FCW.com reports that Sen. Ted Kennedy (D Mass) and Rep. John Dingell (D Mich) have introduced a “Medicare for All” universal coverage bill. Evidently Medicare for All is a bit of a misnomer. Senator Kennedy’s press release informs us that under the measure,

• Benefits available to the under 65 population under the expanded Medicare program will be the same as those provided under Medicare, with additional benefits appropriate to the wider age range served by the new program. Enrollees may also choose any private insurance plan available to members of Congress under the Federal Employees Health Benefit Program.
• The plan will be financed by a combination of payroll taxes and general revenues that will substitute for private payments. A preliminary estimate of the payroll tax financing necessary will be a payment of 7 percent of payroll by businesses and 1.7 percent by workers. By comparison, businesses providing coverage today spend an average of 13% of payroll to cover their workers.

Hey kids! It’s the 5th National DNA Day! “The National Human Genome Research Institute (NHGRI), part of the National Institutes of Health (NIH), will mark the fifth annual National DNA Day on April 25 with events aimed at building high school students’ awareness of genetics and genomics. April 25 commemorates both the discovery in 1953 of DNA’s double helix and the 2003 completion of the Human Genome Project.”

I am confident that the next generation (or possibly Generations X 0r Y members) will fully unlock the potential benefits of the human genome project so that we will be laughing at these current days of high health care costs fifteen or twenty years from now. (Of course, there will be a different crisis by then). Call me optimistic but I don’t think that I going out on limb here.

Government Health IT magazine reports this morning that AHIC, the HHS advisory body, plans to recommend that federal contracts with health plans and insurers include provisions rewarding health care providers for “good performance, including the use of certified electronic medical records.” This report is based on yesterday’s AHIC meeting.

• Former House Speaker Newt Gingrich and representatives of the Blue Cross Blue Shield Association and United Healthcare voiced their support for insurer-developed personal health records at a Capitol Hill briefing yesterday.
• A Health Affairs blogger posted an interesting report on health care transparency viewpoints expressed by speakers at the recent World Health Congress. Among the speakers was OPM Director Linda Springer:

Consumer-driven plans: Office of Personnel Management (OPM) director Linda Springer noted that some 20,000 U.S. government employees are now in high-deductible consumer-driven insurance plans. She expects to see that number rise.

• To celebrate the fourth anniversary of the HIPAA Privacy Rule’s compliance date (April 13, 2003), the Secretary of Health and Human Services delegated his subpoena authority to the director of the HHS agency responsible for Privacy Rule enforcement, the Office for Civil Rights, and the Department created a new Privacy Rule enforcement web site.

Last week. the America’s Heath Insurance Plans trade association proposed a national strategy to improve health care quality and safety. This ties in with the Administration’s four cornerstones of health care policy.

It’s Cover the Uninsured Week. That’s a goal that people can get behind, but the Week’s proponents are pushing for an expansion of the State Children’s Health Insurance Program (SCHIP), which is up for renewal in Congress this year. Grace Marie Turner of the Galen Institute has some interesting observations on this means to the goal:

• First, if Washington pours $75 billion into SCHIP over the next five years, as congressional leaders propose, it will be well on its way to creating a generation of children who think that the place you get health insurance is through the government.
• This expansion means that taxpayers will be paying for coverage that could have been bought with private dollars. Jonathan Gruber of MIT found that at least 60 percent of children enrolled in SCHIP previously had private coverage, strongly suggesting that public programs are crowding-out private insurance.
• And expansion of government health programs has an impact in driving up the cost of private health insurance. Here’s why: Actuary Mark Litow of Milliman Consultants and Actuaries argues that expanding government programs puts added pressure on private health spending.

The reauthorization appears to be an interesting battle between Congress and the White House. The AMA News explains that

Last month, the House and Senate both narrowly passed budget resolutions — roadmaps for federal spending — creating a pathway for a five-year, $75 billion reauthorization of SCHIP. Both resolutions add $50 billion over five years to the existing $25 billion in SCHIP funding. But during the actual appropriations process, both chambers must offset the new spending with new revenues or cuts to meet budget rules, said staff members for the Senate Finance Committee and the chair of the House Budget Committee. When it comes to specific plans, some Democrats are supporting five-year reauthorizations with eligibility as high as 400% of the poverty level and as much as $85 million in funding.But President Bush — in an attempt to refocus SCHIP on low-income children — proposed a $30 billion, five-year reauthorization. This would fund coverage for children in families with incomes up to 200% of the federal poverty level.

But President Bush — in an attempt to refocus SCHIP on low-income children — proposed a $30 billion, five-year reauthorization. This would fund coverage for children in families with incomes up to 200% of the federal poverty level.

HHS Secretary Mike Leavitt submitted a report to Congress this week on an electronic prescribing test required by the Medicare Modernization Act of 2003. E prescribing. of course, is expected to produce significant improvements in patient safety, and doctors appear ready to embrace e-prescribing as opposed to electronic health records. According to the HHS press release,

“The pilot project demonstrated that three initial standards are already capable of supporting e-prescribing transactions in Medicare Part D. These are standard transactions that provide physicians with patients’ formulary and benefit information, medication history, and the fill status of their medications. * * * Some of the initial e-prescribing standards tested by the pilot project were found to have potential but still need further development if they are to be adopted as e-prescribing standards. These include standards used to convey structured patient instructions, a terminology to describe clinical drugs, and messages that convey prior authorization information.”

Government HIT magazine reports that the report concludes that e-prescribing remains in its “infancy. “

Dr. Robert Kolodner was made the Nation’s permanent National Coordinator for Health Information Technology today. (The picture is of the Russian czar Peter the Great, not Dr. Kolodner) Dr. Kolodner, who came over to HHS from the Veterans Affairs Department, has served as the interim health information technology czar for the past year. I think that this is a good choice.

Modern Healthcare.com has a post-appointment interview with Dr. Kolodner here.

Modern Healthcare.com reports that the Senate minority leadership defeated the Senate bill that would allow the Secretary of HHS to negotiate Medicare Part D drug prices on a procedural vote this morning.

CMS recently a proposed rule that would overhaul its Medicare Part A (hospital care) prospective pricing system. According to the HHS press release,

The payment reforms include a proposal to restructure the inpatient diagnosis related groups (DRGs) to account more fully for the severity of the patient’s condition. In addition, the proposed rule includes provisions to ensure that Medicare no longer pays hospitals for their additional costs of hospital-acquired conditions (including infections), and includes an expanded list of publicly reported quality measures. The proposed rule would also reduce payment for a DRG involving the implantation of a device, when a hospital replaces a device and the replacement is supplied to the hospital at no or reduced cost.

The proposed rule also would provide “additional incentives for hospitals to engage in quality improvement efforts.” The new rule, once finalized, will apply to hospital discharges that occur on or after October 1, 2007. HHS is accepting public comments on the proposed rule until June 12, 2007.

FEHBP fee for service plans use the Medicare prospective payment system to pay claims on annuitant members who are not eligible for Medicare Part A (5 U.S.C. § 8904(b)).