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Miami-Dade, Blue Cross Announce Low-Cost PPO Aimed At County's Uninsured
Florida"s Miami-Dade County and BlueCross BlueShield of Florida on Tuesday announced a new low-cost health plan, called Miami-Dade Blue, aimed at helping the estimated 600,000 uninsured county residents, the Miami Herald reports. The plan -- which costs taxpayers nothing -- is a traditional PPO, with no pre-approvals or referrals and will cost a healthy 35-year-old male about $100 per month. Miami-Dade Blue has a $250 deductible and will cover 90% of in-network hospital costs and 100% of fees for in-network lab tests after the deductible is met. The copayment for generic drugs is $10 per prescription; the plan will not offer coverage for brand-name prescriptions.The plan is being offered to individuals younger than age 65 and to small employers with up to 50 workers. Businesses will be guaranteed coverage if 70% of employees take part in the plan and the owner pays at least 50% of the premiums; however, individuals with costly pre-existing health conditions likely will be denied coverage. The plan has an annual out-of-pocket limit of $2,500 and a lifetime benefit of $5 million. About 1,500 physicians agreed to be part of the Miami-Dade Blue network, while 20 clinics and seven hospitals are in the plan"s network (Dorschner, Miami Herald, 5/27).

All Fifty States To Screen Newborns For Cystic Fibrosis By 2010
The Cystic Fibrosis Foundation announced today that all 50 states, plus the District of Columbia, have passed legislation requiring that all newborns be screened for cystic fibrosis (CF) by the year 2010.
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FDA Approves Colchicine For Acute Gout, Mediterranean Fever
The U.S. Food and Drug Administration has approved Colcrys to treat acute flairs in patients with gout, a recurrent and painful form of arthritis, and patients with familial Mediterranean fever (FMF), an inherited inflammatory disorder. The medication"s active ingredient is colchicine, a complex compound derived from the dried seeds of a plant known as the autumn crocus or meadow saffron (Colchicum autumnale).
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Chalenges Faced By HIV Patients Living Longer Lives Due To New Therapies

New HIV therapies have prolonged lives and improved health for patients with HIV, but the treatments have also brought the longer-term effects of the disease into sharper focus. Patients with HIV are not only about twice as likely to smoke as HIV-negative individuals, they are also more susceptible to the detrimental effects of smoking and tend to suffer a swifter decline in lung function, according to new research. Syed Kadri, medical student at Ohio State University Medical Center presented new research documenting this decline among HIV-positive individuals on May 17, at the 105th International Conference of the American Thoracic Society in San Diego. "Early in the epidemic, HIV was a different disease - with few effective drugs, the best that an HIV- positive patient could hope for was a relatively painless death after a brief period," said Mr. Kadri. "The long-term effects of HIV were therefore fairly obvious: death. But with the advent of a new class of anti-retroviral drugs called "highly active anti-retroviral therapy," or HAART, the clinical picture of HIV has changed. The disease has gone from being an automatic death sentence to a chronic condition, and like all chronic conditions, it brings with it other complications that can seriously affect the lives of those who have it." Mr. Kadri and colleagues are directing a prospective study to evaluate declines in lung function among HIV-positive patients. The patients, mostly men in their 40s, half of whom were smokers, were assessed at baseline for two measures of respiratory status, FEV1 and DLCO, and had been followed for two years at the time of reporting. FEV1 is a measure of expiratory flow in one second, a standard gauge of lung capacity, whereas DLCO is a measurement of diffusing capacity of the lungs and is decreased in patients with emphysema. At the end of two years, the 63 patients displayed marked declines in lung function, going from an average FEV1 of 88% predicted to 83.2% and a DLCO of 77.6 to 70.0. "This is the type of decline you might expect to see in elderly individuals who have a long history of smoking," said Mr. Kadri. "These results indicate that HIV-positive patients are more susceptible to lung-related problems than HIV-negative individuals and that HIV-positive smokers are even more susceptible to developing early emphysema. We don"t know when these differences begin to manifest in HIV-positive individuals who smoke, but the severity is likely a function of the time that they have lived with the disease." The researchers have begun a new leg of the study, to analyze the effects of smoking cessation in the same cohort as those in the current study. "We hope this next phase will show us whether lung function improves with smoking cessation in HIV-positive individuals and what factors are associated with successful cessation," said Mr. Kadri. "Clinically, this study shows that HIV patients need to quit smoking, which could be a difficult task given their higher prevalence of smoking. Physicians treating patients with HIV should be aware that they are at much higher risk for emphysema, and counsel them more about smoking cessation." Keely Savoie American Thoracic Society


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