The nascent National Health Information Network was demonstrated yesterday at one of the final meetings of the American Health Information Community. Healthcare IT News reports that

The demonstrator, a cooperative of 19 groups that includes communities, federal agencies and healthcare providers from across the country, showed how the first approved use cases could work to help save lives and give doctors more information to make better medical decisions. The data used in Tuesday’s demonstration was based on fictitious patients; ONC officials said they plan to launch a live public demonstration with real patient data in December.

Also at this meeting, the Board of Directors of AHIC’s public-private replacement, aptly named AHIC Successor, Inc. was announced. According to an HHS press release, HHS Secretary Mike Leavitt remarked that

“This is a key milestone for the health IT movement. It will ensure that the critical work of the AHIC can be effectively leveraged so that interoperable health IT becomes a reality and that the benefits of health IT reach all Americans. I enthusiastically support the new board and look forward to working in partnership with AHIC Successor to move the nation toward an effective, nationwide health information system.”
To demonstrate the commitment of the federal government to the new organization, Secretary Leavitt and Veterans Affairs Secretary James Peake will serve as federal liaisons to the board. The National Coordinator for Health Information Technology, Dr. Rob Kolodner, will continue to coordinate federal input into the public-private process.

In 1996, Congress passed the Defense of Marriage Act which requires that spousal coverage under the FEHB Act be limited to married men and women. Sen. Joe Lieberman (I Conn.) has introduced a bill, S. 2521, that would modify this law to permit FEHB Program coverage of same sex domestic partners. Yesterday, the Senate Homeland Security and Governmental Affairs Committee held a hearing on the bill. OPM testified against the bill for a variety of reasons, including cost. OPM estimated that “the FEHB Program (government) costs would be $41 million for 2010 and approximately $670 million for 2010 through 2019.” OPM also raised specific concerns about the difficulties of administering this coverage. “The bill under consideration would provide benefits to those in domestic partnerships or relationships which are certified by affidavit. OPM believes this process could lead to fraud and abuse in the programs we administer.” According to a Govexec.com article on the hearing, “[m]embers of the committee were skeptical that fraud would be widespread, pointing to the large number of private sector companies — including more than half of Fortune 500 companies — that have domestic partnership benefits.”

The Washington Post reports that both the House and the Senate have enacted the Wellstone – Domenici mental health parity bill. The House did so as a standalone bill (HR 6983) and the Senate included the bill in the bill modifying the alternative minimum tax and extending various otherwise expiring tax provisions. But the House and the Senate still have no resolved their disagreement over how to pay for the bill. According to the Post, “It is unclear whether a joint agreement can be reached in the few days remaining before Congress recesses.” I think that it will. 

• Business Insurance reports that
  

  In 2008, group health care costs increased by an average of 6.0%, to $8,331 per employee, and are projected to rise next year by 6.4%, according to an analysis released Monday by Hewitt Associates Inc. of Lincolnshire, Ill. The analysis is based on information from more than 400 employers. This year’s 6.0% average increase is up from a 5.3% increase in 2007 but is substantially lower than 2006’s average increase of 7.9% and the 9.2% hike in 2005.  * * * As health care plan costs have risen, cost-shifting to employees also has increased. For example, employees’ total health plan costs—which include out-of-pocket expenses, such as deductibles and copayments, as well as premium contributions—averaged $3,513 per employee in 2008, up 9.9% from 2007. Copies of Hewitt’s health care cost analysis are available at www.hewitt.com

• The Chicago Tribune expands on the cost shifting aspect of this Hewitt study.
• On a related note, the Wall Street Journal reports that
  

  As the credit crunch threatens to throw the economy into a deep slump, Americans are already cutting back on health care, a sector once thought to be invulnerable to recession. Spending on everything from doctors’ appointments to preventive tests to prescription drugs is under pressure. * * *
  In a survey by the National Association of Insurance Commissioners last month, 22% of 686 consumers said that economy-related woes were causing them to go to the doctor less often. About 11% said they’ve scaled back on prescription drugs to save money. Some of the areas being hit include hip and knee replacements, mammograms, and visits to the emergency room, according to a survey conducted by D2Hawkeye Inc., a Waltham, Mass., medical data analytics firm, on behalf of The Wall Street Journal.

• Last year, Congress paid for avoiding a statutorily prescribed reduction in Medicare Part B reimbursement to physicians by mandating that insurers and other payers report Medicare related coordination of benefits information to the Centers for Medicare and Medicaid Services (CMS). Payers generally had been providing this information to CMS under Voluntary Data Sharing Agreements with CMS. The new mandate is effective January 1, 2009. CMS has posted a timeline for implementation of this mandate and a paper explaining how payers with VDSAs will be affected by the new mandate. 
• The HHS Office for Civil Rights, which is responsible for enforcing the HIPAA Privacy Rule, has posted guidance for consumers/patients and health care providers on the extent to which the Privacy Rule allows providers to share protected health information with the patient’s family members and friends.

• On Friday, the Centers for Medicare and Medicaid Services announced that the Medicare Part B premium — currently $96.40 will not increase for 2009. This CMS fact sheet explains the rationale for the freeze and it provides the income related premium adjustments for Medicare beneficiaries with taxable income over $85,000. Finally the fact sheet informs us that the 2009 Medicare Part A deductible will be $1,068, a $44 increase over the 2008 Medicare Part A deductible. Medicare Part A pays for inpatient hospital, skilled nursing facility, hospice, and certain home health care services. These changes are significant to the FEHB Program because there is a large contingent of FEHBP annuitant enrollees with primary Medicare coverage.
• The Washington Post reports that in the coming week the Senate will consider the alternative minimum tax / tax extenders bill (H.R. 6049), which now includes the compromise mental health parity bill. According to the Kaiser Daily Health Policy Report, the House leadership, which is not enamored with this expensive bill, plans to take up the mental health parity bill as a stand-alone bill this coming week under suspension of the rules, a procedure that prohibits amendments and requires a two-thirds majority
  for the bill to pass.
• The Wall Street Journal reports that “To pinpoint hereditary sources of longevity, researchers at the Scripps Research Institute in La Jolla, Calif., are recruiting 2,000 healthy people over 80 years old to compare the entire genetic sequences of these “wellderly” to those from people who died of common age-related illnesses before they reached 80.” Keep your fingers crossed. The article cautions that
  

  Many experts in aging are skeptical. “We seem to know a lot about longevity in worms, but we don’t know if any of it is relevant for humans,” says Jan Vijg, who studies the genomics of aging at the Albert Einstein medical college. “The problem is that we don’t really know the basic cause of aging.”

At a February 2007 Senate hearing, GAO banged on HHS for failing, among other things, to create privacy milestones in its efforts to create a nationwide electronic medical records system. This week GAO issued a follow-up report finding that while HHS has made progress, “they have fallen short of fully implementing GAO’s recommendation” — “that HHS include in its overall privacy approach a process for ensuring that key privacy principles and challenges are completely and adequately addressed.”

Senate leaders from both parties agreed yesterday on an alternative minimum tax patch and tax extenders bill (S 6049) that includes as Section 507 the enhanced mental health parity law. According to an AP report, “the tax package is one of the last major issues that Congress must
address in the last weeks before its scheduled adjournment for the year [later this month].” If Congress passes this law before adjournment, the law would be applicable to the FEHB Program in 2010. The major difference between the new law and the FEHBP status quo is that the new law would require parity in network and out of network while the current FEHBP policy is to require parity in-network only.

The Senate Finance Committee held a health care reform-related hearing yesterday titled Aligning Incentives: The Case for Delivery System Reform. The testimony may be found here, and a Kaiser report on the hearing there.

Rep. Pete Stark (D CA), chairman of the Health Subcommittee of the House Ways and Means Committee, has introduced a bill to promote the adoption of health information technology by the medical community (HR 6898). It appears that this issue is being booted into the next Congress.

• The fallout from the Endoscopy Center of Southern Nevada tragedy continues. The Las Vegas Review-Journal reports that

  A 70-year-old woman who has tested positive for hepatitis C filed a lawsuit today against [her HMO] Pacificare of Nevada for referring her to a physician associated with the Endoscopy Center of Southern Nevada for treatment. Alynne Griffiths, who underwent two procedures at the Shadow Lane facility where health officials have linked eight hepatitis C cases due to unsafe injection practices, claims Pacificare won’t pay for her to see a hepatitis specialist outside her network.

  Pacificare is part of United Healthcare.