally, the generic drug makers purchased samples from wholesalers. But because of safety concerns, an increasing number of drugs are sold with restrictions on who can buy them, forcing the generic manufacturers to ask the brand-name companies for samples. When they do, the brand-name firms say no.

HCR Update from Mark Sanna: President Barack Obama today released a proposed $3.8 trillion budget for fiscal 2014 that would shrink the federal deficit by $1.8 trillion over the course of 10 years, but not on the backs of physicians. Instead, they are on the receiving end of some federal largesse. For starters, Obama's deficit reduction would replace the automatic, across-the-board cuts called sequestration that include a 2% decrease in Medicare reimbursement for physicians.

HCR Update from Mark Sanna: Some members of the Medicare Payment Advisory Commission suggested Medicare take stronger steps to recognize and reward the work of advanced practice registered nurses (APRNs) and physician assistants (PAs). If a particular state allows an APRN to operate independently of a physician, Medicare will pay the APRN 85% of what a doctor would receive for providing that service. But if the APRN must work under a physician, that doctor receives 100% of the payment for that service -- at the regular physician fee schedule rate -- even if the doctor didn't provide it.

HCR Update from Mark Sanna: Previews of President Barack Obama's budget proposal, which is expected to be released next week, indicate that he will signal a willingness to compromise with Republicans by including trims to Medicare. The blueprint, though, reportedly will not make major dents in Medicaid.

HCR Update from Mark Sanna: The most rigorous study to date of how much it costs to care for Americans with dementia found that the financial burden is at least as high as that of heart disease or cancer, and is probably higher. And both the costs and the number of people with dementia will more than double within 30 years, skyrocketing at a rate that rarely occurs with a chronic disease. The research, by the RAND Corporation was published Wednesday in The New England Journal of Medicine.

HCR Update from Mark Sanna: Unable to meet tight deadlines in the new health care law, the Obama administration is delaying parts of a program intended to provide affordable health insurance to small businesses and their employees. The law calls for a new insurance marketplace specifically for small businesses, starting next year. But in most states, employers will not be able to get what Congress intended: the option to provide workers with a choice of health plans. They will instead be limited to a single plan.

HCR Update from Mark Sanna: Nearly one in five high school age boys in the United States and 11% of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention. These rates reflect a marked rise over the last decade and could fuel growing concern among many doctors that the A.D.H.D. diagnosis and its medication are overused in American children.

HCR Update from Mark Sanna: The National Survey on Drug Use and Health reported this week that in 2011 that 6.3 percent of adults between the ages of 50 and 59 used marijuana. That number has risen from 2.7 percent in 2002. And anecdotal evidence points to much of this use being sociable rather than medical.

HCR Update from Mark Sanna: After months of waiting, the federal Department of Health and Human Services Office of Civil Rights posted the final rules regarding many of the provisions created in the HITECH Act of 2009. Two primary provisions of HITECH include the expansion of HIPAA compliance to business associates (BAs) and subcontractors of BAs, as well as the Notice of Breach rules. The final rules were published in the Jan. 25, 2013 Federal Register and compliance with the new documentation and contract requirements begins March 26. After that date, HIPAA-related documents or contracts that are modified or renewed should incorporate the new provisions. However, all HIPAA-related documents and contracts, regardless of renewal or modification, must be in compliance with the new rules no later than Sept. 22, 2014. Breakthrough Coaching Members and their practice teams should view AVM 518E and download the associated documents as soon as possible.

HCR Update from Mark Sanna: It was another turbulent week for President Obama’s health care law. Congress rejected a White House request for nearly $1 billion to carry out the law, even as federal responsibilities increased to include the supervision of insurance markets in more than half the states. Then, on Friday, Republican attacks on the law continued in the Senate, where Democrats beat back Republican proposals to repeal the law and many of its tax increases.

HCR Update from Mark Sanna: According to an assessment of health care experts at Deloitte, doctors say they are finding more opportunities in the integrated health systems that have been touted in the federal health law, such as accountable care organizations, which are groups of health providers and hospitals that work together to improve patient care and lower costs. But they are still hesitant to change their practices without more evidence that these systems will work.

HCR Update from Mark Sanna: The health system is girding for millions of new patients under Obamacare, and experts are worried that an already-strained primary care system could buckle unless other health care professionals are marshaled to perform primary care. "We need to get away from the old system of fragmented care and really work on team-based care," said Wanda Filer, director of the American Academy of Family Physicians, at a POLITICO Pro Breakfast Briefing on Tuesday morning.

HCR Update from Mark Sanna: Employers are bracing for a little-noticed fee in the federal health care law that will charge them $63 for each person they insure next year, one of the clearest cost increases companies face when the law takes full effect. Companies and other plan providers will together pay $25 billion over three years to create a fund for insurance companies to offset the cost of covering people with high medical bills.

HCR Update from Mark Sanna: Although Medicare spending for patients with advance cancers varies regionally, a new study suggests that those differences are not related to survival rates. The study, published Tuesday in the Journal of the National Cancer Institute reported that “Increased spending is associated with more frequent and longer hospital visits, more intensive care, and decreased rates of hospice use.” The researchers recommended “that incentives be used to encourage doctors to reduce hospitalizations and make better use of palliative care for patients.”

HCR Update from Mark Sanna: A judge struck down New York’s limits on large sugary drinks on Monday, one day before they were to take effect, in a significant blow to one of the most ambitious and divisive initiatives of Mayor Michael R. Bloomberg’s tenure.

HCR Update from Mark Sanna: Four states won conditional approval from the Obama administration last week to implement the key piece of President Obama's healthcare law in partnership with the federal government. The Health and Human Services Department conditionally approved insurance exchanges in Iowa, Michigan, New Hampshire and West Virginia.

HCR Update from Mark Sanna: The GOP-controlled House of Representatives on Wednesday passed legislation to fund the government through Sept. 30.  The measure keeps “sequestration” — the $85 billion in automatic budget cuts that began March 1 – in place. The bill would fund the government beyond March 27 when the current “continuing resolution” expires. This measure will delay implementation of the health law’s exchanges scheduled to begin enrolling individuals in October.

HCR Update from Mark Sanna: Hundreds of activists and uninsured Texans plan to rally at the steps of the Capitol here Tuesday, increasing the pressure on Gov. Rick Perry and other Republican leaders to switch their stance on expanding Medicaid, a major provision of President Obama’s health care overhaul.

HCR Update from Mark Sanna: The Obama administration says it will require health insurance companies to report all price increases, no matter how small, to the federal government so officials can monitor the impact of the new health care law and insurers’ compliance with it.

HCR Update from Mark Sanna: The sequester is likely to go into effect shortly before midnight tonight. Conventional wisdom in Washington suggests that the cuts will be replaced by March 27 when a continuing resolution for funding of the government expires. The immediate concern to doctors of chiropractic, as well as all Medicare providers, is that reimbursement will be cut 2%. However, as of now, that will not go into effect until April. A deal between now and then may avert these cuts.

HCR Update from Mark Sanna: Unless a Congressional miracle occurs, Medicare reimbursement for physicians will decrease by 2% as $85 billion worth of automatic, across-the-board budget cuts called sequestration take effect on March 1 for the current fiscal year. Organized medicine is complaining not only about reduced pay, which could push struggling medical practices further into a hole.

HCR Update from Mark Sanna: Gov. Chris Christie, one of the most strident Republican critics of President Obama’s health care overhaul, announced on Tuesday that he would accept federal money to expand the Medicaid program in New Jersey. Mr. Christie emphasized that it was a financial decision, not a philosophical shift; if New Jersey did not take the money, he said, the federal government would give it to other states.

HCR Update from Mark Sanna: About 30% of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study has found. The findings were published on The New England Journal of Medicine’s Web site on Monday.

HCR Update from Mark Sanna: The House Ways and Means Health Subcommittee’s Tuesday hearing will focus on Medicare’s traditional fee-for-service program “and consider ideas to update and improve the benefit structure to better meet the needs of current and future beneficiaries,” according to a news release. Subcommittee chairman Kevin Brady, R-Texas, said the hearing would help the panel “investigate the limitations, inefficiencies and inadequacies of traditional Medicare’s cost-sharing structure and identify ways to bring the Medicare program in to the 21st Century.”

HCR Update from Mark Sanna: Under pressure from the health care industry and consumer advocates, 7 Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans. These states include Florida, Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio.

HCR Update from Mark Sanna: Health-insurance plans that cover tens of millions of Americans will have to pay for mental-health and substance-abuse treatments starting next year under federal rules the Obama administration finalized yesterday.

HCR Update from Mark Sanna: It's official. The Obama administration will be running new health insurance marketplaces in half the states— including the major population centers of Texas, Florida and Pennsylvania. The federal government had hoped more states this week would agree to form a partnership exchange—the deadline to apply was Friday—but the offer was largely rebuffed.

HCR Update from Mark Sanna: Friday was the final day for States to decide whether they will create their own health insurance exchanges, partner with the federal government partner with the federal government or allow the federal government to do it for them.

HCR Update from Mark Sanna: An Obama administration official told Congress on Thursday that the government would be ready to enroll millions of people in private health insurance plans this fall, but senators of both parties expressed doubts.

HCR Update from Mark Sanna: One of the nation’s largest nurses’ unions — the National Federation of Nurses — plans to announce on Thursday that it will affiliate with the far larger American Federation of Teachers. Barbara Crane, the president of the nurses’ federation, said her group’s national board voted to join forces with the teachers’ union to give the nurses more political clout and money to try to unionize more nurses.

HCR Update from Mark Sanna: A sharp and surprisingly persistent slowdown in the growth of health care costs is helping to narrow the federal deficit, leaving budget experts trying to figure out whether the trend will last and how much the slower growth could help alleviate the country’s long-term fiscal problems. In figures released last week, the Congressional Budget Office said it had erased hundreds of billions of dollars in projected spending on Medicare and Medicaid.

HCR Update from Mark Sanna: Efforts to curb rising healthcare costs will cause the use of telehealth technology to spike, a new analysis predicted. IMS Research, which studies the electronics industry, forecast a nearly sixfold rise in the number of telehealth patients over the next five years. About 1.3 million U.S. patients will use communications technology to interact with doctors by 2017.

HCR Update from Mark Sanna: The Obama administration has delayed by one year the rollout of a health program aimed at low to moderate-income people who won’t qualify for the expanded Medicaid program under the federal health law. Under the so-called Basic Health Program, some states had planned to offer government insurance to people who don’t qualify for Medicaid, but who would be hard pressed — even with federal subsidies — to afford the premiums and cost-sharing of plans offered in the new insurance marketplaces. 

HCR Update from Mark Sanna: Signing up an estimated 30 million uninsured Americans for coverage under the health care law is shaping up to be, if not a bureaucratic nightmare, at the very least a daunting task. While some people will find registering for health insurance as easy as booking a flight online, vast numbers who are confused by the myriad choices will need to sit down with someone who can walk them through the process.

HCR Update from Mark Sanna: On Friday, CMS released the final 'Sunshine Act' Rule that will expose financial relationships drug and device makers have with doctors. The rules apply to all drugs and devices paid for by the federal government's major health care programs. All cash and in-kind gifts given to doctors for research, speaking fees, meals and travel are required to be disclosed. Likewise, doctors' investments in companies must also be revealed.

HCR Update from Mark Sanna: A health insurance industry report to be released today highlights the exorbitant fees charged by some doctors to out-of-network patients. The report, by America’s Health Insurance Plans contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates.

HCR Update from Mark Sanna: In a flood of lawsuits, Roman Catholics, evangelicals and Mennonites are challenging a provision in the new health care law that requires employers to cover birth control in employee health plans — a high-stakes clash between religious freedom and health care access that appears headed to the Supreme Court.

HCR Update from Mark Sanna: In a unanimous, decision the U.S. Supreme Court on Tuesday dismissed hospitals' and health systems' hopes of recouping millions in Medicare underpayments made between 1987 and 1994. Providers had asked the high court to give them the same extra time to find underpayments in Medicare reimbursement that the government gave its outside contractors to find overpayments.

HCR Update from Mark Sanna: President Obama began his second term with an unapologetically liberal inaugural address, calling on Americans to work together to preserve entitlements, address climate change and extend civil rights. ... "The commitments we make to each other — through Medicare, and Medicaid, and Social Security — these things do not sap our initiative; they strengthen us," the president said.

HCR Update from Mark Sanna: Today the White House said it will give states more time to comply with the new health care law after finding that many states lag in setting up markets where millions of Americans are expected to buy subsidized private health insurance. HHS and the White House will waive or extend the deadline for any states that expressed interest in creating their own exchanges or regulating insurance sold through a federal exchange.

HCR Update from Mark Sanna: Can't get enough of Obamacare's individual mandate? Here's the catch: The individual mandate penalties will be pretty weak as they are phased in over two years — only $95 when they start in 2014, much less than it costs to buy insurance. And yet, everyone with pre-existing conditions will have to be accepted for coverage right away.

HCR Update from Mark Sanna: This week, HHS approved 106 new Accountable Care Organizations (ACOs) under the new Health Law. Among those that gained approval is the South Florida ACO, which has an integrated care model that includes 75 doctors and the Walgreens drug store chain.

HCR Update from Mark Sanna: Deaths before age 50 accounted for about two-thirds of the difference in life expectancy between males in the United States and their counterparts in 16 other developed countries, and about one-third of the difference for females. The countries in the analysis included Canada, Japan, Australia, France, Germany and Spain. Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50. 

HCR Update from Mark Sanna: National health spending climbed to $2.7 trillion in 2011, or an average of $8,700 for every person in the country, the lowest annual rates recorded in the 52 years the government has been collecting such data.

HCR Update from Mark Sanna: Today the American Medical Student Association and the National Physicians Alliance urged the Obama Administration to issue past-due regulations for a database of payments made by pharmaceutical companies and device makers to physicians. The Affordable Care Act requires drug, medical device, biologic, and medical equipment manufacturers to collect data on financial relationships with doctors and hospitals, and to report that data to CMS.

HCR Update from Mark Sanna: Health Insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers. Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

HCR Update from Mark Sanna: A group of doctors who performed unusually high rates of heart procedures on patients at the EMH Regional Medical Center in Ohio settled with the Justice Department this week over accusations that they had billed Medicare for unnecessary medical care from 2001 to 2006. The hospital agreed to pay $3.9 million to settle the accusation.

HCR Update from Mark Sanna: This week the Feds approved 8 State Health Insurance Exchanges. The newly approved states that will run their own exchanges are California, Hawaii, Idaho, Nevada, New Mexico, Vermont and Utah. Arkansas will partner with the federal government for its exchange. Although states with Republican governors have fought the law, such as Texas, four of them - Idaho, Nevada, New Mexico and Utah - have created the exchanges.

HCR Update from Mark Sanna: The fiscal cliff legislation expected to be signed by the president today, contains a one-year delay in a scheduled 27% cut in reimbursement for Medicare providers, including doctors of chiropractic.

HCR Update from Mark Sanna: In a long-awaited interpretation of the new health care law, the Obama administration announced this week that employers must offer health insurance to employees and their children (50 or more employees) but will not be subject to any penalties if family coverage is unaffordable to workers.