Sunday, September 07, 2008

Weekend Update / Miscellany

  • Congress returns to work this week. We should learn this month whether the mental health parity act will be enacted. However, the Washington Post is reporting that appropriations battles in this major election year may lead to a federal government shutdown, which can disrupt the Open Season. The House Ways and Means Committee's Health Subcommittee will hold a hearing on Sept. 11 on the difficult issue of reforming Medicare's physician reimbursement system.
  • The Centers for Disease Control is reporting that childhood vaccination rates are at an all time high. "According to the U.S. Centers for Disease Control and Prevention, immunization rates remain at or near record levels, with at least 90 percent coverage for all but one of the vaccines in the recommended series for children." Furthermore, the San Francisco Chronicle reports that "New research further debunks any link between measles vaccine and autism, work that comes as the nation is experiencing a surge in measles cases fueled by children left unvaccinated."
  • U.S. News and World Report informs us that "Potentially groundbreaking discoveries involving genetic mutations of two deadly cancers -- the brain cancer glioblastoma [which afflicts Sen. Ted Kennedy and Robert Novak] and pancreatic cancer [which afflicts Steve Jobs] -- may lead to new treatments and even cures, researchers say." Scientists are mapping the genomes of these cancers. The Wall Street Journal explains that "Now, scientists are using powerful gene-sequencing machines to identify which genetic alterations cause which cancers -- an ambition reflected in three papers published this week. The hope is to offer differentiated treatment to patients based on their different tumor profiles. But the picture is enormously complicated." U.S. News concurs in this assessment.
  • In response to new federal law, the Food and Drug Administration (FDA) issued its first quarterly report on FDA-approved drugs that are under investigation for adverse side effects. Modern explains that "Under the FDA Amendments Act signed in September 2007, the FDA is required to alert the public to new safety information and potential drug risks based on events analyzed through its events reporting system. Subsequent reports will not be cumulative; each quarter will list only drugs for whichever safety issues have been identified during the previous quarter, according to the FDA."
  • OPM issued a proposed amendment to the Federal Employees Health Benefits Acquisition Regulation that closes that saga of the GHS v. OPM case. The Federal Register preamble explains that In prior years, carriers were not subjected to rate reconciliation in the final year of their contracts. [That was the issue in the GHS case. The courts invalidated this regulation.] Information technology and electronic transmission and storage of data now make it possible to efficiently perform rate reconciliation for the final contract year. Therefore, OPM will begin conducting such rate reconciliation on community rated contracts that terminate after January 1, 2009.
  • The Baltimore Sun reported on a Mercer consulting report on rising deductibles and co-pays. Health Plan Week reports that

    At a recent briefing sponsored by the Washington, D.C.-based Council for Affordable Health Care, several reinsurers told attendees that their high-dollar claims had increased by a factor of 10, according to CAHI Director MerrillMatthews, Ph.D.

    Over the past six years, ING Reinsurance says, it has seen an increase in the number of million-dollar claims. The three most frequent diagnoses for these high-dollar claims, according to the company, are (1) premature infants, (2) congenital defects and (3) cancer.

    The Pittsburgh Post Gazette reported on creative health care cost cutting measures undertaken by employers. The article notes that

    For sheer innovation, it would be tough to top the Hannaford Brothers Co. grocery chain of Portland, Maine.

    When health costs spiraled upward, Hannaford went international, offering employees full coverage for knee replacements in Singapore, where a hospital charged $10,000, instead of U.S. hospitals where the cost typically ran $30,000.

    Once the program was publicized, though, Hannaford Brothers started hearing from U.S. hospitals willing to match or beat what Singapore charged. Those negotiations are ongoing.

    "The hope is that we never have to send anyone to Singapore," said Chris Washburn, employee benefits supervisor.

  • AHIP reported on consumer and provider heath fraud schemes.
  • The National Center for Policy Analysis discussed the recent Census Bureau report finding that the number of uninsured fell last. "In fact, the proportion of people without health insurance was a percentage-point lower in 2007 than a decade earlier (16.3 percent in
    1998). The slight increase in the number of uninsured over the past decade is largely due to immigration and population growth — and to individual choice."

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