Mid-week update

David Ermer–Uncategorized–
The FEHBlog nearly fell off his chair yesterday when he readGove on his phone a brief Bloomberg bulletin that the Justice Department is preparing lawsuits in an effort to block the big, pendinghealth insurer mergers — Anthem / Cigna and Aetna / Humana. A more complete account can be found in this Crain’s Business article. Here’s the section of the article that put the Bloomberg bulletin in perspective for the FEHBlog.

Any lawsuit would continue a string of merger challenges by antitrust enforcers looking to stop industry consolidation and would deal a blow to bids by Anthem and Aetna to gain scale by snapping up rivals. According to the terms of both tie-up deals, the companies have agreed to fight any government lawsuits in court. Such a move would likely require months of litigation to rescue takeovers that were struck last year amid a wave The Herof deals that swept the industry.
Aetna and Humana will probably fight any lawsuit in court, while Anthem and Cigna are less likely to litigate against the government, said Ana Gupte, an analyst at Leerink Partners.
“They’re obligated by the terms of their merger agreement, but they both may decide to walk away,” she said about Anthem’s bid for Cigna. “They recognize the probability is low, and there’s also been a lot of conflict between the two companies.”
For antitrust officials at the Justice Department, it’s standard practice to prepare complaints against deals even in cases that are ultimately settled with remedies like asset sales. But in recent years, the department has shown an increasing willingness to go to court to block deals it believes could stifle competition, and for months antitrust officials have signaled their skepticism about the insurer tie-ups.

Reportedly, the Justice Department likely will take official action by end of this month.

Govexec.com reports that big premium increases will be implemented on November 1, 2016,  for the Federal Employees Long Term Care Insurance Program.

The rate increase, which will affect most enrollees, will vary widely between 0 percent and 126 percent, depending on an enrollee’s option under the Federal Long-Term Care Insurance Program, according to the Office of Personnel Management. The average rate increase will be 83 percent, or $111 more per month, OPM said, for enrollees who opt not to change their coverage.

From Monday [July 25] through Sept. 30, federal employees and retirees with long-term care insurance will be able to view the new premium rates for the program and make changes to their coverage. 

Low interest rates are bad news for long term care insurers.

Here are a few tidbits:

  • HHS’s Office for Civil Rights took another HIPAA scalp yesterday. 
  • Health Affairs Blog, which has a new daily newsletter had interesting stories about off label promotion of prescription drugs and the scope of Public Health Service Act Section 1557.
  • Finally, the FEHBlog got a kick out of this STAT interview with Nobel Prize winner Dr. James Watson.  Dr. Watson, now age 88, is one of pioneers of DNA research in the 1950s.  

On the cancer moonshot announced this year by President Obama:
The depressing thing about the “cancer moonshot” is that it’s the same old people getting together, forming committees, and the same old ideas, and it’s all crap . . .
On the prospects of curing cancer:
Everyone wants to sequence DNA [to treat cancer], but I don’t think that will help you cure late-stage cancer, because the mutations in metastatic cancer are not the same as those that started the cancer. I was pessimistic about curing cancer when gene-targeted drugs began to fail, but now I’m optimistic.