Midweek Miscellany

• On May 5, The Senate Finance Committee held another health reform roundtable meeting. This meeting was on the topic of expanding healthcare coverage, and it featured testimony from the Blue Cross Blue Shield Association, AHIP, the Business Roundtable, and the Heritage Foundation, among others. Blue Cross and the Heritage Foundation support expanding coverage through state based health insurance exchanges established under federal guidelines, similar to the FEHBP. Stuart Butler of the Heritage Foundation explains that

  A national exchange may seem attractive but it is accompanied by many problems. In particular, there could be a mismatch between national rules and the pooling, risk pool and even existing exchanges (e.g. in Massachusetts) at the state level. It would also be difficult for states to explore creative approaches for delivering efficient coverage if they always had to comply with national rules.

  The Heritage Foundation also recommended a federal fallback plan to the state exchanges similar to the Medicare Part D setup. The Heritage Foundation also suggested flexibility in benefit package design similar to the FEHBP.

  The Federal Employees Health Benefits Program (FEHBP) not only does not
  include a public plan, but it also does not have a standard benefits
  package. Instead it simply requires plans to include broad categories of
  coverage, such as emergency care and major medical, and allows plans to
  offer a variety of benefits within these categories. This approach can and
  should be the basis of any subsidized benefits package developed
  by Congress.

• In a speech to the United Nurses of America today, HHS Secretary Kathleen Sibelius discussed "two new HHS reports on the quality of health care in America and challenged hospitals to work to reduce health care associated infections. Published by the Agency for Healthcare Research and Quality, the annual 2008 National Healthcare Quality Report and 2008 National Healthcare Disparities Report indicate that patient safety measures have worsened and that a substantial number of Americans do not receive recommended care. Upon issuing the reports, Sebelius also announced the availability of $50 million in Recovery Act resources to fight health care associated infections and improve patient safety."

• At the end of March, 2009, a federal district court judge in Massachusetts approved a settlement in the First Databank average wholesale price fixing class action that will disrupt prescription benefit management contracts and cause grief for pharmacies. In a companion settlement, McKesson has agreed to create a settlement fund of $350 million which will benefit consumers and third party payers. The objectors to the First Databank settlement, principally pharmacies and pharmacy trade associations, have noticed an appeal to the U.S. Court of Appeals for the First Circuit. The district court judge denied the objectors' motions to stay the settlement pending appeal. The objectors can ask the court of appeals for a stay. Most likely the appellate court will accelerate a decision on the appeal so that the decision is made before the settlement is implemented. Come on, common sense. In any event, the AWP, an outdated yardstick for setting drug prices, will be history in about two years. In that respect, the lawsuit produced a positive result.