• Modern Healthcare Online reports that Sen. Max Baucus (D Mont), the chair of the Senate Finance Committee, has released his “Medicare reform” bill that would retain the current 0.5% increase in doctor reimbursement from Medicare in 2008 and allow a 1.1% increase in 2009. This is higher than the increase that Sen. Baucus initially proposed. Absent the enactment of this legislation, a 10.6% reduction in doctor reimbursement from Medicare will take effect on July 1, 2008. What’s more unless this legislation is enacted by June 16, Medicare will be required to implement the change retroactively according to the Centers for Medicare and Medicaid Services.
• The New York Times reports today on a Capitol Hill controversy over Medicare reimbursement of doctor owned or specialty hospitals.
• Today’s Washington Post includes a Jane Bryant Quinn column on a health care reform proposal offered by the ERISA Industry Committee. Meanwhile, AHIP, the health insurance carrier’s trade association, offered its own reform proposal recently.

• Government Health IT reported on the June 4, 2008, House Energy and Commerce Health Subcommittee hearing on the bipartisan health information technology bill that has emerged from the leadership of that committee. What caught my eye were two points: (1) that the Bush Administration warned that
  

  The adoption of health IT standards, implementation specifications, and certification criteria through the use of rulemaking should be avoided. We have seen from prior statutory requirements that it significantly delays the applicability and usage of new and improved standards.

  Amen! and (2) that there were voices in opposition to the privacy zealots who testified.

• The American Health Information Community (AHIC) met on Tuesday June 3. Healthcare IT News reports that
  

  Officials at Tuesday’s meeting received a positive report on the progress of healthcare IT policy efforts. However, experts cautioned, doctors are still slow to adopt electronic health records, and few of the approved standards for healthcare IT data exchange have made it into use in the real world.

Last December, Congress provided doctors, who were facing a 10.6% cut in Medicare reimbursement, with a stay of execution that expires on June 30. The House of Representative’s rules prevented a longer extension. (In fact, Congress gave doctors a 0.5% reimbursement boost for the first six months of 2008).

The Centers for Medicare and Medicaid Services have warned Congress that unless a new extension is enacted by June 16, the wheels implementing the 10.6% cut on July 1 will be set in motion. While both parties want to create an 18 month extension of the status quo, there is disagreement over how to fund it. Therefore, it is likely that the cut will be implemented and then retroactively reversed by Congress. This eventuality, which has occurred a few times in the recent past, causes problems not only for doctors and Medicare payers but also for FEHB plans which pay thousands of claims secondary to Medicare.

The Treasury Department has released here the 2009 indexed amounts on the maximum contribution levels for Health Savings Accounts (HSAs) and out-of-pocket spending limits for High Deductible Health Plans (HDHPs) that must be used in conjunction with HSAs.

• Following up on last Sunday’s post, the Health subcommittee of the House Energy and Commerce Committee will be holding on June 4 at 10 am a business meeting on the discussion draft of the health information technology legislation that a bipartisan group of Committee members has developed.
• Modern Healthcare Online and Government Health IT report no big commercial payer problems associated with the end of the HIPAA National Provider Identifier contingency period on May 23.
• In an interesting development, the State of Connecticut has filed suit in federal court in Boston against McKesson Corp. based on the alleged average wholesale price fixing scheme that is the subject of a private class action in the same court. The private sector class action was brought against McKesson and its alleged co-conspirator First Databank, Inc. (New England Carpenters Health Benefits Fund et al v. First Databank, Inc., et al., Civil Action No. 1:05-cv-11148-PBS. The class plaintiffs counsel and First Databank have proposed a revised settlement to the court after the court reject the first agreement. The class plaintiffs continue to litigate against McKesson. The Connecticut Attorney General sued McKesson, but not First Databank.
• It’s also worth noting that Health Net, a large managed care company, and various class action plaintiffs are proposing a settlement agreement to a federal court in New Jersey where the subject of the dispute is out of network reimbursement levels. Health Net is one of the defendants in the class action filed in Connecticut federal court against Ingenix, the company that develops out of network reimbursement (UCR) schedules, and various managed care companies.

• Kaiser State Health Facts
• AHRQ Medical Expenditure Survey
• AHRQ Healthcare Cost and Utilization Project

What’s more, prescription benefits manager Medco Health Solutions Inc., has released its 2008 Drug Trend Report.

• Good news! The House of Representatives has dropped its plan to statutorily require health plans to cover all mental illnesses identified by the American Psychiatric Association in its Diagnostic and Statistical Manual according to Workforce Management. This compromise with the Senate increases the chances that a stronger mental health parity law will be enacted this year.
• A bi-partisan group of Representatives produced the outline of a House health information technology bill. Meanwhile, the Congressional Budget Office produced a report concludes, according to Government Health IT magazine, that
  

  “there still are many unknowns about the adoption of health information technology, including what its true costs and benefits might be.

  The report, “Evidence on the Costs and Benefits of Health Information Technology,” does not recommend what Congress should do about health IT, but it states that “if policymakers are interested in promoting health IT, some version of a requirement or an explicit or implicit penalty for providers who fail to adopt health IT is likely to be more cost-effective for the federal government than a subsidy.”

• The National Alliance for Health Information Technology forwarded to the American Health Information Community a report including consenus definitions of the following six terms
  

  Electronic Health Record;

  Electronic Medical Record;

  Health Information Exchange;

  Health Information Organization;

  Personal Health Record; and

  Regional Health Information Organization.

• The Federal Trade Commission reported to Congress last week that “Brand name pharmaceutical companies struck 14 deals that led to delayed sale of cheaper generic drugs in the 2007 fiscal year” according to Reuters. The FTC is encouraging Congress to enact a law restricting this practice which the FTC considers to violate antitrust laws.
• On Friday, Medicare began denying electronic claims that included any provide identifying numbers other than the HIPAA National Provider Identifier and the employer or tax identification number. CMS, which enforces HIPAA standards transaction and identifier rules, advised health plan covered entities to similarly terminate their NPI contingency plans.

The internet giant, Google, launched its personal health record site on Monday. As I am a Google subscriber, I bit and signed in. I was presented with terms of service to approve. Here are some interesting tidbits from that agreement:

4. Use of Your Information If you create, transmit, or display health or other information while using Google Health, you may provide only information that you own or have the right to use. When you provide your information through Google Health, you give Google a license to use and distribute it in connection with Google Health and other Google services. However, Google may only use health information you provide as permitted by the Google Health Privacy Policy, your Sharing Authorization, and applicable law. Google is not a “covered entity” under the Health Insurance Portability and Accountability Act of 1996 and the regulations promulgated thereunder (“HIPAA”). As a result, HIPAA does not apply to the transmission of health information by Google to any third party.

plus indemnification of Google, exclusion of warranties, and limitations on Google’s liability.
Needless to say, I did not click any further. The New York Times reports on the launch here.

The President signed the Genetic Information Non-Disclosure Act (GINA, HR 493) into law today. The Johns Hopkins University Genetics Center published a chart showing what the law does and does not cover.