Mid-week miscellany

• The House passed a tax bill on April 15 that would impose a requirement on health savings account (HSA) trustees, e.g., banks, to substantiate the health care nature of expenses reimbursed out of HSAs. According to Workforce Management, "The 238-179 vote came after intense debate on the House floor in which opponents of the HSA provision—which is part of a broader tax bill, H.R. 5719—warned that such a requirement could cripple HSAs." The White House issued a statement of administration policy that includes a veto warning over this provision.

  These new burdens on HSA administrators are unnecessary for efficient tax administration, inconsistent with the flexibility purposely afforded HSAs at their inception, and could undermine efforts by employers, individuals, and insurers to reduce health care costs and improve health outcomes by empowering consumers to take greater control of health care decision-making. If H.R. 5719 were presented to the President with these provisions, his senior advisors would recommend he would veto the bill.

  We shall have to wait and see what the Senate does with the bill.

• The Centers for Medicare and Medicaid Services published on April 14 a proposed rule concerning changes to the prospective payment system that compensates hospitals for Medicare Part A covered care in the next federal fiscal year that begins October 1, 2008. The CMS fact sheet on the rule is here. Modern Healthcare reports that

  Under the proposal, hospitals would receive the full inflation, or marketbasket, update, projected at 3%, but given all the changes in the rule, the CMS projects that on average, hospitals will see an increase in payments of 4.1%, according to the American Hospital Association.

  The proposed rule also expands the number of quality measures on which hospitals must report to CMS and expands the list of never events that Medicare will not cover.

• Healthcare IT News reports that AHIC's Consumer Empowerment workgroup "considered recommendations on April 15 from the Centers for Disease Control and Prevention on how best to push personal health records." Among other suggestions, CDC recommended market research on consumers.
  

• A Wellpoint subsidiary, Healthcore, Inc., is working with the Food and Drug Administration to mine claims data for the purpose of creating a Safety Sentinel System to promptly identify unanticipated health risks associated with prescription drug use. According to Wellpoint's press release,
  

  Jerry Avorn, M.D., professor of medicine, Harvard Medical School and chief, division of pharmacoepidemiology and pharmacoeconomics, Brigham and Women's Hospital, said, "The discovery of important risks of drugs like Vioxx(R) and Avandia(R) has demonstrated that the health care system currently has no reliable means of quickly measuring the safety of drugs once they're in widespread use. I look forward to working with HealthCore and its partners on this project and bringing the value of WellPoint's Safety Sentinel System to a large number of patients."
  
  Ultimately, the system is expected to be capable of continually monitoring WellPoint's 35-million member database and identifying increases in health problems among members taking a given drug, indicating a potential Serious Adverse Event (SAE). It is anticipated that the company's Safety Sentinel System will also make it possible to examine whether particular combinations of treatments could cause serious medical problems, especially in patients with certain diseases or health conditions.
  
  Sam Nussbaum, M.D., chief medical officer for WellPoint, said, "This critical information will allow health care decision-makers including federal agencies, physicians, consumers and manufacturers to move far more quickly than in the past in addressing potential drug risks. "Our company's Safety Sentinel System will draw upon the vast amount of data generated by WellPoint's health plans, including the use of specific medications. It will enable us to identify potential hazards and allow faster, more informed decision making by health care professionals."
  
  "Our initial developmental work on the system has clearly demonstrated its ability to detect adverse events rapidly," Nussbaum said. "We were able to pick up a safety signal within a few months on certain drugs even though in some cases in the industry's current system it can take more than 5 years."
  
  "WellPoint's investment in its Safety Sentinel System demonstrates the company's commitment to providing the best possible care to its members," said Marcus Wilson, Pharm.D., president of HealthCore. "What differentiates our system from other safety programs is not only our ability to access massive amounts of data to detect the presence of serious safety issues, but also our ability to work in collaboration with our vast network of health care providers across the country to quickly and effectively evaluate the validity of the signal."