Rx stuff -- The Insurance Journal reports on the IMS report Medicines Use and Spending in the U.S.: A Review of 2015 and Outlook to 2020. Politico Pulse observed
PRESCRIPTION DRUG COSTS SPIKED 8.5 PERCENT IN 2015 — That's according to a new report from the IMS Institute for Healthcare Informatics. That figure would be the second straight year of historically high spikes in pharmaceutical costs — but it's significantly higher than the roughly 5 percent growth reported by both Express Scripts and CVS Caremark. Why the discrepancy? According to Murray Aitken, executive director of the IMS Institute, there's a likely explanation: benefit managers cover retail pharmacy spending but not hospital-administered drugs, which have seen sharper cost increases.Drug Channels timely reports here on "outrageous markups" on hospital-administered drugs.
In better news, the Washington Examiner reports that the Food & Drug Administration under Congressional pressure approved more than 700 generic drugs for marketing last year, an agency record. That should help prevent gaming the system.
Finally, Healthcare IT News warns that an ICD-10 claim delay problem may raise its ugly head on October 1, 2016, when the current AMA-CMS compromise expires.
While it’s tempting to think that the healthcare industry pretty much aced the ICD-10 deadline, and those worries have been put to rest, the 6-month mark is a good time to ask if such concerns really have been settled?
The one-year span between Oct. 1, 2015 and Oct. 1, 2016, after all, is something of a grace period during which the Centers for Medicare and Medicaid Services and commercial payers are offering more latitude on claims details.
"The bottom hasn't been reached yet because CMS came along and said it wouldn't be as hard on physicians for 12 months after the deadline,” [Mary Jean] Sage [a consultant] said. “There haven't been too many denials yet, but that could change. So we may not have seen things that we will see after Oct. 1, 2016.”