Policy & Practice


Women Bear HIV/AIDS Burden

Women and girls are being infected with HIV/AIDS at an alarming rate, according to Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. In the United States, the proportion of AIDS cases among women aged 13 years and older has increased from 7% in 1985 to 27% in 2005, Dr. Fauci said in a statement last month to highlight National Women and Girls HIV/AIDS Awareness Day. Worldwide, women and girls now make up nearly half of the 39.5 million people who are living with HIV/AIDS. “The imperative to bolster our collective commitment to fighting HIV/AIDS among women and girls has never been stronger,” Dr. Fauci said. Researchers have found that women are affected by HIV/AIDS differently from the way men are and have a higher incidence of drug toxicity when taking antiretroviral therapy. In an effort to better understand and address these differences, NIH is supporting the Women's Interagency HIV Study, which aims to shed light on the course of HIV/AIDS in women.

Women Face Sleep Problems

About two-thirds of women report experiencing some type of sleep problem a few nights a week, according to a survey released by the National Sleep Foundation. The sleep problems include waking up unrefreshed, waking frequently during the night, difficulty falling asleep, and waking too early and being unable to return to sleep. About 42% of women surveyed reported signs of snoring, restless legs syndrome, or sleep apnea at least a few nights a week, with 28% saying they experienced one of these problems every night or almost every night. Older women reported more signs of sleep problems. For example, 36% of women aged 25–34 years reported signs of a sleep problem at least a few nights a week, compared with 44% of women aged 35–44 years and 48% of women aged 55–64 years. The random telephone survey included more than 1,000 women aged 18–64 years.

Pregnancy Discrimination Case

A federal judge has upped the stakes for an Illinois-based HMO that was found guilty of health care fraud for discriminating against pregnant women. The judge raised the $144 million verdict to $334 million, calling the company's conduct “egregious and calculated.” The lawsuit against Amerigroup Illinois and its parent company, Amerigroup Corporation, alleged that the insurer was paid $243 million to establish a Medicaid managed care health plan in Illinois aimed at providing insurance coverage, including prenatal care, to low-income residents. The jury concluded that Amerigroup avoided enrolling pregnant women and others with expensive health conditions while at the same time accepting state and federal money. The company plans to appeal the ruling.

FDA Women's Health Office Funded

Officials at the Food and Drug Administration plan to provide the full $4 million allocated by Congress to fund the Office of Women's Health in fiscal year 2007. In February, news reports circulated that the FDA commissioner intended to cut funding for the office by about 25% and use the money for other projects at the agency. That idea was met with swift criticism by members of Congress and women's health advocates, who said such a slash in funding would essentially shut down the Office of Women's Health for the rest of the year. With the announcement that FDA will retain full funding for the office, many of those critics applauded the agency's change in course. “The FDA has done the right thing for women's health,” Sen. Patty Murray (D-Wash.), Sen. Hillary Rodham Clinton (D-N.Y.), Sen. Barbara Mikulski (D-Md.), and Sen. Olympia Snowe (R-Maine) said in a statement. “By responding to our call and heeding Congress' clear intentions, the Office of Women's Health will have the funding needed to continue the leadership role it has served for 16 years in improving the health and well-being of women across the United States.”

New Imaging-Cut Moratorium

Several members of Congress have introduced legislation to put a 2-year moratorium on cuts to Medicare payments for medical imaging that started this year. The bill also requires a Government Accountability Office study of patient access to imaging. The bill—H.R. 1293—was introduced by Rep. Carolyn McCarthy (D-N.Y.), Rep. Gene Green (D-Tex.), and Rep. Joseph Pitts (R-Pa.) and had 49 cosponsors at press time. Rep. Pitts sponsored similar legislation in the last Congress; the cuts were mandated as part of the Deficit Reduction Act (DRA) of 2005. A Senate companion bill is expected soon. Under the DRA, payments for the technical component of an imaging service are to be set at the hospital outpatient department rate, if the payment under the Medicare physician fee schedule is higher.

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