Sunday, February 07, 2010

Weekend update

Happy Super Sunday!

The House Oversight & Government Reform Committee's federal workforce committee will be holding a hearing Wednesday February 10 about its Chairman Stephen Lynch's bill, HR 4489, The FEHBP Prescription Drug Integrity, Transparency and Cost Savings Act.  The hearing will begin at 10 am assuming that we are dug out from the snowcopalypse before then. The witness list has not been posted yet. The National Community Pharmacists Association recently sent Chairman Lynch a letter suuporting the bill but cautioning that
"There are several areas of the bill which we would encourage be modified. The current language establishes that the amount that the carrier plan may pay a PBM for a prescription drug may not exceed the drug's average manufacturer price (AMP). The use of AMP as a pricing benchmark for the carrier, and in turn the pharmacy provider, is problematic unless AMP were to be significantly redefined or increased in such a way that truly reflects the retail pharmacy acquisition cost of a prescription drug, which is higher than a drug's current AMP. Moreover, use of AMP would be inappropriate to pay for generic drugs because of the need for reimbursement policies to encourage the use of generics.

"In addition, the definition of AMP in the legislation is not appropriate because it includes mail order sales. It should only reflect sales to retail pharmacies. Without modification of these provisions, community pharmacy participation in the program would be threatened, reducing patients' access to prescription medications."
PCMA, the PBM trade association, has expressed its opposition to the bill.

The U.S. Office of Personnel Management has posted its 2009 health information technology and transparency report. The web page lists
The health plans [which] met OPM's HIT, quality and price/cost transparency standards at the time this Guide went to press. As other plans bring these tools on line, we will add them to the list on our website. So, please check the updated information at before you make your healthcare decisions.
Congratulations to those FEHB plans.

The New York Times reports that
Democrats were also pushing to include [in the jobs bill that is the President's current top legislative priority] an extension of unemployment benefits and of health care coverage for those out of work [which refers to the 65% COBRA / TCC subsidy program]. Discussions were also under way about potentially attaching other initiatives, including a provision to prevent a steep [21%] cut in Medicare payment rates for doctors.
As noted here last week, Congress needs to act on extending the COBRA / TCC subsidy program and avoiding the Medicare cut this month.

The Wall Street Journal yesterday featured an interesting interview with Wellpoint's CEO Angela Braly. "'It's just not clear where we go from here,' says the highest ranking woman in the Fortune 500, sounding as astonished as anyone about Scott Brown's victory."

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