Rep. Dingell Promises To Pass Bill Blocking New Medicaid Rules; Senate Introduces Similar Bill
Rep. John Dingell ( D-Mich. ) , chair of House Energy and Commerce Committee, on Thursday promised to pass a measure ( HR 5613 ) aimed at blocking seven new Medicaid regulations that would reduce health care coverage for pregnant women, low-income children, nursing home residents and other groups during a health subcommittee hearing, CQ Today reports. In addition, a bipartisan group of senators introduced legislation ( S 2819 ) on Thursday that aims to block new rules, first of which took effect March 3.
According to CQ Today , seven rule changes at issue aim to restrict the services covered by some states' case management plans; limit Medicaid reimbursement to public hospitals; narrow federal Medicaid reimbursement eligibility for outpatient hospital services; bar federal reimbursement for transportation to school and school-based care for Medicaid-eligible children; restrict the types of " rehabilitative " services covered by federal funding; cut federal Medicaid reimbursement for students at teaching hospitals; and limit taxes some states charge health providers. The Congressional Budget Office has estimated the new rules would save Medicaid programs $17. 8 billion over five years.
Dingell's bill would postpone the rule changes until April 2009. The measure would cost about $1. 65 billion, taking into account savings from regulations, according to CBO estimates. Dingell aides said the cost would be balanced with a cost-cutting measure that would require electronic verification of people who apply for Medicaid. Dingell on Thursday urged Rep. Frank Pallone ( D-N. J. ) , chair of Energy and Commerce Committee's Subcommittee on Health, to approve bill in subcommittee. An unnamed Pallone spokesperson said the subcommittee has planned a mark up of bill " in the coming weeks. '
The Senate bill -- co-sponsored by Sens. Edward Kennedy ( D-Mass. ) , John Rockefeller ( D-W. Va. ) and Olympia Snowe ( R-Maine ) -- would postpone seven regulations covered in Dingell's bill, as well as two separate new rules regarding HHS and SCHIP. In addition, Senate bill would provide states with $12 billion in emergency aid for budget shortfalls, with $6 billion earmarked for Medicaid programs.
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Dingell said the new rules " go beyond any justifiable point to curb any abuses in system and instead would shift costs to states and prohibit federal support for legitimate expenditures " for Medicaid beneficiaries. Barbara Coulter Edwards, interim director of the National Association of State Medicaid Directors, said the rules " appear to have unintended consequences on good programs and will limit legitimate services to vulnerable people. '
The Bush administration and other Republicans have said that the regulations are reasonable and that they would not affect " medically necessary " health care for Medicaid beneficiaries, CQ Today reports. Dennis Smith, Medicaid director at CMS, said Dingell's measure would hinder efforts to monitor waste and abuse of Medicaid services. Smith said Bush administration " strongly opposes " measure ( Wayne, CQ Today , 4/3 ) . Reprinted with kind permission from http: //www. nationalpartnership. org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company. 2007 The Advisory Board Company. All rights reserved.
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Fluoxetine benefits. Fluoxetine: uses Fluoxetine is a selective serotonin reuptake inhibitor ( SSRI ) used to treat depression, anxiety disorders ( panic attacks ) , obsessive-compulsive disorder ( OCD ) , a certain eating disorder ( bulimia ) , and a severe form of premenstrual syndrome ( premenstrual dysphoric disorder ) .
SSRIs work by helping to restore balance of certain natural substances in the brain ( neurotransmitters such as serotonin ) . Fluoxetine may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease anxiety/unreasonable fears, persistent/troubling thoughts ( obsessions ) , and unwanted urges that keep returning ( compulsions ) . It may decrease number and severity of panic attacks. Fluoxetine may lessen premenstrual symptoms such as irritability, increased appetite, and depression. It may decrease bingeing and purging behaviors in bulimia. Fluoxetine: how to use Read the Medication Guide provided by your pharmacist before we start using Fluoxetine and each time we get a refill. If we have any questions, consult your doctor or pharmacist.
Take Fluoxetine by mouth with or without food, usually once daily or as directed by your doctor. Fluoxetine may make you either sleepy or wakeful. Therefore, depending on how Fluoxetine affects you, your doctor may direct you to take entire dose once daily in either the morning or evening. If you are taking Fluoxetine twice a day, your doctor may direct we to take it in morning and at noon.
If you are taking Fluoxetine for premenstrual problems, your doctor may direct you to take it every day of month or just for 2 weeks before your period through first full day of your period. To help you remember, mark your calendar.
If we are using liquid form of Fluoxetine, measure the dose carefully using a special measuring device/spoon. Don't use a household spoon because we mayn't get the correct dose.
The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may start we at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Don't take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Use Fluoxetine regularly in order to get most benefit from it. To help we remember, use it at the same time ( s ) each day.
It's important to continue taking Fluoxetine as prescribed even if we feel well. Don't stop taking Fluoxetine without first consulting your doctor. Some conditions may become worse when drug is abruptly stopped. Your dose may need to be gradually decreased.
We should see some improvement in 1 to 2 weeks. It may take several weeks before you feel full benefit.
Tell your doctor if your condition doesn't improve or if it worsens. Fluoxetine: other used This section contains uses of Fluoxetine that aren't listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use Fluoxetine for a condition that's listed in this section only if it has been so prescribed by your health care professional.
Fluoxetine is also used to treat certain other eating disorders ( anorexia nervosa ) , obesity, and certain nervous system/sleep disorders ( catalepsy, narcolepsy ) . Fluoxetine: side effects See also Warning section.
Nausea, drowsiness, dizziness, anxiety, trouble sleeping, loss of appetite, weakness, tiredness, sweating, or yawning may occur while use Fluoxetine. If any of these effects persist or worsen, tell your doctor promptly.
Remember that your doctor has prescribed Fluoxetine because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using Fluoxetine do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur:
Tell your doctor immediately if any of these rare but very serious side effects occur:
Fluoxetine may rarely cause a very serious condition called serotonin syndrome. The risk increases when Fluoxetine is used with certain other drugs such as " triptans " used to treat migraine headaches ( e. g. , sumatriptan, eletriptan ) , certain antidepressants including other SSRIs ( e. g. , citalopram, paroxetine ) and SNRIs ( e. g. , duloxetine, venlafaxine ) , lithium, tramadol, tryptophan, or a certain drug to treat obesity ( sibutramine ) . See also Drug Interactions section. Before taking Fluoxetine, tell your doctor if we take any of these medications. Serotonin syndrome may be more likely when we start or increase dose of any of these medications. Seek immediate medical attention if we develop some of following symptoms:
For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using Fluoxetine and seek immediate medical attention, or permanent problems could occur.
A very serious allergic reaction to Fluoxetine is rare. However, seek immediate medical attention if we notice any symptoms of a serious allergic reaction, including:
This is not a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist. Fluoxetine: precautions Before taking Fluoxetine, tell your doctor or pharmacist if you are allergic to it; or if we have any other allergies.
Before using Fluoxetine, tell your doctor or pharmacist your medical history, especially of:
Fluoxetine may make we dizzy or drowsy. Use caution while driving, using machinery, or doing any other activity that requires alertness. Avoid alcoholic beverages.
If you have diabetes, Fluoxetine may affect your blood sugar levels. Monitor your blood sugar regularly and share the results with your doctor. Your doctor may need to adjust your medication, diet, and exercise when you start or stop Fluoxetine. Liquid forms of Fluoxetine may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.
Caution is advised when using Fluoxetine in elderly because they may be more sensitive to its effects. The elderly are more likely to lose too much salt ( hyponatremia ) , especially if they are also taking " water pills " ( diuretics ) with Fluoxetine.
Fluoxetine isn't recommended for use during pregnancy. It may harm an unborn baby. Also, babies born to mothers who have used Fluoxetine during last 3 months of pregnancy may infrequently develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.
Since untreated depression can be a serious condition, don't stop taking Fluoxetine unless directed by your doctor. If you're planning pregnancy, become pregnant, or think we may be pregnant, immediately discuss benefits and risks of using Fluoxetine during pregnancy with your doctor.
Fluoxetine may pass into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using Fluoxetine. Consult your doctor before breast-feeding. Fluoxetine: interactions Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring we for them. Don't start, stop, or change dosage of any medicine before checking with your doctor or pharmacist first.
Fluoxetine can stay in your body for many weeks after your last dose and may interact with many other medications. Before using any medication, tell your doctor or pharmacist if we have taken Fluoxetine in previous 5 weeks.
Certain medications taken with Fluoxetine could result in serious ( rarely fatal ) drug interactions. Avoid taking MAO inhibitors ( e. g. , furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine ) with Fluoxetine for 2 weeks before, during treatment, and at least 5 weeks after your last dose of Fluoxetine. Consult your doctor or pharmacist for additional information.
The following medications shouldn't be used with Fluoxetine and for 5 weeks after your last dose of Fluoxetine because very serious ( possibly fatal ) interactions may occur while use Fluoxetine:
If we are currently using any of these medications listed above, tell your doctor or pharmacist before starting Fluoxetine.
Before using Fluoxetine, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:
Aspirin can increase risk of bleeding when used with Fluoxetine ( see above ) . If your doctor has directed we to take low-dose aspirin for heart attack or stroke prevention ( usually at dosages of 81-325 milligrams a day ) , you should continue taking it unless your doctor instructs we otherwise. Discuss the risks and benefits with your doctor.
Also tell your doctor if we take any other drugs that increase serotonin, such as bromocriptine, buspirone, dextromethorphan, lithium, meperidine, propoxyphene, phentermine, SSRIs, SNRIs, tryptophan, St. John's wort, drugs used to treat migraines such as " triptans " and dihydroergotamine, street drugs such as MDMA/ " ecstasy, " amphetamine. ( See also Side Effects section. )
Tell your doctor or pharmacist if we also take drugs that cause drowsiness, such as certain antihistamines ( e. g. , diphenhydramine ) , anti-seizure drugs ( e. g. , carbamazepine ) , medicine for sleep or anxiety ( e. g. , lorazepam, zolpidem ) , muscle relaxants, narcotic pain relievers ( e. g. , codeine ) , psychiatric medicines ( e. g. , chlorpromazine, quetiapine, nortriptyline, trazodone ) .
Check labels on all your medicines ( e. g. , cough-and-cold products ) because they may contain ingredients that cause drowsiness. Dextromethorphan is a commonly used cough medication and may interact with Fluoxetine. Ask your pharmacist about using those products safely.
Cimetidine is a nonprescription drug that's commonly used to treat extra stomach acid. Because it may cause undesirable interactions when used with Fluoxetine, ask your pharmacist about other products to treat stomach acid.
This document doesn't contain all possible interactions. Therefore, before using Fluoxetine, tell your doctor or pharmacist of all products you use. Keep a list of all your medications with you, and share list with your doctor and pharmacist. Fluoxetine: overdose If overdose of Fluoxetine is suspected, contact your local poison control center or emergency room immediately. US residents can call US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: irregular heartbeat, fainting, severe dizziness, seizures. Fluoxetine: notes Don't share Fluoxetine with others.
Psychiatric/medical check-ups should be done periodically to monitor your progress or check for side effects. Consult your doctor for more details. Fluoxetine: missed dose If you miss a dose Fluoxetine, take it as soon as we remember. If it's near time of the next dose, skip missed dose and resume your usual dosing schedule. Do not double dose of Fluoxetine to catch up. Fluoxetine: storage Store Fluoxetine at room temperature between 59-86 degrees F ( 15-30 degrees C ) away from light and moisture. Don't store Fluoxetine in bathroom. Keep all medicines away from children and pets. Different brands may have different storage instructions. Check product label or ask your pharmacist how to store your particular product.
Properly discard Fluoxetine when it's expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Fluoxetine: warning Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people ( especially children/teenagers ) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it's very important to talk with the doctor about risks and benefits of antidepressant medication ( especially for children/teenagers ) , even if treatment isn't for a mental/mood condition.
Tell doctor immediately if we notice worsening depression/other psychiatric conditions, unusual behavior changes ( including possible suicidal thoughts/attempts ) , or other mental/mood changes ( including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech ) . Be especially watchful for these symptoms when a new antidepressant is started or when dose is changed.
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