Letter to Congress: NCL calls for safe CBD

/in , , , , /by

December 10, 2019

Dear Member of Congress,

For more than 120 years, the National Consumers League has pursued the values of access to quality products, honest labeling, and safe, effective medicines for America’s consumers. We write to you today about a growing public health concern affecting millions of Americans in every state and congressional district across the country. Unregulated, untested cannabidiol (CBD), an extract of the hemp plant, has infiltrated the market in a dizzying range of products. These products pose a significant threat to consumers.
 
The CBD market is one of the fastest growing retail segments in the nation. By 2022, Americans are expected to purchase approximately $1.8 billion worth of these products, triple the amount since last year. CBD, however, continues to raise questions and concerns for consumers.
 
CBD products are not currently tested or evaluated for safety and efficacy, nor required to meet similar safety standards as the tube of toothpaste we buy at the grocery store. CBD products are too often deceptively labeled and may contain contaminants that can harm consumers. Independent testing of the 240 top-selling CBD products found that 70 percent were contaminated with substances including lead, arsenic, herbicides, pesticides, and toxic mold.
 
New public opinion research conducted by Greenberg Quinlan Rosner finds that voters overwhelmingly – an 83 percent majority – support allowing the Food and Drug Administration (FDA) to evaluate and regulate CBD products. The research found that ensuring the safety and effectiveness of CBD grows even stronger among those who have used CBD products or describe themselves as very familiar with them. When asked about illness resulting from vaping CBD, 83 percent of respondent expressed concern, with nearly half, 48 percent, being very concerned.
 
This is why NCL created Consumers for Safe CBD in partnership with Consumer Federation of America (CFA) and Community Anti-Drug Coalitions of America (CADCA) to encourage the FDA to take strong, effective, and prompt action to protect the public from the potential harms posed by unregulated, untested CBD.
 
As Executive Director of NCL, I hope you will lend your voice in calling for the FDA to take immediate action to protect consumers from potentially harmful CBD products and pursue four common-sense objectives:

1. WARN THE PUBLIC OF THE DANGERS OF THE CBD MARKET

The public should be warned regarding the dangers of unapproved, untested CBD products. Clearly, as verified by the explosive growth in sales, the public is not appropriately informed about the potential dangers of unapproved, untested CBD products that contain harmful contaminants and may not have the ingredients listed on product labels. Resources should be devoted to a national informational campaign that warns consumers of these dangers. There is a growing interest in CBD products, but the marketplace is largely an unregulated “wild west,” and consumers literally often have no way of knowing what is contained in the products they are purchasing.

2. ENFORCE EXISTING REGULATIONS REGARDING LABELING (INGREDIENTS, RISKS, ETC.)

The FDA should curtail the proliferation of potentially dangerous, unapproved CBD products by using its existing legal authority. The FDA should use its authority to penalize manufacturers, marketers, and distributors of CBD products that: 1) make medical claims that cannot be scientifically verified, 2) market products to minors, 3) sell products that contain higher or lower-than-advertised levels of CBD and/or THC, or harmful ingredients and 4) sell products that have inaccurate labels. Swift and strong enforcement can serve as an effective deterrent effect against the future marketing of unapproved, potentially harmful CBD products.

3. DETERMINE SAFE LEVELS OF THC/CBD TO BE ALLOWED IN CBD PRODUCTS

Clear differentiation between medicines and consumer products should be established, including firm parameters as to CBD levels that can be safely included in a particular product. The FDA should establish a firm, enforceable ceiling on the potency of CBD that can be contained in an individual product and require safe packaging practices, similar to the child-proof cap closures on prescription medicines. All products should include a 1-800 phone number to allow concerned consumers to call the manufacturer to make specific inquiries about the product.

4. ENCOURAGE ROBUST CLINICAL RESEARCH INTO THE POTENTIAL OF CBD TO IMPROVE HEALTH AND LIVES

The FDA should incentivize CBD research, clinical trials, and the creation of new CBD treatments that are thoroughly vetted through the proven FDA process. CBD has the potential to improve lives, but with little research and clinical data, the risk is currently greater than the reward. We should encourage research to ensure that CBD reaches its full potential. 
 
Your constituents should be protected from the potential dangers related to CBD products. This does not require the creation of new laws or regulations, but rather that the FDA simply use its existing authority to protect public safety. The agency has already sent more than 50 warning letters to CBD product manufacturers making egregious health claims about their products’ ability to treat cancer and other serious illnesses. It recently advised women who are pregnant or breastfeeding to avoid using any CBD products, citing a number of health and safety risks. But these efforts need to be stepped up. We hope you will join us in asking the FDA to erect stronger safeguards, including safe concentration limits, around a rapidly growing, but unregulated, industry that is already causing harm to consumers.
 
If you or your staff has any questions, please reach out to our Director of Health Policy Patricia Kelmar at patriciak@nclnet.org or 202-207-2824.
 
Thank you for your consideration.

Sally Greenberg
Executive Director
National Consumers League

###

About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL announces new action center to help patients steer clear of deadly counterfeit drug websites

/in , , , , , , , , /by

December 5, 2019

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL), America’s pioneering consumer advocacy organization, today launched Fraud.org/FakeRx, a new digital consumer education campaign to address the growing global crisis of harmful counterfeit medications. The World Health Organization estimates that one in every 10 medical products circulating in developed countries is either substandard or fake, and nearly $83 billion in counterfeit drugs are sold annually. Counterfeit drugs can be, at best, a waste of money and, at worst, fatal.  The Partnership for Safe Medicines has found counterfeit pills made with fentanyl in 48 states, with deaths attributed in 33.

“Counterfeit drugs are everywhere, and they are dangerous. Going to the Internet to buy medicines is a bad idea if you don’t know how to protect yourself from illegal pharmacies selling counterfeit drugs. Consumers do not realize how common counterfeits are; our campaign aims to provide the tools and resources to help consumers steer clear of illegal products and protect themselves and their families,” said NCL Executive Director Sally Greenberg. “NCL is launching Fraud.org/FakeRx to serve as a hub for reliable information for consumers and law enforcement.  Our action center helps consumers learn how to spot the red flags of counterfeit drugs and report issues to law enforcement.”

With the growth of Internet sales of medications, the problem of illegal pharmacies hawking counterfeit drugs is a growing risk to consumers. Visitors to Fraud.org/FakeRx can arm themselves with information to:

  • Reduce the chances they’ll encounter counterfeit drugs and shop safely for medications online
  • Learn to spot harmful counterfeit drugs if they do; and
  • Report counterfeit drugs and the websites offering them to the authorities fighting the problem.

“Criminals posing as legitimate online pharmacies are a serious threat to our nation’s drug supply and to unsuspecting consumers who purchase contaminated or potentially deadly counterfeit medications,” said George Karavetsos, former director of the U.S. Food and Drug Administration’s Office of Criminal Investigations. “Policymakers, regulators, and manufacturers have clear roles for doing their part to protect our drug supply, but having informed consumers is essential to shutting down this illegal online market. This campaign gives consumers the tools they need to stay safe and keep criminals from lining their pockets with consumers’ money.”

NCL has worked with victims of suspected and confirmed counterfeit drugs to capture their experiences and report them to authorities. Two mothers who each lost their adult children to tainted counterfeit medications have lent their stories to the new campaign in hopes of helping others avoid falling to the same fate.

“I lost my son, Jerome, himself a loving big brother and father of three beautiful children, to a counterfeit drug laced with fentanyl. It took one single pill to take Jerome away from us,” said Natasha Butler, whose son was one of a wave of victims of counterfeit drug deaths in Sacramento in 2016. “We had no idea that these dangerous drugs, manufactured to look exactly like the real thing, are out there and could be the last drug someone ever takes. Anyone who takes medication or fills prescriptions needs to be aware of the risks of counterfeits, and that where you get drugs is so crucial for your safety and health. Everyone should visit Fraud.org/FakeRx to learn about the risks and how to avoid being the next victim.”

 “On June 11, 2018 my phone rang at 7:24 am. The voice on the other line told me that my beautiful daughter, Ashley, was dead. Ashley had been given a counterfeit pill laced with fentanyl. I was told by the coroner that she probably died instantly,” said Andrea Thomas, a Colorado mother who, since her daughter’s death from a counterfeit drug, co-founded Voices for Awareness Foundation. “The deadly pill Ashley took looked just like her normal medication. This is an epidemic in our country that I previously knew nothing about. It is time to take action. The National Consumers League’s new resources for consumers will help spread awareness and will make a difference to many.”

To hear from additional victims who know the issue firsthand, visit the new Fraud.org/FakeRx. The site also includes tips for consumers about ways to save on prescription drugs without increasing their risks of purchasing counterfeits. 

NCL thanks its partners for providing support for the new campaign: Allergan, Celgene, Eli Lilly, Gilead Sciences, Pfizer, and PhRMA.

###

About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL statement on nomination of Hahn to head FDA

/in , , , /by

December 3, 2019

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL), the nation’s pioneering consumer advocacy organization, welcomes Dr. Stephen Hahn’s nomination to lead the Food and Drug Administration (FDA). The statement below is attributed to Sally Greenberg, NCL executive director:

“Dr. Hahn is a veteran doctor and cancer researcher who served as chair of radiation oncology at the University of Pennsylvania School of Medicine and most recently as chief operating officer and medical executive at MD Anderson in Houston. He holds rare dual board certifications in both medical oncology and radiation oncology and has authored more than 200 academic works. He also brings a wealth of experience supervising and facilitating clinical trials. In an era where science is under attack, Dr. Hahn brings a welcome commitment to evidence-based medicine, science, and research. The FDA is the gold standard across the globe for ensuring the highest standards of safety and efficacy of medications and devices, and for the safety of our food supply. Consumers are being barraged by a plethora of untested products claiming health and safety. The FDA needs a strong leader who will bring an evidence-backed approach to protecting consumers and ensuring a clear pipeline for new therapies that are tested for safety and efficacy and hold true promise for treatments and cures.

“If confirmed, we look forward to working with Dr. Hahn to improve consumer protections in a number of areas, including regulation in the CBD product marketplace, addressing the clear health hazards of e-cigarettes, especially to underage users, and fully implementing the Food Safety and Modernization Act to reduce foodborne illness, which kills an estimated 3,000 people each year. We need a well-funded FDA that can offer a pipeline for medications to treat diseases while protecting the public from unsafe products, including drugs, devices, and foodborne illness.”

Greenberg is a board member of the Reagan Udall Foundation, created by Congress, to support the work of the FDA.

###

About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

National Consumers League statement on FDA action regarding CBD

/in , , , , /by

November 29, 2019

Leading consumer advocate urges ‘buyer beware’ as busiest shopping season of the year gets underway

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—Sally Greenberg, executive director of the National Consumers League and a convening partner of Consumers for Safe CBD, today released the following statement in response to FDA’s recent action regarding CBD:

“The decision by the FDA to send 15 new warning letters and remind consumers of potential harm caused by untested and illegal CBD is a step forward in keeping millions of Americans safe. While regular communication from the FDA is helpful, it’s critical that we pursue tangible actions that will lead to broad awareness and prevent the sale of harmful CBD products in a marketplace that is growing by the day. This includes enforcing existing regulations regarding labeling and ingredients, as well as setting safe concentration levels. We cannot wake up a year from now and wish that we had done something when there are practical and achievable solutions right in front of us. Our recent polling shows that 83 percent of registered voters support regulating CBD. We need the gold standard that the FDA provides now more than ever.

“Today marks the start of the busiest shopping season of the year. As consumers head to stores and browse the Internet for deals, we are urging buyer beware when it comes to CBD products. The risk of not getting what you pay for and, even worse, putting one’s own health in jeopardy is far too great. Until the FDA steps in with its stamp of approval, we have no choice but to warn consumers to avoid unregulated CBD products and encourage family and friends to do the same.

“The National Consumers League and Consumers for Safe CBD will continue to work with advocates, policymakers and other stakeholders to ensure that we keep people safe, provide a much-needed sense of clarity and put the interests of the consumer first.”

Learn more about the CBD Myths and Facts HERE.

Learn more about what could be in CBD products HERE.

See what others are saying about CBD HERE.

###

About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

CBD is not the cure for whatever ails you

/in , , , /by

Unless you’ve been living under a rock, you’ve surely seen the dozens of ‘miraculous’ CBD products available today. Health food stores, pet supply stores, gas stations, and even your neighborhood pharmacy and grocery stores are carrying a plethora of CBD-infused products. CBD is included in everything from lotions and oils, beauty products, pet treats, and “tampons.” You can buy CBD-infused workout clothing and even take CBD yoga classes.

CBD, or cannabidiol, is a compound found in cannabis and derived from the hemp plant. After the passage of the Farm Bill, CBD is now legal and CBD products are marketed as having little or no THC, the primary psychoactive element in marijuana. However, under the bill, these products may lawfully contain as much as 0.3 percent THC, which is enough to produce intoxication or a positive result on a drug test, which has led to many workers unwittingly losing their jobs.

Sales of products containing CBD have exploded in recent years. In 2018, Americans purchased $500 million in products containing CBD. By 2022, that amount is expected to more than triple to reach $1.8 billion nationwide.

Consumers, take note! Illegal marketing of these products include unsubstantiated health claims as innocuous as offering “a higher sense of well-being” to the extreme claims of therapeutic benefits such as treating Alzheimer’s and Parkinson’s disease, schizophrenia, or AIDS. 

Our concern is that most CBD products on the shelves today fail to meet the safety standards we have come to expect:

  • Most have not been scientifically tested for safety and efficacy.
  • CBD product labels aren’t accurate in lists of ingredients and potency.
  • The purity and potency of ingredients in most CBD products have not been verified by reliable third parties.

Without these safeguards, consumers may be using these products or offering them to their children and pets with blindfolds on.

Exaggerated claims of unproven benefits are nothing new, but with the legalization of CBD, there’s a new explosion of untested products that demand attention from regulators. CBD could be key to the development of many new treatments and therapies. One indication is the success of the first FDA-approved drug containing CBD in controlling two types of rare, childhood-onset seizures. However, without better regulation and enforcement, unsafe dosages of CBD and the use of adulterated products make for a minefield of consumer caveat emptor.

Clinical studies have demonstrated potential risks of CBD, including liver toxicity, fatigue, and harmful interactions with other drugs. The Food and Drug Administration (FDA) has recently begun to take action. In October, it issued a strongly worded advisory discouraging pregnant and breastfeeding mothers from using CBD products. It also recently warned a Florida company that was illegally selling unapproved products containing CBD online with unsubstantiated claims that the products treat teething pain and earaches in infants, autism, attention-deficit/hyperactivity disorder (ADHD), among other conditions or diseases. We welcome that action by the FDA, and we want to see it doing more.

Advocates recognize the dangers for consumers and we are mobilizing. Earlier this month, National Consumers League (NCL) staff presented at a roundtable discussion of consumers and other partners about FDA’s authority to protect consumers via product testing and regulation of product marketing. The discussion allowed further sharing of information and identified opportunities to bring commonsense changes to the marketplace.

Consumers need access to good information about CBD, how to understand concentration levels in products, and the products’ risks. The FDA should take a more active role as a regulatory agency overseeing products that make health benefit claims. Our regulators should help consumers understand the difference between FDA-approved medicines and consumer products, including a definition of a safe level of CBD.

We welcome the potential that CBD has to offer new therapies and treatments, but the products in the marketplace must be safe and proven effective with hard science. NCL is committed to doing its part to help protect and educate consumers.

Why won’t New York’s governor Cuomo ban a nasty pesticide that harms children?

/in , , , , , , /by

Reid Maki is the director of child labor advocacy at the National Consumers League and he coordinates the Child Labor Coalition.

Something really curious is happening in New York State. In June, the New York Assembly passed a bill to ban the nasty pesticide chlorpyrifos, which damages the development of children. But that’s not the weird part.

What’s surprising is that Governor Andrew Cuomo has not signed the bill, despite the fact that the NY Attorney General Letitia James joined five other attorneys general in suing the Trump Administration’s federal Environmental Protection Agency because it overturned an Obama Administration ban on the pesticide.

“Chlorpyrifos is extremely dangerous, especially to the health of our children,” said Attorney General Letitia James. “Yet, the Trump Administration continues to ignore both the science and law, by allowing this toxic pesticide to contaminate food at unsafe levels. If the Trump EPA won’t do its job and protect the health and safety of New Yorkers, my office will take them to court and force them to fulfill their responsibilities.”

The other states that joined the suit are Washington, Maryland, Vermont, Massachusetts, and California—the latter is the country’s largest agricultural producer (measured by cash receipts) and has decided to remove chlorpyrifos from the market in 2020. 

Studies have also linked chlorpyrifos to autism, cancer, Parkinson’s disease, reduced IQ, loss of working memory, attention deficit disorders, and delayed motor development.

Nationally, home use was banned in 2001 because of its impact on children’s developing brains. In 2018, Hawaii became the first state to enact a complete ban on its use, which includes farms.

Chlorpyrifos is also thought to damage male reproductive organs to the point that it can make men sterile.

Since food safety authorities determined that there was no safe exposure level to chlorpyrifos—that any trace of the pesticide was too dangerous—the European Union is expected to ban entry of food products contaminated with the pesticide next year.

In August, the National Consumers League (NCL) and the Child Labor Coalition (CLC), which NCL co-chairs, joined 80+ groups—including many from New York—on a letter, urging Governor Cuomo to sign the chlorpyrifos ban. We were naïve enough to think he would.

With an avalanche of data suggesting it is too dangerous to use and his own attorney general suing over its use, why has Cuomo seemingly decided not to ban the pesticide? We can only guess. In July, the governor signed landmark legislation to protect farmworkers from labor abuses, ensure equitable housing and working conditions, and grant them collective bargaining, overtime pay, unemployment compensation and other benefits.

Farmworkers are some of the most exploited workers in America, and we applaud the governor for doing the right thing, but he seems to be taking the position that—having done something farm owners didn’t like—he shouldn’t sign the chlorpyrifos ban because they won’t like that either. The farmers see the pesticide as an effective tool to help them grow crops.

The problem is that chlorpyrifos doesn’t just harm those who eat farm produce; It harms the very people that produce crops—the farmers and the farmworkers and the children of both.

Should giving farmworker labor rights mean that it’s okay to endanger their fertility and cause their children to suffer developmental delays or autism? And from the farmers’ perspective, shouldn’t their children be protected from those afflictions? The governor shouldn’t be striving to protect some of the people some of the time, but should protect all of the people all of the time.

AAOA and National Consumers League Raise Awareness About Prescription Opioid Abuse Safety

/in , , , , , , /by

October 16, 2019

Media contact: press@againstopioidabuse.org or National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Alexandria, VA—Allied Against Opioid Abuse (AAOA) and the National Consumers League (NCL) released a new suite of resources to help educate consumers about prescription opioid safety. The AAOA-NCL Consumer Toolkit provides materials to help reinforce the need for patients, caregivers, parents and others to understand their rights, risks and responsibilities associated with prescription opioid use.

“Education plays a crucial role in helping consumers understand the importance of safely using, storing and disposing of prescription opioids,” said Sally Greenberg, Executive Director, NCL. “We are pleased to partner with AAOA on this important set of resources, which will provide individuals with actionable steps that they can take to keep prescription opioids secure and prevent misuse and abuse of these medicines among family and friends.”  

The AAOA-NCL Consumer Toolkit addresses common questions that patients may have about their rights, risks and responsibilities associated with prescription opioids, and highlights facts about opioid medications to fill a knowledge gap and prevent misuse before it occurs. The toolkit includes the following resources:

“AAOA has taken a leading role in sharing information and fostering communication between patients, consumers and the medical community to help reduce prescription opioid abuse,” said John Parker, Senior Vice President of Communications for the Healthcare Distribution Alliance, the founding member of AAOA. “By leveraging NCL’s expertise, our goal is to communicate directly with consumers about the important role everyone has to play in ensuring the appropriate use, storage and disposal of prescription opioids.”  

In August, the AAOA-HealthyWomen Toolkit was released to help educate women, in their role as consumers and caregivers, about what they can do to prevent the misuse and abuse of prescription opioids in the home. To learn more about AAOA’s resources, including a series of videos that raise awareness about prescription opioid safety, visit www.AgainstOpioidAbuse.org/Act.

For press inquiries, contact press@againstopioidabuse.org. 

###

About Allied Against Opioid Abuse
Allied Against Opioid Abuse is a national education and awareness initiative to help prevent abuse and misuse of prescription opioids. Founded by the Healthcare Distribution Alliance, the initiative is a collaborative effort with diverse partners across the pharmaceutical supply chain, as well as organizations that are experts in public health and healthcare, including Alliance for Aging Research, American Pharmacists Association, American Physical Therapy Association, BeMedWise, Caregiver Action Network, Gerontological Society of America, Healthcare Leadership Council, HealthyWomen, Men’s Health Network, Mental Health America, National Alliance of State Pharmacy Associations, National Association of Directors of Nursing Administration, National Association of States United for Aging and Disabilities, National Community Pharmacists Association, National Consumers League, National Transitions of Care Coalition, Pharmacy Technician Certification Board, and the PA Foundation. Our goal is to contribute to solving the opioid crisis in a meaningful way by educating patients about their rights, risks and responsibilities. To learn more, visit www.AgainstOpioidAbuse.org or follow us on Twitter: @AAOA_Tweets.

About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Calling an end to the health and humanitarian crisis at the border

/in , , , , , /by

Nissa ShaffiFlorence Kelley, first general secretary of the National Consumers League (NCL), was a pioneer in progressive social reform during a time in our nation’s history that was defined by mass immigration and egregious health violations. 120 years later, we bear witness once again to the unconscionable transgressions occurring in migrant detention centers across the border with regards to immigrant rights and access to health care. 

At this very moment, people who are exercising their legal right to seek asylum, according to international and U.S. law, are being systemically dehumanized. The atrocities occurring at our border completely tarnish the social protections that NCL has historically fought to solidify.

On July 10, the House Oversight Committee held a hearing to examine the humanitarian crisis at the border. The investigation followed the release of a July 2 report by the Office of Inspector General (OIG) detailing the dangerous and unsanitary conditions migrant detainees are experiencing at Custom and Border Patrol (CBP) and Immigration Customs Enforcement (ICE) facilities.

Images of children sprawled across cold concrete floors in overcrowded holding cells, wrapped in nothing but flimsy mylar blankets, prompted members of Congress, immigration lawyers, and physicians to visit various migrant detention centers throughout Texas to witness the matter firsthand.

Visitors noted a stench that could be detected immediately upon entry into the facilities, which was attributed to detainees being sardined into holding cells, in conditions that have been classified as inhumane and in violation of international law. A majority of detainees have been denied access to basic toiletries like soap and toothbrushes to help them maintain their hygiene. Additionally, individuals have not been able to shower in weeks, are sleep deprived, and are housed in frigid temperatures in rooms that have been given the apt moniker of the “ICE Box.” Many migrants have claimed that they were wearing the same soiled clothes that they wore during their long passage into the country.

These facilities were not designed to house migrants for prolonged detainment. Regulations prohibit the detention of detainees for longer than 72 hours, yet OIG reported that migrants had been held indefinitely, some even as long as several weeks. The unsanitary conditions prevalent in the detention centers have resulted in outbreaks of the flu, lice, shingles, scabies, and chickenpox. The processing centers in the facilities are housed beyond infrastructural capacity, leading border officials to take desperate measures to hold detainees in cages and under overpasses. These dangerous conditions will inevitably advance the spread of disease, endangering the lives of detainees as well as the general public who will come into contact with CBP and ICE agents.

These facilities are privatized, for-profit migrant detention centers that function outside the purview of federal oversight and accountability. Shareholder interests call for incentivized cuts to medical staffing, which as a result, has led to cruel and negligent practices that have encouraged the spread of disease, the proliferation of trauma, and the violation of human rights.

NCL calls on Congress to address the harrowing health and human rights violations taking place at our borders. NCL strongly advocates for a principled, comprehensive immigration reform that treats all immigrants with respect and dignity, no matter their legal status in the United States. NCL’s immigration policy advocates to:

  • keep families together;
  • ensure a humane pathway to citizenship and builds upon the success of Deferred Action for Childhood Arrivals (DACA) to incorporate young immigrants into mainstream society; and
  • ensure effective enforcement that protects our borders, fosters commerce, and promotes the safe and legitimate movement of people and goods at our ports of entry.

To learn about NCL’s immigration policy, click here.

The National Consumers League calls on lawmakers to work together to enact humane immigration policy reform that genuinely encompasses the promise of American values. Congress must act swiftly and in the best interest of migrants detained to collectively bring an end to this humanitarian crisis.

No more surprises: Congress and patients alike sick of surprise billing

/in , , , , , , /by

headshot of NCL Health Policy intern Alexa

By NCL Health Policy intern Alexa Beeson

This July, the House Energy and Commerce’s Health Subcommittee passed the No Surprises Act (H.R. 3630) to protect patients from surprise billing. The Senate Health, Education, Labor and Pensions Committee also passed its companion to address surprise billing, the Lower Health Care Costs Act (S.1895). These bills were being considered after a press conference at which President Trump called for reform in surprise billing.

Stakeholder witnesses at the House hearing this June on H.R. 3630 included patient, provider, and insurance payer groups. Reimbursement models were discussed at length, but the unifying theme was that patients should be held harmless in surprise billing situations.

Surprise billing happens mostly in a small subsect of out-of-network providers; the patient has no idea about who’s in or out of network. Some professionals are out-of-network technicians subcontracted by an in-network facility, such as a last-minute anesthesiologist switch for a surgery, or any other non-disclosed provider. To get reimbursed for their services, providers send a bill to the patient for whatever wasn’t covered by the insurance company.

Surprise billing also occurred among patients who should receive reduced prices for care. Johns Hopkins Hospital filed suit on more than 2,400 patients in the last decade, collecting the equivalent of 0.03 percent of its operating revenue. Some of these patients were never told about their right to charity care, and many who qualify never received a discounted rate. These bill collections are inconsequential for Johns Hopkins but could bankrupt a patient.

Legislation to address balance or surprise bills will protect patients, ensuring they will only have to pay in-network rates for out-of-network emergency care. This will help patients avoid bills that can set them back, sometimes, hundreds of thousands of dollars. Although surprise bills only come from a small portion of providers, 1 in 7 insured adults will receive a surprise medical bill from an in-network hospital. The Kaiser Family Foundation found that 70 percent of such patients were not aware that the provider was out-of-network when they received the care.

Panelist Sonji Wilkes, a patient advocate, presented testimony about her struggle with a surprise bill sent after the birth of her son, who was diagnosed with hemophilia. That child was treated by a charitable out-of-network hematologist who did not charge them for her services. However, the NICU that observed the boy was subcontracted to a third-party provider. This meant that the NICU was out-of-network. The Wilkes were sent a $50,000 bill by the hospital that still haunts them 15 years later.

Thomas Nickels, the executive vice president of the American Hospitals Association, claimed that fixed reimbursement rates, such as a median benchmark or percentage of the Medicaid reimbursement value, would disincentivize insurers from maintaining adequate provider networks. Nickels supported the Alternative Dispute Resolutions method, which involves baseball-style arbitration where providers and payers settle on reimbursement value on a case-by-case basis.

Jeanette Thornton, a senior vice president at America’s Health Insurance Plans, argued that the New York model of baseball-style arbitration would create immense clerical burden, resulting in lost time and greater administrative costs. She argued the arbitration reimbursement model would raise costs for patients in the end. Instead, she advocated for the government-dictated fixed reimbursement rates.

Both versions of the bill call for a benchmark to resolve payments between insurance plans and out-of-network providers. This benchmark says health plans would reimburse providers with the median in-network rate already contracted within specific geographic areas. The House bill contains binding arbitration as a fallback in case either the provider or payer decide the payment was an unfair price.

The National Consumers League supports Congress’ tackling of this issue of surprise or balance billing. NCL has taken no position on how these bills are settled between the payer and provider, as long as patients are protected from outrageously expensive bills they can never hope to pay and were never anticipating. In addition, medical debt is the greatest contributor to consumers declaring bankruptcy, and balance billing is a contributor to that troubling consumer issue. The bottom line is that a bill for medical services should never cause bankruptcy, and a patient should never have to choose between medical treatment and food or housing. We are hopeful this issue will be resolved during this Congressional session.

Alexa is a student at Washington University in St. Louis where she studies Classics and Anthropology and concentrates in global health and the environment. She expects to graduate in May of 2020