In-Office AIDS Test, Please
Americans would much prefer to be tested for AIDS in a physician's office or clinic, instead of performing a home test, according to a survey of 2,500 adults by the Kaiser Family Foundation. Overall, 62% of respondents preferred a doctor's office or clinic, compared with 26% who preferred home testing; only 10% said the location did not matter. However, respondents did think home tests should be an option; 65% said home tests help people who otherwise would not learn their HIV status. On the other hand, 27% agreed with the statement that home tests are “a bad idea” because people need counseling that is available only in a physician's office or clinic. HIV testing should be treated like any routine screening and included as part of regular check-ups and exams, according to 65% of respondents. Slightly more than one-fourth (27%) of respondents disagreed; instead, they agreed with the statement that HIV testing is different and requires special procedures such as written permission from the patient.
MinuteClinic: Quality Council
MinuteClinic, the nation's largest provider of retail-based health care, has created a National Clinical Quality Advisory Council. The eight-member council has five physicians, including a representative of the American Academy of Family Physicians. To develop its own standards, MinuteClinic uses quality guidance from AAFP and the American Academy of Pediatrics Red Book as well as the Midwestern Institute for Clinical Systems Improvement, Dr. James Woodburn, chief medical officer, said in an interview. Dr. Ari Brown, a spokesperson for the Texas Pediatrics Society, said that she was surprised that MinuteClinic was creating a quality council after the company was already up and running. Dr. Brown questioned the retail clinic's role in providing a quality “medical home” to patients. Dr. Woodburn said patients should have a medical home, but about 30% of the time, MinuteClinic patients either have no regular doctor or else do not want to reveal the name. If the patient does have a regular physician, the MinuteClinic mails a record of the visit to that office, Dr. Woodburn said.
Maine PBM Law Stands
The U.S. Supreme Court rejected a challenge to Maine's pharmacy benefit management company law. The Maine statute requires PBMs to disclose “all financial terms and arrangements for remuneration of any kind that apply between the pharmacy benefits manager and any prescription drug manufacturer or labeler, including … formulary management and drug-switch programs, educational support, claims processing and pharmacy network fees that are charged from retail pharmacies, and data sales fees.” The PBM trade group Pharmaceutical Care Management Association (PCMA) sued Maine when it enacted the law in 2003, claiming that it overstepped federal, state, and contract boundaries. But an independent pharmacy group hailed the high court's decision. “The decision to affirm the state's right to regulate PBMs is a major victory for consumers in Maine and many other states” the National Community Pharmacists Association said in a June statement. PBMs were disappointed. The state pushed into the “contractual relationship” between PBMs and their customers, Stephanie Kanwit, special counsel to PCMA, said in an interview. She noted that physicians might have fewer choices when writing prescriptions, because weaker PBMs could lead to higher drug prices.
Chiropractors Sue Insurers
Chiropractors, podiatrists, and others have petitioned the U.S. District Court in Miami to join Solomon vs. Anthem, a class-action suit by nonphysician providers against insurance companies, charging that the companies conspired to systematically underpay providers and deny medically necessary care to patients. The American Chiropractic Association (ACA) also asked that ACN Group Inc. and United Healthcare Services Inc. be named as additional defendants. The suit seeks unspecified monetary damages and changes in the companies' practices. A similar class-action suit by physicians—known as the consolidated Provider Track cases—has been in that same court. The next steps in the Solomon case may depend upon resolution of the Provider Track cases, Thomas Daly, counsel for ACA, said in an interview. On June 19, Judge Federico A. Moreno dismissed United Healthcare from the Provider Track cases. “There is simply insufficient evidence of the wrongdoing claimed, i.e. agreeing with their competitors to defraud the doctors,” Judge Moreno wrote. Two other insurers in the Provider Track cases, Aetna and Cigna, settled in 2003, agreeing to change their coding and claims procedures.
Marlboro Case at Supreme Court
The U.S. Supreme Court has agreed to hear Philip Morris USA's appeal of an $80 million punitive damage award involving the death of a Marlboro smoker, raising concerns about the future of punitive damages in tobacco and other public health matters. The estate of Oregon resident Jesse Williams was awarded the money in a fraud and negligence suit against the tobacco maker. Mr. Williams, who died of lung cancer, was a heavy smoker of Marlboros, and his estate argued that his smoking habit killed him. The estate urged the jury to award punitive damages based on the estimated number of Marlboro smokers in Oregon. The high court agreed to address due process of law and punitive damage amount questions. Now that the states have signed the master settlement agreement, individual suits are one of the remaining vital weapons against tobacco products, David Dobbins, deputy general counsel of the American Legacy Foundation said.