Weekend Update

Well, we are heading into the final week of this year's Federal Benefits Open Season which ends one week from tomorrow on December 10.  The Hill's Floor Watch blog notes that "Congress returns to work [tomorrow] under the same circumstances it has faced for the last few weeks — no sign of a deal on the fiscal cliff, and no real sense that either party will back down on taxes (Republicans) or spending (Democrats)."

Bloomberg reports that on Friday the American Psychiatric Association approved a new edition (the fifth) of its Diagnostic and Statistical Manual, which is used to diagnose mental illnesses. Not surprisingly, the vote was controversial. This was the first revision since 1994.  "Among the revisions is a decision to collapse several conditions, including Asperger’s syndrome and child disintegrative disorder, into a single autism diagnosis."  DSM diagnosis codes, however, are not HHS approved HIPAA code sets for electronic claims transaction purposes. Instead providers must use the diagnosis codes found in the ICD which align with the current DSM-IV. The new DSM V will be published in May 2013.

AHIP, the health plan trade association, announced that it filed with the U.S. Court of Appeal for the Sixth Circuit a friend of the court brief supporting the Federal Trade Commission's antitrust challenge to a Toledo Ohio hospital merger. Tit for tat, the AMA, the doctors' trade association, released its annual report on health plan consolidation according to Medical Economics. The AMA's position strikes the FEHBlog as weak considering the fact that health plans reimburse health care provider bills and the ACA caps insurer profits.

But the FEHBlog is not without sympathy for the medical profession. The following squib from the AMA News about the government's new emphasis on patient satisfaction is telling:

A study of more than 50,000 U.S. adults found that patients who grade their care the highest are likelier to have worse health outcomes and rack up more medical expenses than the least-satisfied patients, even after adjusting for factors such as age, income, illness severity and insurance coverage.