Weekend update / Miscellany

The 111th Congress convenes on Tuesday, January 6, at noon. I expect that the most pressing health care items on its agenda will be reauthorizing the State Children’s Health Insurance Program, which otherwise expires on March 31, 2009, and providing up to $25 billion in funding for interoperable electronic medical records in the anticipated economic stimulus bill.

Speaking of Congress, Modern Healthcare.com reports that “Democratic leaders on Capitol Hill have named Douglas Elmendorf, a former Clinton administration economist, to head the Congressional Budget Office. He will replace Peter Orszag, who resigned in November to head incoming President Barack Obama’s White House budget office.”

On the Medicare front, CMS announced on December 29 the publication of a final regulation requiring certain durable medical equipment suppliers to post a $50,000 surety bond by October 2, 2009 (May 4 for new suppliers). According to CMS, “[t]his requirement was due in part to the large number of improper and potentially fraudulent payments to medical equipment suppliers for furnishing medical equipment and devices to people with Medicare. The 2007 Medicare error rate report found approximately $1 billion in improper payments for medical equipment and supplies.”

The Drug Benefit News featured an interesting article on health insurer funding of clinical drug trials. “[M]ore and more health plans are covering medical expenses of members participating in clinical trials, as well as the experimental drugs. Some insurers urge all plans to develop clear policies around clinical trials as a way to benefit both members and themselves.”

CAQH announced on December 30 the continuing expansion of it CORE initiative. CORE is “an all-payer solution that enables provider access to patient insurance information before or at the time of service using the electronic system of their choice. [CAQH] has brought together more than 100 industry stakeholders to collaborate on a multi-phase set of uniform business rules to achieve that goal.”

Another CAQH initiative is its “Save Antibiotic Strength” campaign. “Through the program, CAQH and our partners – including the U.S. Centers for Disease Control and Prevention (CDC) – are educating Americans about the importance of using antibiotics safely, and providing physicians with information and tools to deliver this message to their patients. Together, we are addressing one of America’s most pressing public health concerns.” Last week, Giant Food, a DC metro area grocery chain, and its sister company Stop & Shop, a New England grocery chain, announced that their pharmacies will supply 14 days of generic antibiotics at no charge with a prescription during the period January 2 through March 21, 2009. I think that the trend of charging $4 generics is good for everyone, but I’m not so sure about free antibiotics.