Monday, August 08, 2011

Weekend Update

Congress is in recess until after Labor Day. According to, Sen. Ben Cardin (D Md) that "assured federal employees that since Congress had set aside money for the fiscal 2012 budget as a result of the recent deal, another showdown in the fall over appropriations was unlikely." That is good news.

On the Express Scripts acquisition of Medco front, the Chicago Tribune reports that Rep. John Conyers (D Mich.) called for a Congressional hearing on the deal and two drug store trade associations recorded an early opposition to the deal with the Federal Trade Commission. According to Business Week, Larry Merlo, the CEO for CVS Caremark, the principal competitor which reported second quarter results last week, remarked 
Assuming that the proposed transaction is completed, I am more confident than ever that CVS Caremark can and will effectively compete in this vibrant industry. That's because we believe that our suite of assets uniquely positions us to assist payers in controlling costs, while enhancing member access and improving health outcomes. And with the evolution of U.S. health care to more consumer-directed care, our multiple consumer touch points make us best positioned to promote cost-effective and healthy behaviors. And the success that we are having in both the 2011 and `12 selling season clearly demonstrates that our model is resonating with payers.
Reuters reports that "Evaluating generic versions of complex biotechnology medicines will require a new, more rigorous review process, U.S. drug regulators said, in the first glimpse of their thinking on the subject." A copy of the article published in the New England Journal of Medicine is available here. Biosimilars (or bio generics) offer the potential for bending the health care cost curve down.

Modern Healthcare reports that the Centers for Medicare and Medicaid Services announced that National 5010 testing week begins on August 22. HIPAA rules and a federal law require HIPAA covered entities to replace the ANSI X4010 healthcare electronic transaction standards with the X5010 standards effective January 1, 2012. The new standards can accomodate the International Classification of Diseases 10th edition (ICD 10) data set codes which are mandated as of October 1, 2013.  The ICD 10 codes are lengthier and much more complex than the current ICD 9 codes.
During that week, providers and other organizations that process Medicare claims can test the compliance of their software systems with the ASC X12 Version 5010 data-exchange standards. A real-time help desk and Medicare administrative contractors will be available for assistance, the CMS announced in an e-mail.

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