Wednesday, August 13, 2008

Mid-week Miscellany

  • The U.S. Court of Appeals for the Federal Circuit today affirmed a lower court opinion invalidating an OPM regulation prohibiting final year SSSG pricing reconciliations as in conflict with the FEHB Act, 5 U.S.C. § 8902(i). HMOs participating in the FEHB Program use the similarly sized subscriber group ("SSSG") methodology to set the community rates for their FEHB plans.
  • Speaking of OPM, Director Linda Springer left office today. The Washington Post's new Federal Diary columnist, Joe Davidson, reported on Ms. Springer's reflections concerning this transition.
  • CVS Caremark acquired the West Coast based Long's Drug Store chain. The AP reports that "Longs operates 521 drug stores in California, Hawaii, Nevada and Arizona, which will give CVS about 6,800 stores when the deal is completed. It also operates the Rx America pharmacy benefits management business, which provides services to about 8 million members and prescription drug coverage to about 450,000 Medicare beneficiaries."
  • The Consumer-Purchaser Disclosure Project announced today that it "has named the nonprofit National Committee for Quality Assurance (NCQA) as an independent reviewer to certify that health insurers and other organizations assess and report on the quality of physicians in an effective and fair manner. NCQA is the first approved independent
    reviewer that can ensure that organizations follow the guidelines of the Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs."

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