Tuesday, April 03, 2012

Tuesday Tidbits

Well the Federal Trade Commission announced yesterday morning following a 3-1 vote that it would not object to the merger of the two large prescription benefit management firms Express Scripts and Medco Health Solutions. The FTC did not attach any strings to this decision. The merger closed shortly after the announcement according to an Express Scripts press release

The opposition remains vociferous as illustrated by this press release from two drug store associations. Bloomberg reports that the federal judge in Pennsylvania has scheduled an April 10 hearing on the motion to undo the merger in a connection with a private anti-trust case. No state attorney generals have filed suit against the merged company yet.

It's interesting that the press was reporting that the FTC asked the drug store trade associations and consumer groups for suggested strings to attach to the deal, but none were. It appears that Express Scripts and Medco did a very skillful job crafting this deal and the opponents simply overplayed their hand.

Senator Joe Lieberman (I CT) recently announced that he has 21 new Senate co-sponsors for his bill that would open up the FEHBP to same sex domestic partners of federal employees.  A panel of U.S Court of Appeals judges will hear a constitutional challenge to the Defense of Marriage Act tomorrow morning in Boston. The Defense of Marriage Act requires that the word spouse be interpreted to mean a person of the opposite sex whenever the word spouse is used in a federal statute or regulation. The FEHB Act defines family coverage to include the enrollee's spouse. This issue is likely to reach the U.S. Supreme Court later this year. The DOMA issue is narrower than the Lieberman bill issue because there is only a small but growing number of states that recognize same sex marriage.

OPM's 2013 call letter encourages FEHB plans to expand their wellness programs. The AMA News and Business Insurance report that wellness programs similarly are popular with state and private sector employers.

Finally, the AMA, now feeling its oats over the HHS announcement of a delay in the ICD-10 implementation date for certain covered entities has joined up with other medical groups to ask CMS to delay other regulatory deadlines so that the providers can focus on their patients.  Let's not lose sight of the fact that the Affordable Care Act showered the health insurance industry with regulatory deadlines.

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