Midweek Update

David Ermer–Uncategorized–

Of course, in the mid-term elections held on Tuesday the Republicans gained control of the House of Representatives and increased their number in the Senate but falling short of a majority there. Before that change occurs in January the current Democratically controlled Congress will hold a lame duck session. (The FEHBlog likes Daffy Duck who is not lame.)  The AMA News explains that

Daffy Duck

Physicians are slated to get hit with a 25% reduction in Medicare payments over two months, according to the final 2011 physician fee schedule released Nov. 2 by the Centers for Medicare & Medicaid Services. CMS revised that downward from its original estimate of a 29.5% cut. Pay is still slated to go down 23% on Dec. 1 but would go down 2% — rather than 6.5% — on Jan. 1, 2011, assuming Congress takes no action.

The medical community is pushing for the lame duck Congress to pass a 13 month patch to allow for negotiations with the new Congress. That should be really interesting, given the new budget cutting environment on Capitol Hill.

Reuters reports on the third quarter results of the other two leading prescription benefits managers — CVS Caremark (bearish outlook) and Express Scripts (bullish) outlook).

 Finally, Computerworld reports that the Center for Democracy and Technology and fourteen other privacy advocacy groups submitted comments to OPM on the October 5, 2010, Federal Register notice announcing a new system of records under the Privacy Act in connection with a FEHBP health claims data warehouse. The CDT’s press release explains that

In a letter to OPM Director John Berry, the Center for Democracy and Technology (CDT) and 15 other organizations asked the agency to release more details on the need for the database and how the data contained in it will be protected and used.
The OPM “should not create this massive database full of detailed individual health records without giving the public a full and fair chance to evaluate the specifics of the program,” the letter cautioned.
It also called upon the OPM to delay its proposed Nov. 15 launch date for the database because there was not enough time for independent observers to evaluate the proposal.