Henry J Aaron

Increasingly over the past five years, uncertainty about reimbursement for routine patient care has been suspected as contributing to problems enrolling people in clinical trials. Clinical trial investigators cannot guarantee that Medicare will pay for the care required, and they must disclose this uncertainty to potential participants during the informed consent process. Since Medicare does not routinely "preauthorize" care (as do many commercial insurers) the uncertainty cannot be dispelled in advance. Thus, patients considering whether to enter trials must assume that they may have to pay bills that Medicare rejects simply because they have enrolled in the trial. This report recommends an explicit policy for reimbursement of routine patient care costs in clinical trials. It further recommends that HCFA provide additional support for selected clinical trials, and that the government support the establishment of a national clinical trials registry. These policies (1) should assure that beneficiaries would not be denied coverage merely because they have volunteered to participate in a clinical trial; and (2) would not impose excessive administrative burdens on HCFA, its fiscal intermediaries and carriers, or investigators, providers, or participants in clinical trials. Explicit rules would have the added benefit of increasing the uniformity of reimbursement decisions made by Medicare fiscal intermediaries and carriers in different parts of the country. Greater uniformity would, in turn, decrease the uncertainty about reimbursement when providers and patients embark on a clinical trial.

Leo Mazzone is pro baseball's premier pitching coach. In his years with the Atlanta Braves, he has trained several Cy Young Award winners and helped lead his team to the World Series. In Pitch like a Pro, Mazzone and coauthor Jim Rosenthal offer step-by-step instructions for players and coaches in Little League through high school. They teach all of the pitching basics and give athletes advice on how they can use the right training techniques to grow stronger and stay healthier. Contents include: Mazzone's between-starts throwing programHow to grip different pitchesProper mechanics and delivery techniquePitching strategies and tacticsField the positionPitch like a Pro offers contributions by such well known pitchers as Greg Maddux, Tom Glavine, John Smotz, and Denny Neagle, along with black-and-white instructional photographs.

These proceedings present a spectrum of opinions on such questions as: Should Social Security be in or out of the budget? Should Social Security reserves be included in deficit reduction targets? How large will the cost of the aging population be? What does the public think about Social Security and the budget and how will those opinions influence the budget process?