Tuesday, July 26, 2011

Tuesday Tidbits

The Affordable Care Act regulators issued in today's Federal Register corrections to the June 24, 2011, amendments to the July 23, 2010, claims, internal and external appeals procedures rule. None of the corrections impact the applicability of the rule to the FEHB Program.

The FEHBlog ran across this Institute of Medicine report on improving access to oral health for vulnerable and underserved populations in the U.S. This report strongly suggests to the FEHBlog that the essential benefits package that the IOM's recommended esssential benefits package will include at least routine dental benefits for children and adults. FEHB plans and other group health plans that provide dental coverage would not be able to place annual or lifetime dollar limits on on dental (or any other) benefits that HHS deems essential. The HHS Secretary is expected to announce this package in 2013 based on the IOM recommendations and public hearings.

On the Express Scripts purchase of Medco front, Bloomberg reports that a Medco shareholder has filed suit in federal court alleging that the Medco board did not obtain the best price for the shareholders.  Medco's stock price continues to trade below the Express Scripts offer of $71.36 in Express Scripts stock and cash for each Medco share. Medco closed today at $64.58. Meanwhile, Business Insurance reports that "Medco Health Solutions Inc. and AstraZeneca P.L.C. were subpoenaed by the U.S. Department of Justice over their relationship involving four of AstraZeneca's drugs, including widely used acid reflux medicines Nexium and Prilosec."

The AMA News reports that the Centers for Medicare and Medicaid Services is adding the question "Do you accept new Medicare patients" to the forms that doctors and other health care providers must use to enroll or re-enroll in Medicare programs.
Officials working on the Medicare agency's Physician Compare website had requested that the question be added for future versions of the online comparison tool, said CMS spokeswoman Ellen Griffith.
"We actually have received suggestions from both physicians and beneficiaries to add this element, since it is frustrating to beneficiaries to call physicians who are not accepting new patients and for those physicians to field those calls when they are not taking new patients," Griffith said.

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