Last night, the Senate passed its version of the enhanced mental health parity legislation (S. 558) by unanimous consent. Today, the Health Subcommittee of the House Ways and Means Committee cleared the more aggressive House version of this legislation by a 10-3 vote (HR 1424). The House Labor and Education Committee previously cleared H.R. 1424 and the full Ways and Means Committee and the Energy and Commerce Committee also must consider it. Business Insurance explains that

[The Senate bill] differs in several significant respects from legislation passed in July by the House Education and Labor Committee. Under the Senate bill, self-funded employers would decide which mental health care disorders they would cover. In the case of insured plans, the Senate bill would act as a floor and not pre-empt tougher state parity laws. By contrast, the House committee bill would tie the type of mental health care disorders that group health care plans must offer to coverage provided by health plans available to federal employees.

An interest group called Wellstone Action is urging the House speaker Nancy Pelosi to hold a vote on the House bill as soon as possible. According to the Associated Press, the Speaker is planning a mid-October vote.
The House of Representatives today passed a compromise version of the FDA Prescription Drug User Fee reauthorization bill by a 405 – 7 vote. The bill now goes to the Senate which is expected to give its prompt approval and the President has indicated that he will sign the bill. The compromise bill includes a number of new prescription drug safety measures, including post-market safety studies, but not a pathway to biogenerics. Crisis averted.

According to the Wall Street Journal, House and Senate conferees are in the process of essentially adopting the Senate version of the State Children’s Health Insurance Program reauthorization bill, which includes a $35 billion increase in SCHIP funding over 5 years but no Medicare changes. The President has threatened to veto the SCHIP funding increase greater than the $5 billion that he proposed, but the Senate passed its bill by a veto proof margin. The solons agreed to consider the Medicare changes later this year. I would not be surprised if the same result is achieved with the mental health parity legislation as the Senate bill has the most bipartisan support.

• Well, it has been a busy week due to OPM’s press release about the 2008 FEHB Program premiums.
• OPM also issued a notice in the Federal Register on Friday about the medically underserved states for 2008. The fee for service plans must provide certain extended benefits in those states under 5 U.S.C. § 8902(m)(2). According to the agency’s announcement,”for calendar year 2008, OPM’s calculations show that the following states are Medically Underserved Areas under the FEHB Program: Alabama, Arizona, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Montana, New Mexico, North Dakota, South Carolina, South Dakota, and Wyoming. For the 2008 calendar year Texas and West Virginia are being removed from the list, and no new states have been added.”
• Congress continues to debate the SCHIP and FDA Prescription Drug User Fee reauthorization bills. According to the Kaiser Capitol Hill Watch, a short extension of the SCHIP authorization is likely while the solons work out the funding level and whether to include Medicare changes in the bill. However, Senator Enzi (R Wyo) has announced his opposition to House Speaker Nancy Pelosi’s proposal for a three month extension of the FDA user fee reauthorization bill.
• The GAO released a report on the future of health care in the U.S.
• In the same vein, today’s New York Times featured another article on its series concerning the impact of new genetic technology on American life.

OPM has posted the 2008 FEHBP premiums on its website. Govexec.com and the Federal Times continue to report on the fallout from OPM’s announcement. NARFE and NTEU also posted press releases about OPM’s announcement. The Open Season will run from November 12 to December 10, 2007.

The U.S. Office of Personnel Management announced today that Federal Employees Health Benefit Plan premiums will increase on average about 2 percent for the second straight year. The Washington Post, FedNewsRadio.com and Govexec.com have reported on OPM’s press conference.

At 2 pm tomorrow, Sept. 13, OPM Director Linda Springer will hold a press conference to announce 2008 premiums for the Federal Employees Health Benefits Program and the Federal Employees Dental and Vision Program. As a point of reference, a Kaiser Family Foundation study released yesterday states that employer sponsored health insurance costs have increased 6.1% on average in 2007. The Wall Street Journal reports that

This is the fourth straight year premiums have decelerated since soaring nearly 14% in 2003.But after a decade of inflation-topping increases, the annual cost for family coverage through an employer plan is now more than $12,000, well over what a minimum-wage worker earns in a year. Workers now pay on average $3,281 a year to cover their share of that family policy, double what they did in 2000, the survey found.

• Congressional Quarterly reports that the Senate Republican leadership is delaying the naming of a Conference Committee with the House on the State Children’s Health Insurance Plan (SCHIP) reauthorization bills. It further reports that a brief extension of the SCHIP law, e.g., to November 15 may be in the offing. Absent such action, the SCHIP Program authorization will expire on September 30.
• Govexec.com reported this week on federal employee union and NARFE efforts to require FEHB plan carriers to purchase prescription drugs off the Federal Supply Schedule, just like VA and Defense Department health care facilities. Govexec.com also reported this reaction from OPM Associate Director Nancy Kichak:
  

  Nancy Kichak, associate director for strategic human resources policy at OPM, said the agency opposes such a bill. “We want our carriers to have the flexibility to offer a variety of products to encourage competition,” she said, adding that OPM would prefer making the supply schedule discounts optional for FEHBP carriers.Kichak added that while use of the FSS would lower drug costs, it could do away with valuable elements of some plans, such as encouraging the use of generic drugs and allowing employees to obtain prescriptions through mail order. Use of the supply schedule “would only help in one element of the drug purchase, which is cost, and only for those drugs on the schedule,” she said.

• Modern Healthcare.com reported on HHS’s September 5 forum on converting the American Health Information Community to a private sector organization.
• The September 2007 issue of AIS Health’s Report on Patient Privacy is freely available online to sample. My colleague Theresa Defino wrote the interesting front page article on how to handle security breaches and yours truly is quoted inside the publication.
• The Senate confirmed President Bush’s appointment of Jim Nussle to serve as Office of Management and Budget Director.

In my view, the one great hope for resolving our health care crisis (besides the private market) is the ongoing research to inexpensively decode the human genome at an individual level. The New York Times and the Washington Post featured fascinating articles today about recent progress in this research. The Washington Post article explains that

Cost trends [in personalized genome sequencing] are encouraging. The first 3 billion-letter genome sequences took more than a decade to complete and cost billions of dollars. During Venter’s latest project, costs dropped precipitously, and today, several scientists said, an entire diploid genome could probably be done for about $100,000. Some predict that a $1,000 genome will be available within five years.Venter and others hope that at that point many people will get sequenced and, as Venter has already done with his own, will post their genomes on public databases along with their medical information and family history. That will allow computers to start drawing connections between gene patterns and diseases.

• The U.S. Office of Personnel Management (OPM) announced this week that it is expanding the Open Season guide, which traditionally has focused on the FEHB Program, to include the federal supplemental dental and vision program (FEDVIP) and federal flexible spending account (FEDFSA) offerings. OPM’s benefits administration letter explained that
  

  You can find more information about these programs at www.opm.gov/insure. OPM will post FEDVIP and FEHB premiums for 2008 in mid-September. You will be able to find specific Federal Benefits Open Season information on our web site during the first week of November. The 2007 Federal Benefits Open Season will be held from Monday, November 12, 2007, through Monday, December 10, 2007.

• On a weekly basis, I scout around the HHS website for interesting Medicare and health information technology information. The week, I discovered that HHS Secretary Leavitt has his own blog where he currently is reporting on his trip to Africa. On the more mundane front, CMS completed the third phase of its regulation project to implement the Stark Act’s prohibition against physician self-referral of Medicare business. The press release notes that “the Phase III final rule eliminates the requirement that entities providing professional courtesy provide written notice to an insurer of a reduction of any coinsurance obligation.”
• The New York Times reports that the American Cancer will devote its entire $15 million advertising budget to the issue of covering the uninsured.
• The U.S. Centers for Disease Control (CDC) released child and adolescent vaccination rates on Thursday. The CDC voiced concern over lagging vaccination rates for older children:
  

  The percentage of adolescents who had received recommended vaccines varied widely by both vaccine and age, with the nation′s Healthy People 2010 goals for adolescents ages 13-15 years not being met for any of the vaccines.
  The lowest estimates were associated with the most recently recommended vaccines. About 60 percent of 13-to-17 year olds received a tetanus-diphtheria or tetanus, reduced diphtheria and acellular pertussis vaccination since age 10, but only 10.8 percent for tetanus, reduced diphtheria and acellular pertussis alone, and 11.7 percent had received a meningococcal conjugate vaccine vaccination. “The new survey information shows we have more work to do to protect older children from vaccine-preventable diseases,” said Dr. Melinda Wharton, deputy director of CDC′s National Center for Immunization and Respiratory Diseases. “We need to continue to build awareness of these recommendations among parents and health care providers, and we need to continue our efforts to educate everyone about the health benefits of these vaccines.” Wharton encouraged parents of all 11- and 12-year-olds to have their child get a routine checkup as a way to ensure the children receive recommended vaccinations.

The U.S. Census Bureau today released its 2006 report on health insurance coverage, among other topics. The report notes that

The number of people with health insurance increased to 249.8 million in 2006 (up from 249.0 million in 2005). In 2006, the number of people covered by private health insurance (201.7 million) and the number of people covered by government health insurance (80.3 million) were not statistically different from 2005.

However, the report adds that

Both the percentage and the number of people without health insurance increased in 2006. The percentage without health insurance increased from 15.3 percent in 2005 to 15.8 percent in 2006, and the number of uninsured increased from 44.8 million to 47.0 million.

While the report cautions that “Research shows health insurance coverage is underreported in the [study] for a variety of reasons,” its finding that the number of uninsured children has increased from 8 million (10.9 percent) in 2005 to 8.7 million (11.7 percent) in 2006″ will play a factor in the SCHIP reauthorization debate. It is puzzling to me that the percentage of children living in poverty without health insurance — the intended beneficiaries of the SCHIP program — is 19.3% (unchanged from 2005) while the percentage of uninsured senior citizens — the intended beneficiaries of the Medicare program — is only 1.5%.

AIS.com posted this interesting report on proposals to wipe out the business associate concept in favor of sweeping application of the covered entity concept to all parties that handle protected health information except patients. Wouldn’t it be simpler for Congress to extend the HIPAA criminal and civil penalties to current business associates? It’s worth noting that these Patient Privacy articles posted on AIS.com often are written by Theresa Defino who has been helping me write the AFHO legislative reports for many years.