The FEHBlog is back from vacation == it’s catch-up time

David Ermer–Uncategorized–

The FEHBlog has returned from vacation, and by golly there was a lot of news last week.

OPM News

  • OPM released its Inspector General’s semi-annual report to Congress for the period ended March 31, 2007. Both the Federal Times and Govexec.com reported on this development.
  • OPM released a benefit administration letter describing the schedule by which federal employees will be able to begin making pre-tax allotments of salary to their health savings accounts.
  • OPM revised an earlier benefits administration letter by concluding that retired public safety officers may self-elect to exclude up to $3,000 of their FEHB plan premiums provided those premiums are paid directly out of their federal annuity. OPM bases this decision on Section 845 of the Pension Protection Act of 2006 and it refers annuitants to IRS Publication 721 for more information on how to make the election.
  • The Federal Times offered a report reflecting on OPM’s recent employee satisfaction survey relating to federal employee benefit programs. The report’s theme was that “While federal health and retirement programs are the darlings of government benefits programs, many employees aren’t aware of or making use of many others, according to [this] new survey” previously noted on the FEHBlog. OPM recently produced a “quick guide” to these programs.
  • OPM released guidance to federal agencies on combatting against identity theft.

HHS/CMS News

  • As promised CMS began to report hospital mortality data for for heart attacks and heart failure on its Hospital Compare website. It’s important to understand that information on all hospital admissions, not just Medicare patient admissions, is used to develop the patient safety information on the Hospital Compare web site.
  • CMS launched a Medicare personal health records pilot program. According to the UPI, “To choose the best personal health record format, Medicare is partnering with four private plans that already offer the records: HIP USA, Humana, Kaiser Permanente, and the University of Pittsburgh Medical Center.”
  • The Washington Post reports that several insurers entered into a voluntary agreement with CMS regarding the marketing of popular Medicare Advantage private fee-for-service plans.
  • On February 1, 2007, the Government Accountability Office (GAO) criticized HHS for failing to establish milestones for integrating privacy and security requirements in its national health information network (NHIN) prototype. At a June 19 Congressional hearing, GAO updated this report and the agency is displeased with HHS’s continuing lack of progress. Modern Healthcare.com offered two articles — here and here — on this hearing. Government HIT magazine reported that “Witnesses at a House Oversight and Government Reform subcommittee hearing June 19 on the privacy of health information differed on almost every aspect of the issue, including whether existing privacy laws are adequate and whether the Health and Human Services Department is doing enough to enforce the law.” And so it goes.
  • In a related development, Senators Kennedy, Clinton, Enzi, and Hatch introduced a bipartisan health information technology bill that is substantively similar to the Wired for Health Care Quality bill (S. 1418) that the Senate passed in the 109th Congress.

Prescription drug news

  • Last summer, I followed in the FEHBlog Apotex’s generic challenge to Bristol Myers Squibb’s (BMS) and Sanofi-Aventis’s blockbluster anti-coagulant drug Plavix. Apotex took advantage of a settlement agreement with BMS to temporarily flood the market with its generic versions. A federal court preliminarily enjoined Apotex from marketing its generic version but the court did not require Apotex to withdraw from the market the pills that it already had sold. Last week, the federal district court upheld the Plavix patent against Apotex’s challenge. The patent now will remain in effect until 2011 and BMS and Plavix will seek patent infringement damages against Apotex. The court also made the preliminary injunction final. Apotex plans to appeal the decision.
  • U.S. District Judge Patti Saris, who sits in Boston, issued a 183 page opinion holding BMS, AstraZeneca, and Schering Plough liable for overcharging the Medicare program and third party payers operating in Massachusetts by inflating the average wholesale price of certain doctor administered drugs covered by Medicare Part B. (Medicare no longer uses AWP as its reimbursement yardstick.) According to the Wall Street Journal, the Judge “ordered AstraZeneca to pay damages of $4.45 million to non-Medicare third-party payers and Bristol-Myers Squibb to pay damages of $183,000. The ruling affects third-party payers who paid for certain prescription drugs from December 1997 to 2003.” The next step in the litigation is for the judge to decide whether to extend her ruling, which was based on Massachusetts state law, to other states via a class action. The Judge held that Johnson & Johnson was not liable.
  • A University of Michigan study endorsed the practice of splitting scored pills in order to reduce prescription drug plan copayments. Many health plans encourages this practice.
  • The House Energy & Commerce Committee cleared drug safety legislation unanimously last week, according to the Washington Post.
  • Senators Kennedy, Clinton, Hatch, and Enzi have crafted a bipartisan bill designed to create a pathway for Food and Drug Administration approval of generic versions of biotechnology drugs (so-called biogenerics).