Sunday, July 29, 2007

Weekend Wrap-Up / Miscellany

  • The Kaiser Family Foundation's Health Policy Report noted that the House leadership version of the State Children's Health Insurance Program's reauthorization bill (HR 3162) requires revised to meet pay as you go requirements before the entire House considers the bill. Congressional Quarterly reports that the Senate leadership plans a vote on the Senate bill on Monday July 30.
  • Sen. Tom Coburn (R. Okla.) and four other Republican colleagues introduced the market based "Every American Insured Health Act" as an alternative to the major SCHIP expansion proposed by the House and Senate.
  • The American Hospital Association News reported that House approved an amendment as part of the Labor-HHS-Education appropriations bill (HR 3043) that would delay by one year (from Oct. 1, 2007, to Oct. 1, 2008) CMS's initiative to implement the Medicare Severity Diagnostic Related Groups classification system. CMS has projected that the new system which included a 2.4% "behavioral reduction" in payments to hospitals would save Medicare $24 billion over the next five government fiscal years. The Senate is expected to take up the bill after the August recess.
  • There were several articles published this week about how college students will be facing higher prices for oral contraceptives when they return to school in the fall. These articles illustrate the arcane nature of drug pricing in the U.S. The Wall Street Journal reports that

    For years, drug companies sold birth-control pills and other contraceptives to university health services at a big discount. This has served as an entree to young consumers for the drug companies, and a profit center for the schools, which sell them to students at a moderate markup. Students pay perhaps $15 a month for contraceptives that otherwise can retail for $50 or more.

    But colleges and universities say the drug companies have stopped offering the discounts, and are now charging the schools much more. The change has an unlikely origin: the Deficit Reduction Act signed by President Bush last year. The legislation aimed to pare $39 billion in spending on federal programs, from subsidized student loans to Medicaid. And among the changes was one that, through an arcane set of circumstances, created a disincentive for drug makers to offer school discounts.

    The contraceptive prices offered to schools are now included in a complex calculation that determines certain Medicaid-related rebates that drug makers must pay to states. In this calculation, deep discount prices would have the effect of increasing drug makers' payments.

    Under the 2005 Deficit Reduction Act, the discounts remain available to "safety net" providers serving the low income population.
  • Today's NY Times featured an article on cancer treatment. The article explains that
    [Cancer t]reatment guidelines approved by experts already exist for 70 to 80 types of cancer (http://www.nccn.org/), but the new measures are the first to be formally endorsed by cancer organizations to assess whether hospitals are performing up to par. The measures were developed by the American College of Surgeons’ Commission on Cancer, the American Society of Clinical Oncology and the National Comprehensive Cancer Network, and are available online at www.facs.org/cancer/qualitymeasures.html.

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