Yesterday, OPM posted on its web site the Federal Civilian Benefit Programs Annual Report for Fiscal Year 2006, which ended on September 30, 2006. This report includes the audited financial statements for the Federal Employees Health Benefits Program, as well as CSRS and FEGLI. Here’s the link. The report discloses that the FEHB Program “covers approximately 82 percent of all eligible participants” (p. 27).

Kaiser Permanante arranged for a telephonic survey of 1,000 health care consumers asking about their views on health information technology. Interestingly 57% of the respondents believe that their primary care doctors uses a computerized medical records system. However, a majority of the respondents had not heard about electronic medical records before the survey. In any event, a significant majority of respondents believe that electronic medical records will improve health care.

The President today nominated a permanent administrator for the Centers for Medicare and Medicaid Services (CMS), an assistant Secretary of Labor (Pension and Welfare Benefits) to handle ERISA matters, and the Pension Benefit Guaranty Corporation director.

• Kerry N. Weems, of New Mexico, was nominated to be the CMS Administrator, replacing Leslie Norwalk, the interim administrator. Mr. Weems currently serves as Deputy Chief of Staff at the Department of Health and Human Services. Prior to this, he served as the Acting Assistant Secretary for Budget, Technology, and Finance and Chief Financial Officer. Earlier in his career, he served as Deputy Assistant Secretary for Budget at the Department of Health and Human Services. Mr. Weems received his bachelor’s degree and BBA from New Mexico State University and his MBA from the University of New Mexico.
• Bradford P. Campbell, of Virginia, was nominated to be Assistant Secretary of Labor (Pension and Welfare Benefits). Mr. Campbell currently serves as Acting Assistant Secretary and Deputy Assistant Secretary at the Employee Benefits Security Administration. Prior to this, he served as Senior Legislative Officer in the Office of Congressional Affairs at the Department of Labor. Earlier in his career, he served as legislative director to U.S. Representative Ernie Fletcher and as senior legislative assistant to former U.S. Representative Christopher Cox. Mr. Campbell received his bachelor’s degree from Harvard University.
• Charles E. F. Millard, of New York, was nominated to be Director of the Pension Benefit Guaranty Corporation. Mr. Millard currently serves as Managing Director at Broadway Partners, LLC. Previously, he served as a Managing Director at Lehman Brothers. From 1995 to 1999 he served as President of the New York City Economic Development Corporation. He also served as Group Head and Managing Director at Prudential Securities, Inc. and was twice elected to the New York City Council. Mr. Millard received his bachelor’s degree from the College of the Holy Cross and his JD from Columbia University.

The Wall Street Journal’s Health Blog reports on a study of health plan payment practices conducted by Athena Healthcare. The link to the press release is here, and the link to the ratings is here.

Big pharma Merck charges high price for a new vaccine against a cervical cancer virus (HPV), Gardasil. Insurers try to control the cost of the vaccine. Doctors and patients complain according to the Washington Post. Meanwhile, the Wall Street Journal’s Health Blog reports that an American Medical Association Journal editor has published an opposition to mandatory Gardadil vaccines for girls and young women. While routine administration of Gardasil “undoubtedly is beneficial to the public’s health, as it is likely to reduce the incidence of cervical cancers, the rush to make HPV vaccination mandatory in school-aged girls presents ethical concerns and is likely to be counterproductive.”

On Friday, twenty-three Blue Cross and Blue Shield Plans and the Blue Cross and Blue Shield Association (BCBSA) announced that “they have reached an agreement with representatives of a nationwide class of physicians to settle a lawsuit that was filed in U.S. District Court in Miami in 2003” and is known as the Thomas/Love case. Business Insurance reports that in addition to making payments to a compensation fund and attorneys fees

The Blues plans have agreed to make several business practice changes, including implementing a definition of medical necessity that ensures that patients are entitled to receive medically necessary care as determined by a physician exercising clinically prudent judgment; ensuring the payment of valid clean claims within 15 days for electronically submitted claims and 30 days for paper claims; providing fee schedules to physicians; and establishing an independent external review board for resolving disputes with physicians concerning many common billing disputes.

These changes are similar to those accepted by previously settling health insurer defendants. The American Medical Association’s President applauded the settlement, which is now pending approval by U.S. District Judge Moreno in Miami.

• OPM issued a press release on Director Springer’s address to the 4th World Health Care Congress. “Shopping for quality health care should be as easy and open a process as shopping for basic consumer goods,” Director Springer concluded. In the concluding address at the Congress, Wal-mart’s CEO announced that Wal-Mart will open 400 health clinics in its stores over the next three years with a goal of opening 2,000 in the next five to seven years.
• Mutual of Omaha issued a press release on its exit of the employer sponsored group health insurance business, which process included the sale of its FEHBP business to Coventry Health Care.

The House passed the genetic non-discrimination bill (H.R. 493) last night 420-3. The bill, if enacted would regulate health plan and employer collection and handling of genetic data. The bill is pending Senate floor action and is on a very fast track toward enactment. President Bush has said that he will sign this bill if it lands on his desk.

Modern Healthcare Online offers more nuanced and detailed view of the April 24 AHIC meeting (as compared to the Government Health IT article mentioned here on Wednesday). According to this article David Brailer, the AHIC co-chair suggested that the AHIC electronic health records work group hold a public hearing on its pay for performance (and use of certified electronic health record) proposals, which are described as “controversial.” I need to read up more on this meeting.

Coventry Health Care, Inc., announced this morning that it is acquiring from Mutual of Omaha its nationwide FEHB plan business and its employer sponsored group health plan business in Nebraska and Iowa. Mutual of Omaha serves as the underwriter for several employee organization sponsored FEHB plans, including the Rural Letter Carriers Plan and the Foreign Service Benefit Plan. Coventry, through subsidiaries, underwrites another employee organization sponsored FEHB plan the Mail Handlers Benefit Plan.