Lawmakers OK Rx Rule Delay
Coming down to the wire on a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions, lawmakers in the House and the Senate passed legislation in late September that would delay the mandate's start until March 31, 2008. At press time, President Bush was expected to sign the legislation, National Community Pharmacists Association spokesman John Norton said. The delay was bundled with extensions on several programs due to expire Sept. 30, including an abstinence education initiative that the Bush administration supports, Mr. Norton said. The original mandate, passed as part of war funding legislation earlier this year, requires all Medicaid prescriptions to be written on tamper-resistant paper to be eligible for federal reimbursement. Even though many states have similar requirements, pharmacists' organizations have maintained that most physicians do not currently use these types of pads, nor are supplies readily available.
Insurance Premium Increase Slows
Employer-sponsored health insurance premiums rose on average 6.1% in 2007, reflecting a continuing slowdown in premium increases. The 2007 premium increase is the smallest hike since 1999, according to an employer survey by the Kaiser Family Foundation and the Health Research and Educational Trust. But experts say the slowdown is likely temporary and isn't providing relief to individuals or employers. In fact, the 6.1% increase is higher than the average increase in wages (3.7%) and in the overall inflation rate (2.6%). In 2007, the average premium for family coverage in the United States is $12,106, with workers paying about $3,281 for their share of the policy. The market continues to be dominated by preferred provider organizations, which insure about 57% of covered workers; consumer-driven plans account for only about 5%. For details, visit
N.J. Task Force Examines MD Gifts
The New Jersey Attorney General's Advisory Task Force on Physician Compensation, which met for the first time in September, is examining the potential impact of payments and gifts to physicians from the drug and device industry. The task force will also consider public disclosure of gifts, direct disclosure to patients, and limits on payments to physicians. Vermont, Maine, Minnesota, West Virginia, and the District of Columbia have passed laws requiring some form of reporting of payments made to physicians by drug and medical device companies. In response to the formation of the task force, the Pharmaceutical Research and Manufacturers of America issued a statement citing its 2002 Code on Interactions with Healthcare Professionals as an important safeguard. The code declares all forms of entertainment to be inappropriate gifts and says that any gifts given to physicians should support medical practice and be valued at less than $100.
Taxing Health Benefits
Proposals to cap the tax deductions employers and employees can take regarding health insurance could spell the end of employer-based health benefits, according to a new report from the Employee Benefit Research Institute. Currently, employers are allowed to deduct the cost of the health insurance coverage they provide to their workers with no limits and workers are not taxed on the value of the health coverage they receive. Capping these tax exclusions could cause young, healthy workers to seek insurance outside of their employers' offering, leaving employers with an older, sicker pool of patients, the EBRI report said. The organization also examined the potential effect of offering tax credits as a way to reduce the number of uninsured Americans. But even a sizable tax credit is unlikely to be enough to offset the high costs of health insurance, the report noted. The full report is available online at
One-Third of Americans Uninsured
According to a September report by Families USA, almost 35% of Americans had no health care coverage for at least part of 2006–2007, up from about 30% in 1999–2000. Of these, 19% were uninsured for the entire period and 19% were uninsured for longer than 1 year; more than half were uninsured for longer than 6 months. Of the 89.6 million individuals who lacked health care coverage, 71% were employed full time and another nearly 9% were working part time; only 17% were unemployed. The numbers in the report are substantially larger than those published by the U.S. Census Bureau (which cites 47 million uninsured in 2006, or 16%), because Census Bureau statistics include only those who were uninsured for a full year. The report is available at
Required Audits of Limited Value
The Centers for Medicare and Medicaid Services did not meet the audit requirement for private insurers participating in Medicare during 2001–2005, nor did it attempt to recover overpayments to the insurers that should have been channeled back to the beneficiaries and government, according to a report by the Government Accountability Office. The Balanced Budget Act of 1997 required CMS to conduct annual audits of at least one-third of the participating insurers. During 2001–2005, between 19% and 23% of organizations were audited, and only 14% were audited in 2006. In 2003, 49 of 220 participating plans were audited; a contractor identified errors for 41, which would have translated into $59 million for additional benefits or to offset costs for beneficiaries. CMS claimed that it does not have legal authority to pursue such financial recoveries, but the GAO asserted that CMS has the authority but did not exercise it.