Current Awareness in Aging Research (CAAR) Report #561 -- November 4, 2010

CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:


I. Data:

1. HEALTH AND RETIREMENT STUDY UPDATES: On Oct. 29, 2010, the University of Michigan's HRS announced:

A. "Respondent Benefits File Updated for 2008 (Restricted)"

B. "Respondent Detail Earnings File Updated for 2008 (Restricted)"

C. "Respondent Summary Earnings File Updated for 2008 (Restricted)"


2. HUMAN MORTALITY DATABASE: Note: HMD requires free registration before providing data. The following updates have been added to the database.

Data for Taiwan were revised and updated through 2009 (Nov. 2, 2010).

Data availability:

Data access:


3. MEDICAL EXPENDITURE PANEL SURVEY: The US Agency for Healthcare Research and Quality has released several new MEPS data file (October 2010, data in .zip or self decompressing [.exe] ASCII text and SAS Transport format, with documentation in HTML and .pdf format, and SAS and SPSS programming statements in ASCII format).

A. "MEPS HC-119: 2008 Person Round Plan Public Use File"

B. "MEPS HC-118G: 2008 Office-Based Medical Provider Visits File"

C. "MEPS HC-118A: 2008 Prescribed Medicines File"


4. US CENSUS BUREAU: "2009 ACS 1-year Public Use Microdata Sample (PUMS) files" (Nov. 2, 2010) Data are available through Census Bureau's American Factfinder:


5. INTER-UNIVERSITY CONSORTIUM FOR POLITICAL AND SOCIAL RESEARCH DATA UPDATE: "Florida Elder Abuse Survey in Seven Sites, 2007-2008 [United States]" (#25941).

Note: Some ICPSR studies are available only to ICPSR member institutions. To find out whether your organization is a member, and whether or not it supports ICPSR Direct downloading, see:


II. Reports and articles:


A. "Medicare Hospital Outpatient Services" (2009, tables 10.1-10.5, (.zip compressed .pdf and Microsoft Excel format).

B. "Medicare Hospices" (2009, tables 8.1-8.3, (.zip compressed .pdf and Microsoft Excel format).

C. "National Trends 1966 - 2009:The HI-SMI Trend Table shows the unduplicated count of persons enrolled in either or both parts of the program (HI and/or SMI)" (October 2010, .pdf format, 1p.).

D. "The HI Trend Table shows those enrolled in HI regardless if they are enrolled in SMI (October 2010,.pdf format, 1p.).

E. "The SMI Trend Table shows those enrolled in SMI regardless if they are enrolled in HI" (October 2010, .pdf format, 1p.).

F. Contract Suppliers Selected Under New Medicare Program" (Nov. 3, 2010).

G. "CMS Announces 2011 Payment Changes For Medicare Home Health Services" (Nov. 3, 2010).

H. "CMS Sets 2011 Hospital Outpatient, Ambulatory Surgical Center Rates" (Nov. 3, 2010).

I. Medicare Improves Access To Preventive Services For 2011 (Nov. 3, 2010).



A. "Review of Terminated Drugs in the Medicare Part D Program" (A-07-09-03130, November 2010, .pdf format, 15p.).

B. "The Use of Payment Suspensions to Prevent Inappropriate Medicare Payments" (OEI-01-09-00180, November 2010, .pdf format, 15p.).


We found that CMS used payment suspensions in 2007 and 2008 almost exclusively as a tool to fight fraud. We also found that CMS guidance for payment suspensions provides incomplete or inconsistent requirements. Since the time when we collected data for this evaluation, the Patient Protection and Affordable Care Act (hereinafter referred to as the Affordable Care Act) established new provisions for payment suspensions.

On September 23, 2010, CMS issued proposed regulations for these provisions. The information in this report may be useful to CMS when it finalizes these regulations and develops guidance for the new provisions.

CMS may suspend payments to any Medicare provider when it possesses reliable information that the provider was overpaid for previously submitted claims. CMS imposes suspensions under any of three circumstances: (1) fraud or willful misrepresentation, (2) when an overpayment exists but the amount has not been determined, and (3) when payments made or to be made may be incorrect.

We found that Part B providers composed 85 percent of the 253 payment suspensions that CMS imposed in 2007 and 2008. Overpayments to providers in those years totaled at least $206 million, and CMS extended more than half of the suspensions. We also found that the great majority of providers that CMS suspended in 2007 and 2008 exhibited characteristics that suggest fraud. CMS recommends that providers suspended due to fraud receive no advance notice; in all but three of the suspensions, no such advance notice was given.

Reliable information included evidence of questionable billing patterns for 74 percent of suspensions and information from beneficiaries and other providers for 63 percent of suspensions. Prior to their suspensions, 24 percent of providers billed Medicare despite having vacant physical locations.

Lastly, we found that CMS provides some inconsistent guidance regarding payment suspensions, particularly in specifying the types of information that its contractors should submit with a request for a suspension, as well as in describing the circumstances in which an extension is permitted.

We conclude that payment suspensions were used in 2007 and 2008 almost exclusively as a tool to fight fraud. The Affordable Care Act states that a provider's payments may be suspended based on a credible allegation of fraud, unless there is good cause not to suspend such payments. The statute also requires CMS to consult with OIG in determining whether a credible allegation of fraud exists. In the guidance that CMS develops for the new provisions for payment suspensions, CMS could also address the inconsistencies that this report identifies.

C. "Comparison of First-Quarter 2010 Average Sales Prices and Average Manufacturer Prices: Impact on Medicare Reimbursement for Third Quarter 2010, (OEI-03-10-00440, November 2010, .pdf format, 20p.).


We identified a total of 38 Healthcare Common Procedure Coding System (HCPCS) codes with average sales prices (ASP) that exceeded average manufacturer prices (AMP) by at least 5 percent in the first quarter of 2010. Of these 38 HCPCS codes, 13 had complete AMP data (i.e., AMP data for every drug product that CMS used to establish reimbursement amounts). If reimbursement amounts for all 13 codes with complete AMP data had been based on 103 percent of the AMPs during the third quarter of 2010, we estimate that Medicare expenditures would have been reduced by almost $1 million in that quarter alone.

By law, the Office of Inspector General (OIG) must notify the Secretary of Health & Human Services (the Secretary) if the ASP for a particular drug exceeds the drug's AMP by a threshold of 5 percent. If that threshold is met, the Secretary may disregard the ASP for the drug when setting reimbursement and shall substitute the payment amount with the lesser of either the widely available market price or 103 percent of the AMP.

This is OIG's 18th report comparing ASPs to AMPs. Although CMS has yet to make any changes to Part B drug reimbursement as a result of these studies, the agency published a proposed rule in July 2010 that, among other things, specifies the circumstances under which AMP-based price substitutions would occur. For example, CMS would lower reimbursement amounts only for HCPCS codes with complete AMP data that meet the 5-percent threshold in two consecutive or three of four quarters.

If CMS's proposed price substitution policy had been in effect, reimbursement amounts for 10 of the 13 drugs with complete AMP data would have been reduced. The remaining 25 of 38 HCPCS codes also met the 5-percent threshold in the first quarter of 2010 but did not have AMP data for every drug product that CMS used when calculating reimbursement.

Although CMS's proposed price substitution policy would not apply to codes with partial AMP data, price reductions for 7 of the 25 HCPCS codes may be legitimately warranted because missing AMPs likely had little influence on the pricing comparison results for these codes.

We could not compare ASPs and AMPs for an additional 68 HCPCS codes because AMP data were not submitted for any of the national drug codes that CMS used to calculate reimbursement. Manufacturers for 23 percent of those drug products had Medicaid drug rebate agreements and were therefore generally required to submit AMPs.

OIG will continue to work with CMS to evaluate and pursue appropriate actions against manufacturers that fail to submit required pricing data.



A. "OASDI and SSI Program Rates & Limits, 2011" (October 2010, .pdf format, 1p.).

B. "Social Security Bulletin" (Vol. 70, No. 4, 2010, HTML and .pdf format, 76p.).


9. PUBLIC HEALTH AGENCY OF CANADA/AGENCE DE LA SANTE PUBLIQUE DU CANADA REPORT: "Annual Report on the State of Public Health in Canada, 2010: Growing Older - Adding Life to Years" (2010, HTML and .pdf format, 140p.).


10. AUSTRALIAN GOVERNMENT DEPARTMENT OF HEALTH AND AGEING AGED CARE SERVICE LISTS: June 2010 lists for the nation and states (Microsoft Excel format) are available at the bottom of the page:


11. UK OFFICE OF NATIONAL STATISTICS REPORT: "Occupational Pension Schemes 2009" (October 2010, .pdf format, 65p.).


12.AARP PRIME TIME RADIO: The following Prime Time Radio show (RealPlayer and MP3 format, running time, between 23 and 30 minutes) has been added to the PTR site:

"Shock of Gray: The aging of the worlds population" (Nov. 2, 2010).


13. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH FACT SHEET: "The NRRI and Annuities" (October 2010, .pdf format, 2p.).


14. BROOKINGS INSTITUTION REPORT: "Achieving Better Chronic Care at Lower Costs Across the Health Care Continuum for Older Americans," (October 2010, .pdf format, 13p.).


15. CENTER FOR ECONOMIC POLICY RESEARCH ISSUE BRIEF: "The Impact of Income Distribution on the Length of Retirement," by Dean Baker and David Rosnick (October 2010, .pdf and Flash format, 5p.). Links to an abstract and full text are available at:

More information about CEPR:


16. INTERNATIONAL LONGEVITY CENTRE UK THINK PIECE: "Technology and Care: Can the web transform social care?" by David Sinclair (October 2010, .pdf format, 9p.). Link to full text is at the bottom of the page.


17. KAISER FAMILY FOUNDATION CHARTBOOK: "Medicare Chartbook, 2010" (November 2010, .pdf format, HTML and .pdf format, 108p.).


18. NATURE LETTER ABSTRACT: "Antibodies to human serum amyloid P component eliminate visceral amyloid deposits," by Karl Bodin, Stephan Ellmerich, Melvyn C. Kahan, Glenys A. Tennent, Andrzej Loesch, Janet A. Gilbertson, Winston L. Hutchinson, Palma P. Mangione, J. Ruth Gallimore, David J. Millar, Shane Minogue, Amar P. Dhillon, Graham W. Taylor, Arthur R. Bradwell, Aviva Petrie, Julian D. Gillmore, Vittorio Bellotti, Marina Botto, Philip N. Hawkins, and Mark B. Pepys (Vol. 468, No. 7320, Nov. 4, 2010, p. 93-97).



A. "3-Ketoacyl thiolase delays aging of _Caenorhabditis elegans_ and is required for lifespan extension mediated by sir-2.1," by Alina Berdichevsky, Simona Nedelcu, Konstantinos Boulias, Nicholas A. Bishop, Leonard Guarente, and H. Robert Horvitz (Vol. 107, No. 44, Nov. 2, 2010, p. 18927-18932).

B. "Genetic reduction of striatal-enriched tyrosine phosphatase (STEP) reverses cognitive and cellular deficits in an Alzheimers disease mouse model," by Yongfang Zhang, Pradeep Kurup, Jian Xu, Nikisha Carty, Stephanie M. Fernandez, Haakon B. Nygaard, Christopher Pittenger, Paul Greengard, Stephen M. Strittmatter, Angus C. Nairn, and Paul J. Lombroso (Vol. 107, No. 44, Nov. 2, 2010, p. 19014-19019).


20. JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION SPECIAL THEME ISSUE: The Nov. 3, 2010 (Vol. 304, No. 17) issue is a special theme issue on Aging. Check your library for full text availability.


21. NEW ENGLAND JOURNAL OF MEDICINE ARTICLE ABSTRACT: "Reimbursement Policy and Androgen-Deprivation Therapy for Prostate Cancer," by Vahakn B. Shahinian, Yong-Fang Kuo, and Scott M. Gilbert (Vol. 363, No. 19, Nov. 4, 2010, p. 1822-1832).


22. BRITISH MEDICAL JOURNAL NEWS EXTRACT: "Experts question government delays in improving end of life care," by Adrian O'Dowd (BMJ 2010; 341:c6018, Oct. 30, 2010, HTML and .pdf format p. 907). This article is available free of charge.


III. Working Papers:

23. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH: "State Wage-Payment Laws, the Pension Protection Act of 2006 and 401(k) Saving Behavior," by Gary V. Engelhardt (WP 2010-14, October 2010, .pdf format, 14p.). Links to an abstract and full text are available at:


24. UNIVERSITY OF MICHIGAN RETIREMENT RESEARCH CENTER: "Borrowing from Yourself: The Determinants of 401(k) Loan Patterns," by Timothy Jun Lu and Olivia S. Mitchell (WP 2010-221, September 2010, .pdf format, 30p.). Links to an abstract and full text are available at:


25. PENSION RESEARCH COUNCIL, WHARTON SCHOOL, UNIVERSITY OF PENNSYLVANIA: Note: PRC requires free registration before providing working papers. PRC has recently released several new working papers (all .pdf format). All are available from:

Pecuniary Mistakes? Payday Borrowing by Credit Union Members Susan P. Carter, Paige M. Skiba, Jeremy Tobacman WP2010-32

Annuities, Financial Literacy and Information Overload Julie Agnew and Lisa Szykman WP2010-33

Financial Counseling, Financial Literacy, and Household Decision Making Sumit Agarwal, Gene Amromin, Itzhak Ben-David, Souphala Chomsisengphet, and Douglas D. Evanoff WP2010-34

Time Perception and Retirement Saving: Lessons from Behavioral Decision Research Gal Zauberman and B. Kyu Kim WP2010-35

Making Savers Winners: An Overview of Prize-Linked Saving Products Melissa S. Kearney, Peter Tufano, Jonathan Guryan, and Erik Hurst WP2010-36

How to Improve Financial Literacy: Some Successful Strategies Diana Crossan WP2010-37

Bringing Financial Literacy and Education to Low and Middle Income Countries Robert Holzmann WP2010-38

Improving Financial Literacy: The Role of Nonprofit Providers J. Michael Collins WP2010-39



A. "The Growth in Social Security Benefits Among the Retirement Age Population from Increases in the Cap on Covered Earnings," by Alan L. Gustman, Thomas Steinmeier, and Nahid Tabatabai (w16501, October 2010, .pdf format, 32p.).


This paper investigates how increases in the level of maximum earnings subject to the Social Security payroll tax have affected Social Security benefits and taxes. The analysis uses data from the Health and Retirement Study to ask how different the present value of own benefits and taxes would be for the cohort born from 1948 to 1953 (ages 51 to 56 in 2004) if they faced the lower cap on the payroll tax that faced those born twelve and twenty four years earlier, but otherwise had the same earnings stream and faced the same benefit formula. We find that for those in the Early Boomer cohort of the Health and Retirement Study, ages 51 to 56 in 2004, that after adjusting for nominal wage growth, benefits were increased by 1.5 percent by the increase in the payroll tax ceiling compared to the cohort twelve years older, and by 3.7 percent over the benefits under the payroll tax ceiling for the cohort twenty four years older. Tax receipts were increased by 5.3 and 10.7 percent over tax receipts that would have been collected under the tax ceilings that applied to the cohorts 12 and 24 years older respectively. About 25 percent of the additional tax revenues created by the increase in the payroll tax cap between the Early Boomer cohort and those twelve years older was diverted to increased benefits. Similarly, about 31 percent of the additional tax revenues created by the increase in the payroll tax cap between the Early Boomer cohort and those twenty four years older took the form of increased benefits. Results are also presented separately for men and women, for those in the top quartile of earners, and for those at the tax ceiling throughout their work lives.

B. "Policy Effects in Hyperbolic vs. Exponential Models of Consumption and Retirement," by Alan L. Gustman and Thomas L. Steinmeier (w16503, October 2010, .pdf format, 43p.).


This paper constructs a structural retirement model with hyperbolic preferences and uses it to estimate the effect of several potential policy changes. Estimated effects of policies are compared under hyperbolic and standard exponential preferences. Sophisticated hyperbolic discounters may accumulate substantial amounts of wealth for retirement. We find it is frequently difficult to distinguish empirically between models with the two types of preferences on the basis of asset accumulation paths or consumption paths around the period of retirement. The simulations also suggest that, despite the much higher initial time preference rate, individuals with hyperbolic preferences may actually value a real annuity more than individuals with exponential preferences who have accumulated roughly equal amounts of assets. This appears to be especially true for individuals with relatively high time preference rates or who have low assets for whatever reason. This affects the tradeoff between current benefits and future benefits on which many of the retirement incentives of the Social Security system rest.

Simulations involving increasing the early entitlement age and increasing the delayed retirement credit do not show a great deal of difference whether exponential or hyperbolic preferences are used, but simulations for eliminating the earnings test show a non-trivially greater effect when exponential preferences are used.


27. INSTITUTE FOR THE STUDY OF LABOR (IZA) [UNIVERSITY OF BONN, GERMANY]: "Aging and Pensions in General Equilibrium: Labor Market Imperfections Matter," by David de la Croix, Olivier Pierrard, and Henri R. Sneessens (Discussion Paper 5276, October 2010, .pdf format, 32p.). Links to an abstract and full text are available at:


28. PENSIONS INSTITUTE, CITY UNIVERSITY [LONDON, UK]: "One-Year Value-At-Risk For Longevity And Mortality," by Richard Plat (PI-1015, June 2010, .pdf format, 17p.).


Upcoming new regulation on regulatory required solvency capital for insurers will be predominantly based on a one-year Value-at-Risk measure. This measure aims at covering the risk of the variation in the projection year as well as the risk of changes in the best estimate projection for future years. This paper addresses the issue how to determine this Value-at-Risk for longevity and mortality risk. Naturally this requires stochastic mortality rates. The last decennium a vast literature on stochastic mortality models has been developed. However, very few of them are suitable for determining the one-year value-at-risk. This requires a model for mortality trends instead of mortality rates. Therefore, we will introduce a stochastic mortality trend model that fits this purpose. The model is transparent, easy to interpret and based on well known concepts in stochastic mortality modeling. Additionally, we introduce an approximation method based on duration and convexity concepts to apply the stochastic mortality rates to specific insurance portfolios.


29. UK DEPARTMENT FOR WORK AND PENSIONS: "Research on predictions of income in retirement," by Mehul Kotecha, Rachel Kinsella and Sue Arthur (WP 87, 2010, .pdf format, 53p.).


30. NEP-AGE: Working papers in the Economics of Aging are available through the bibliographic database provided by Research Papers in Economics (RePEc). The latest compilations are for Oct. 23, 2010.


IV. Journal Tables of Contents (check your library for availability):

31. Alzheimer's & Dementia: The Journal of the Alzheimer's Association (Vol. 6, No. 6, November 2010).

32. American Journal of Epidemiology (Vol. 172, No. 10, Nov. 15, 2010).

33. Demography (Vol. 47, Supplement, 2010).

34. European Journal of Palliative Care (Vol. 17, No. 6, 2010).

35. International Journal of Aging and Human Development (Vol. 71, No. 3, 2010).,2,284;searchpublicationsresults,1,1;

36. Journal of Aging and Health (Vol. 22, No. 8, December 2010).

37. Journal of the American Geriatric Society (Vol. 58, Supplement 2, October 2010). This is a special issue on "State-of-the-Art in Longitudinal Studies on Aging."

38. Journal of Gerontology (A): Biological Sciences (Vol. 65A, No. 11, November 2010).

39. Journal of Gerontology (B): Psychological Sciences (Vol. 65B, No. 6, November 2010).

40. Research in Nursing and Health (Vol. 33, No. 6, December 2010).


41. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of Nov. 1, 2010:

B. Alzheimer's Disease: Literature for the week of Nov. 1, 2010:

C. Parkinson's Disease: Literature for the week of Nov. 1, 2010:

D. Prostate Cancer: Literature for the week of Nov. 1, 2010:

E. Stem Cell Research: Literature for the week of Nov. 1, 2010:

F. Ophthalmology: Literature for the week of Nov. 1, 2010:

AMEDEO Literature Guide:


V. Books:

42. UNIVERSITY OF CHICAGO PRESS: The Economic Consequences of Demographic Change in East Asia, edited by Takatoshi Ito and Andrew K. Rose (2010, 472p., ISBN: 9780226386850). For more information see:


VI. Funding Opportunities/Employment Opportunities:

43. AGEWORK.COM: has updated its employment listings through Nov. 4, 2010.


VII. Conferences:

44. US CENTERS FOR MEDICARE AND MEDICAID POLICY WEBINAR: "CMS National Conference on Care Transitions," to be held Dec. 3, 2010, 8:00 am - 4:00 pm US Eastern Standard time. For more information see:


VIII. Websites of Interest:

45. ALBERT EINSTEIN COLLEGE OF MEDICINE SUPERAGERS.COM: "Einstein launches to spotlight aging research" (Eurekalert [American Association for the Advancement of Science], Nov. 1, 2010). The news release links to the website.


It is not by muscle, speed, or physical dexterity that great things are achieved, but by reflection, force of character, and judgement; and in these qualities old age is usually not only not poorer, but is even richer

Cicero--106-43 B.C.


Jack Solock
Director--Data and Information Services Center
Social Sciences Research Services
3313 Social Science
University of Wisconsin-Madison
Madison, WI 53706