The Washington Post reports that “The nation’s two electronic prescription networks plan to announce today that they are merging in an effort to encourage the adoption of their technology by doctors and patients.” Interestingly, the merger is between “SureScripts [which] is owned by the National Association of Chain Drug Stores and National Community Pharmacists Association [and] RxHub [which- is owned by CVS Caremark, Express Scripts and Medco Health Solutions,” the leading mail-order pharmacies and prescription benefit managers.

• Congress recessed for the Fourth of July holiday without approving a Medicare doctor reimbursement fix bill. HHS announced that it will temporarily freeze Medicare doctor reimbursement rates according to the Washington Post. “Congressional aides said the freeze could last 10 days.”
• The IRS released additional health savings account/high deductible health plan guidance on June 25. “Notice 2008-59 contains over 40 new frequently asked questions and answers that cover a wide range of topics, including:

  • Who is an Eligible Individual;
  • Issues related to High Deductible Health Plans;
  • Contributions to HSAs;
  • Distributions from HSAs; and
  • Establishing an HSA.”
    

• The Baltimore Sun published an article last week comparing the Google and Microsoft personal health records systems.
• The Congressional Budget Office (CBO) released a report concluding that a Senate bill (S. 1695) creating a pathway to biogeneric drugs would generate over $25 billion in national healthcare savings over a ten year period.
• I discovered that the CBO Director also has a blog . The Director’s entry for today is about a front page New York Times article on the cost effectiveness of the uses CT scans to diagnose heart disease. The article points out the utility of creating an institute to study and report on the effectiveness of diagnostic and treatment procedures as many have suggested.

• The Markle Foundation’s Connecting for Health Program framework for protecting the privacy and security of electronic personal health records has gained the support of Microsoft, Google, WebMD, the American Medical Association, the Blue Cross Blue Shield Association, and American’s Health Insurance Plans (“AHIP”) according to a press release. According to an AP report,
  

  The new “Connecting For Health” guidelines aim to give electronic PHRs at least the same level of protection already governing paper medical records. The rules also call for patients to be notified in a “timely way” if their medical information is released by mistake, computer hacking or other mischief.

• AHIP’s Board of Directors released principles on the patient centered medical home concept.

Earlier this month, the Internal Revenue Service (“IRS”) published Notices 2008-51 and 2008-52.

Notice 2008-51 “provides guidance on a qualified Health Savings Account (“HSA”) funding distribution from an individual’s Individual Retirement Account (IRA) or Roth IRA to a Health Savings Account (HSA). The qualified HSA funding distribution is a one-time transfer from an individual’s IRA to his or her HSA and generally excluded from gross income and is not subject to the 10% additional tax under Internal Revenue Code (“IRC”) § 72(t).”

Notice 2008-52 provides guidance on contributions to HSAs under IRC amendments made by §§ 303 and 305 of the Health Opportunity Patient Empowerment Act of 2006 (the Act) included in the 2006 Tax Relief and Health Care Act , Pub. L. No. 109-432.

The House approved a Medicare fix bill today by a veto-proof margin. The National Journal reports that Senators Baucus and Grassley have reached a compromise that may lead to enactment of a law this month. According to the National Journal,

Baucus did not discuss details of the compromise he worked out with Senate Finance ranking member Charles Grassley, but industry sources say the compromise prevents a 10.6 percent Medicare physician pay cut for 18 months by giving physicians a 0.5 percent Medicare payment increase in 2008 and freezing payments in 2009. By contrast, the House-passed measure bumps up physicians’ pay 1.1 percent in 2009.

Previously CMS announced that any Medicare fix law enacted after June 16 must be applied retroactively.

Your FEHBlog learned from the Business Insurance reporter that the House and Senate negotiators adopted the effective date provision from the Senate bill (S 558) which reads as follows:

The provisions of this Act shall apply to group health plans (or health insurance coverage offered in connection with such plans) beginning in the first plan year that begins on or after January 1 of the first calendar year that begins more than 1 year after the date of the enactment of this Act.

Assuming enactment in 2008, the new mental health parity provisions would apply to FEHB plans for the 2010 contract year, which is a relief.

Business Insurance reports that House and Senate negotiators have resolved the benefit related differences between the mental health parity bills that their respective chambers passed. Earlier the House backed off on its provision requiring health plans to cover all mental disorders identified by the American Psychiatric Association.

According to Business Insurance, “Negotiators now have also set the date for plans to comply with the new parity requirements at Jan. 1 of the first calendar year after the date of enactment.” I hope that’s an error because if this account is accurate then the new requirements would apply to health plans, including FEHB plans, on January 1, 2009, if the bill is enacted this year. 2010 would be much more reasonable in my view for such a major change. The negotiators now are turning to the pay go provisions adopted by the House that the Administration has threatened to veto. Stay tuned.

Mark your calendars now. The Indian generic drug manufacturer Ranbaxy has struck a deal with Pfizer to begin marketing a generic version of the blockbuster anti-cholesterol drug/statin Lipitor at the end of November 2011 according to the Financial Times. Ranbaxy will have 180 days of exclusive marketing rights to generic Lipitor.

Daiichi Sankyo of Japan is seeking to acquire Ranbaxy. The Indian business press reports today that the Bombay stock market which lists Ranbaxy reacted unfavorably to the deal. Reuters reports that the deal caused UBS to cut ratings on two large U.S. prescription benefits managers Medco and Express Scripts as a result of this deal because the UBS analysts expected Lipitor to go generic in 2010.

AIS Health Business Daily reprinted today an interesting article on how health plans can help avoid security breaches. The article reads in part as follows:

Health plan privacy and security officers interviewed by HPW say that while no information-protection system is totally foolproof, there are certain key steps plans can take to reduce significantly the risk of data being lost, stolen or inappropriately viewed. And they agree that in most cases, the problem is internal mistakes and carelessness rather than threats from hackers. “Typically the weak link is not some exotic hacker,” Craig Shumard, CIGNA Corp.’s chief information security officer, tells HPW. “In many cases, it’s an employee or third-party outsourcer who just didn’t consider the security implications of what they were doing.” Among the weak links cited by privacy and security officers:

• Overlooking the importance of a culture that values information protection;
• Sending PHI or other sensitive data by unsecured channels;
• Using laptops with unencrypted hard drives; and
• Not monitoring an outside vendor’s privacy and security procedures.

These weak links can be addressed by the right blend of administrative practices and technology safeguards. “The most important step you can take is arming your employees with the technology and the knowledge they need to protect this information,” says Mike Elinski, associate vice president for technology and e-business development at Michigan-based Health Alliance Plan. “Doing this puts you and your customers in the best possible position.”

Common sense also helps.

The American Medical Association has announced that it will begin to rank health plans on the quality and timeliness of their claims administration according to the Chicago Tribune. The AMA believes that their ratings will serve as a counterpoint to health plan on-line ratings of physicians. However, the AMA News reports this week that relatively few people select their physicians by using these ratings:

A Harris Interactive poll commissioned by the California HealthCare Foundation found that although more than 80% of the state’s adults turn to the Internet for health-related information, less than one-quarter have looked at physician ratings sites. Only 2% of those surveyed made a change in physicians based on information posted on a rating site.

That lack of reliance on ratings is not limited to choosing a physician. The survey, released in June, also found that only 1% of respondents made a change in their hospital or health plan based on ratings sites devoted to those entities.

The health plan trade association, AHIP, released a statement on the AMA’s actions.