Jane Anderson

Formularies under Medicare Part D plans vary widely, but nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research that was published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview with this newspaper.

But “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006.

Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

“While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive,” he said.

Formularies under Medicare Part D plans vary widely, but nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research that was published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview with this newspaper.

But “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006.

Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

“While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive,” he said.

Formularies under Medicare Part D plans vary widely, but nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research that was published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview with this newspaper.

But “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006.

Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

“While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive,” he said.

Leaders Back Payment Reform

The vast majority (95%) of key public officials, analysts, and executives say fundamental health care payment reform is needed, and 75% support Medicare reform that would pay “medical homes” for care coordination, according to the latest Commonwealth Fund Health Care Opinion Leaders survey. The survey found consensus for specific strategies; for example, 90% of respondents said use of health information technology should be mandated for Medicare providers within 5–10 years, and half supported financial incentives for physicians and hospitals to provide high quality care. Around three-quarters of respondents agreed that greater organization and integration of provider care is necessary for improved quality and efficiency, but nearly 8 of 10 said that physician autonomy would be a challenge to care integration. A total of 59% said they support public reporting of providers' performance on quality measures, and more than half said they support the creation of a new public-private entity to coordinate quality efforts and form a national quality agenda.

Publix to Offer Free Antibiotics

Publix Super Markets will offer seven oral antibiotics free of charge at its 684 pharmacy locations, the Lakeland, Fla.-based store chain announced. The antibiotics included in the program—amoxicillin, cephalexin, sulfamethoxazole/trimethoprim (SMZ-TMP), ciprofloxacin (excluding Cipro XR), penicillin VK, ampicillin, and erythromycin (excluding Ery-Tab)—account for almost 50% of the generic prescriptions filled for adolescents and children at Publix, the company said. New or current customers simply need to provide the Publix pharmacists with their prescriptions, up to a 14-day supply, and they will be filled at no charge. There is no limit to the number of prescriptions customers can fill for free, and the free antibiotics are offered to customers regardless of their prescription insurance provider, the store chain said.

FDA, DoD to Share Data

The Department of Defense will share data and expertise with the Food and Drug Administration related to the review and use of FDA-regulated drugs, biologics, and medical devices in an effort to identify potential concerns and recognize benefits of products, the two agencies said. The DoD will share general patient data from military health system records with the FDA, although the agencies will protect all personal health information exchanged under the agreement. Among the DoD programs involved in the agreement is TRICARE, which serves 9.1 million members of the uniformed services, retirees, and their families, and TRICARE prescription data likely will be the first information shared as part of the project. The partnership between the DoD and FDA is part of the FDA's Sentinel Network, a project intended to explore linking private sector and public sector information to create an integrated electronic network.

Bill Would Improve Import Safety

User fees on imported food and drug shipments would fund additional personnel to inspect shipments both at the border and at FDA laboratories under legislation proposed by the chairman of the House Energy and Commerce Committee. Funds from the proposed user fees also would be used to test import samples and research new testing techniques. “We are importing twice as much food as we were a decade ago, yet the FDA examines less than 1% of it,” said Chairman John Dingell (D-Mich.). “Without regular inspections and analysis there is little incentive for food producers and importers to ensure that our food supply is free from harmful and sometimes fatal contaminants.” The legislation also would expand FDA authority to issue recalls, require country of origin labeling, and halt imports of certain products in the case of problems.

GAO Finds Medicaid Decline

A law requiring most U.S. citizens applying for Medicaid coverage to document their citizenship has caused eligible citizens to lose Medicaid coverage, and the law costs far more to administer than it saves, according to two government analyses. The law went into effect on July 1, 2006, and affects 30 million children and 16 million parents currently enrolled in Medicaid, as well as millions of new applicants. The first analysis, from the Government Accountability Office, found that half the states are reporting declines in Medicaid coverage because of the requirement, and many of those losing coverage appear to be U.S. citizens. The second analysis, produced by the House Committee on Oversight and Government Reform, found that for every $100 spent by federal taxpayers to implement the documentation requirements in six states, only 14 cents in Medicaid savings can be documented.

R.I. to Begin Information Exchange

Rhode Island is one step closer to a health information system that will allow physicians to access patient health data from a variety of sources. The state has chosen Electronic Data Systems Corp. and its subcontractor, InterSystems Corp., to build and integrate the necessary technology and software. Through a 3-year, federally funded $1.71 million contract, the companies will build the core components of the system under the oversight of the Rhode Island Department of Health. Initially, data will come from several state laboratories and from SureScripts, a national e-prescribing services company. When the system is complete, authorized health care providers will have access to laboratory results and medication histories for their patients, state officials said.

Leaders Back Payment Reform

The vast majority (95%) of key public officials, analysts, and executives say fundamental health care payment reform is needed, and 75% support Medicare reform that would pay “medical homes” for care coordination, according to the latest Commonwealth Fund Health Care Opinion Leaders survey. The survey found consensus for specific strategies; for example, 90% of respondents said use of health information technology should be mandated for Medicare providers within 5–10 years, and half supported financial incentives for physicians and hospitals to provide high quality care. Around three-quarters of respondents agreed that greater organization and integration of provider care is necessary for improved quality and efficiency, but nearly 8 of 10 said that physician autonomy would be a challenge to care integration. A total of 59% said they support public reporting of providers' performance on quality measures, and more than half said they support the creation of a new public-private entity to coordinate quality efforts and form a national quality agenda.

Publix to Offer Free Antibiotics

Publix Super Markets will offer seven oral antibiotics free of charge at its 684 pharmacy locations, the Lakeland, Fla.-based store chain announced. The antibiotics included in the program—amoxicillin, cephalexin, sulfamethoxazole/trimethoprim (SMZ-TMP), ciprofloxacin (excluding Cipro XR), penicillin VK, ampicillin, and erythromycin (excluding Ery-Tab)—account for almost 50% of the generic prescriptions filled for adolescents and children at Publix, the company said. New or current customers simply need to provide the Publix pharmacists with their prescriptions, up to a 14-day supply, and they will be filled at no charge. There is no limit to the number of prescriptions customers can fill for free, and the free antibiotics are offered to customers regardless of their prescription insurance provider, the store chain said.

FDA, DoD to Share Data

The Department of Defense will share data and expertise with the Food and Drug Administration related to the review and use of FDA-regulated drugs, biologics, and medical devices in an effort to identify potential concerns and recognize benefits of products, the two agencies said. The DoD will share general patient data from military health system records with the FDA, although the agencies will protect all personal health information exchanged under the agreement. Among the DoD programs involved in the agreement is TRICARE, which serves 9.1 million members of the uniformed services, retirees, and their families, and TRICARE prescription data likely will be the first information shared as part of the project. The partnership between the DoD and FDA is part of the FDA's Sentinel Network, a project intended to explore linking private sector and public sector information to create an integrated electronic network.

Bill Would Improve Import Safety

User fees on imported food and drug shipments would fund additional personnel to inspect shipments both at the border and at FDA laboratories under legislation proposed by the chairman of the House Energy and Commerce Committee. Funds from the proposed user fees also would be used to test import samples and research new testing techniques. “We are importing twice as much food as we were a decade ago, yet the FDA examines less than 1% of it,” said Chairman John Dingell (D-Mich.). “Without regular inspections and analysis there is little incentive for food producers and importers to ensure that our food supply is free from harmful and sometimes fatal contaminants.” The legislation also would expand FDA authority to issue recalls, require country of origin labeling, and halt imports of certain products in the case of problems.

GAO Finds Medicaid Decline

A law requiring most U.S. citizens applying for Medicaid coverage to document their citizenship has caused eligible citizens to lose Medicaid coverage, and the law costs far more to administer than it saves, according to two government analyses. The law went into effect on July 1, 2006, and affects 30 million children and 16 million parents currently enrolled in Medicaid, as well as millions of new applicants. The first analysis, from the Government Accountability Office, found that half the states are reporting declines in Medicaid coverage because of the requirement, and many of those losing coverage appear to be U.S. citizens. The second analysis, produced by the House Committee on Oversight and Government Reform, found that for every $100 spent by federal taxpayers to implement the documentation requirements in six states, only 14 cents in Medicaid savings can be documented.

R.I. to Begin Information Exchange

Rhode Island is one step closer to a health information system that will allow physicians to access patient health data from a variety of sources. The state has chosen Electronic Data Systems Corp. and its subcontractor, InterSystems Corp., to build and integrate the necessary technology and software. Through a 3-year, federally funded $1.71 million contract, the companies will build the core components of the system under the oversight of the Rhode Island Department of Health. Initially, data will come from several state laboratories and from SureScripts, a national e-prescribing services company. When the system is complete, authorized health care providers will have access to laboratory results and medication histories for their patients, state officials said.

Leaders Back Payment Reform

The vast majority (95%) of key public officials, analysts, and executives say fundamental health care payment reform is needed, and 75% support Medicare reform that would pay “medical homes” for care coordination, according to the latest Commonwealth Fund Health Care Opinion Leaders survey. The survey found consensus for specific strategies; for example, 90% of respondents said use of health information technology should be mandated for Medicare providers within 5–10 years, and half supported financial incentives for physicians and hospitals to provide high quality care. Around three-quarters of respondents agreed that greater organization and integration of provider care is necessary for improved quality and efficiency, but nearly 8 of 10 said that physician autonomy would be a challenge to care integration. A total of 59% said they support public reporting of providers' performance on quality measures, and more than half said they support the creation of a new public-private entity to coordinate quality efforts and form a national quality agenda.

Publix to Offer Free Antibiotics

Publix Super Markets will offer seven oral antibiotics free of charge at its 684 pharmacy locations, the Lakeland, Fla.-based store chain announced. The antibiotics included in the program—amoxicillin, cephalexin, sulfamethoxazole/trimethoprim (SMZ-TMP), ciprofloxacin (excluding Cipro XR), penicillin VK, ampicillin, and erythromycin (excluding Ery-Tab)—account for almost 50% of the generic prescriptions filled for adolescents and children at Publix, the company said. New or current customers simply need to provide the Publix pharmacists with their prescriptions, up to a 14-day supply, and they will be filled at no charge. There is no limit to the number of prescriptions customers can fill for free, and the free antibiotics are offered to customers regardless of their prescription insurance provider, the store chain said.

FDA, DoD to Share Data

The Department of Defense will share data and expertise with the Food and Drug Administration related to the review and use of FDA-regulated drugs, biologics, and medical devices in an effort to identify potential concerns and recognize benefits of products, the two agencies said. The DoD will share general patient data from military health system records with the FDA, although the agencies will protect all personal health information exchanged under the agreement. Among the DoD programs involved in the agreement is TRICARE, which serves 9.1 million members of the uniformed services, retirees, and their families, and TRICARE prescription data likely will be the first information shared as part of the project. The partnership between the DoD and FDA is part of the FDA's Sentinel Network, a project intended to explore linking private sector and public sector information to create an integrated electronic network.

Bill Would Improve Import Safety

User fees on imported food and drug shipments would fund additional personnel to inspect shipments both at the border and at FDA laboratories under legislation proposed by the chairman of the House Energy and Commerce Committee. Funds from the proposed user fees also would be used to test import samples and research new testing techniques. “We are importing twice as much food as we were a decade ago, yet the FDA examines less than 1% of it,” said Chairman John Dingell (D-Mich.). “Without regular inspections and analysis there is little incentive for food producers and importers to ensure that our food supply is free from harmful and sometimes fatal contaminants.” The legislation also would expand FDA authority to issue recalls, require country of origin labeling, and halt imports of certain products in the case of problems.

GAO Finds Medicaid Decline

A law requiring most U.S. citizens applying for Medicaid coverage to document their citizenship has caused eligible citizens to lose Medicaid coverage, and the law costs far more to administer than it saves, according to two government analyses. The law went into effect on July 1, 2006, and affects 30 million children and 16 million parents currently enrolled in Medicaid, as well as millions of new applicants. The first analysis, from the Government Accountability Office, found that half the states are reporting declines in Medicaid coverage because of the requirement, and many of those losing coverage appear to be U.S. citizens. The second analysis, produced by the House Committee on Oversight and Government Reform, found that for every $100 spent by federal taxpayers to implement the documentation requirements in six states, only 14 cents in Medicaid savings can be documented.

R.I. to Begin Information Exchange

Rhode Island is one step closer to a health information system that will allow physicians to access patient health data from a variety of sources. The state has chosen Electronic Data Systems Corp. and its subcontractor, InterSystems Corp., to build and integrate the necessary technology and software. Through a 3-year, federally funded $1.71 million contract, the companies will build the core components of the system under the oversight of the Rhode Island Department of Health. Initially, data will come from several state laboratories and from SureScripts, a national e-prescribing services company. When the system is complete, authorized health care providers will have access to laboratory results and medication histories for their patients, state officials said.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics. They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans, and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview.

But “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined, we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596-602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006. Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics. They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans, and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview.

But “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined, we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596-602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006. Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics. They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans, and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview.

But “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined, we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596-602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006. Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

E-Prescribing Called 'Win-Win'

Electronic prescribing could prevent nearly 2 million medication errors and save the federal government $26 billion over the next decade—even after providing funds for equipment, training, and support—if physicians were required to use the technology for their Medicare patients, according to a study released by the Pharmaceutical Care Management Association. The study found that when physicians use e-prescribing to learn their patients' medication history and prescription choices, both patient safety and savings improve dramatically. However, fewer than one in 10 physicians actually use e-prescribing, according to PCMA. The group, which represents pharmacy benefit managers, is pushing the Centers for Medicare and Medicaid Services to require e-prescribing for all Medicare Part D prescriptions by 2010, while providing incentive payments for physicians that would offset their costs for equipment, training and support.

Feds Release Medicaid Drug Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reining in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs.

N.Y. AG Fights Rankings

New York's attorney general has asked insurer UnitedHealthcare to halt the introduction of a program that would rank physicians in the state according to quality of care and cost of service. United was slated to release its New York physician rankings next month, and State Attorney General Andrew Cuomo's staff said they feared that consumers would be steered to physicians based on faulty data and criteria. In addition, the letter from Linda Lacewell, the attorney general's counsel for economic and social justice, said that consumers may be encouraged through the program to “choose doctors because they are cheap rather than because they are good.” Ms. Lacewell wrote, “UnitedHealthcare's profit motive may affect the accuracy of its quality ratings because high-quality doctors may cost UnitedHealthcare more money.”

APhA Urges Delay in Rx Rule

The American Pharmacists Association and three lawmakers have urged CMS to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions beginning Oct. 1. The mandate, included in recently approved legislation to fund the war in Iraq, requires that all Medicaid prescriptions be written on “tamper-resistant” paper to be eligible for federal reimbursement. But even though many states have similar requirements, it will take much longer than 3 months to roll out such a program across the country, said APhA executive vice president and CEO John Gans in a statement. The three lawmakers—Rep. Charlie Wilson (D-Ohio), Rep. Marion Berry (D-Ark.), and Rep. Mike Ross (D-Ark.)—say that most physicians do not currently use these types of pads, nor are supplies readily available. “The tamper-proof pad law was designed to prevent Medicaid fraud,” the legislators said in a statement. “However, the timeline for implementation could result in patients being turned away from their pharmacies as of Oct. 1, 2007, if doctors fail to write prescriptions on 'tamper-resistant' paper.” The congressmen have introduced a bill that would require only prescriptions for Class II narcotics to be written on the tamper-proof prescription pads.

Army to Educate on Mental Health

The U.S. Army is beginning a program to have all soldiers—and their families—learn the symptoms of traumatic brain injury and posttraumatic stress disorder and to help service personnel seek treatment. The goal is for all active-duty and reserve military personnel to receive training by mid-October. The Army will use what it calls a “chain-teaching” method, with education coming down the chain of command. Leaders can retrieve materials—consisting of a 35-page guide and video and slide shows—at

www.army.mil

New Orleans MD Charges Dropped

A grand jury refused to indict Dr. Anna Pou, the New Orleans surgeon who was accused of murder in the wake of Hurricane Katrina. The decision by the Orleans Parish grand jury came just days after Dr. Pou sued the state attorney general over the case, and ends the year-long criminal investigation into Dr. Pou's performance at Memorial Medical Center immediately after the hurricane. Dr. Pou had been accused of giving four patients a “lethal cocktail” of painkillers and sedatives shortly before the sweltering hospital was evacuated. Dr. Pou's suit against State Attorney General Charles Foti accuses the attorney general of using the murder case against her to fuel his reelection campaign. The lawsuit, filed in state district court in Baton Rouge, also asks the court to force the state to defend Dr. Pou against wrongful death lawsuits filed by family members of three of the patients who died at Memorial.

E-Prescribing Called 'Win-Win'

Electronic prescribing could prevent nearly 2 million medication errors and save the federal government $26 billion over the next decade—even after providing funds for equipment, training, and support—if physicians were required to use the technology for their Medicare patients, according to a study released by the Pharmaceutical Care Management Association. The study found that when physicians use e-prescribing to learn their patients' medication history and prescription choices, both patient safety and savings improve dramatically. However, fewer than one in 10 physicians actually use e-prescribing, according to PCMA. The group, which represents pharmacy benefit managers, is pushing the Centers for Medicare and Medicaid Services to require e-prescribing for all Medicare Part D prescriptions by 2010, while providing incentive payments for physicians that would offset their costs for equipment, training and support.

Feds Release Medicaid Drug Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reining in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs.

N.Y. AG Fights Rankings

New York's attorney general has asked insurer UnitedHealthcare to halt the introduction of a program that would rank physicians in the state according to quality of care and cost of service. United was slated to release its New York physician rankings next month, and State Attorney General Andrew Cuomo's staff said they feared that consumers would be steered to physicians based on faulty data and criteria. In addition, the letter from Linda Lacewell, the attorney general's counsel for economic and social justice, said that consumers may be encouraged through the program to “choose doctors because they are cheap rather than because they are good.” Ms. Lacewell wrote, “UnitedHealthcare's profit motive may affect the accuracy of its quality ratings because high-quality doctors may cost UnitedHealthcare more money.”

APhA Urges Delay in Rx Rule

The American Pharmacists Association and three lawmakers have urged CMS to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions beginning Oct. 1. The mandate, included in recently approved legislation to fund the war in Iraq, requires that all Medicaid prescriptions be written on “tamper-resistant” paper to be eligible for federal reimbursement. But even though many states have similar requirements, it will take much longer than 3 months to roll out such a program across the country, said APhA executive vice president and CEO John Gans in a statement. The three lawmakers—Rep. Charlie Wilson (D-Ohio), Rep. Marion Berry (D-Ark.), and Rep. Mike Ross (D-Ark.)—say that most physicians do not currently use these types of pads, nor are supplies readily available. “The tamper-proof pad law was designed to prevent Medicaid fraud,” the legislators said in a statement. “However, the timeline for implementation could result in patients being turned away from their pharmacies as of Oct. 1, 2007, if doctors fail to write prescriptions on 'tamper-resistant' paper.” The congressmen have introduced a bill that would require only prescriptions for Class II narcotics to be written on the tamper-proof prescription pads.

Army to Educate on Mental Health

The U.S. Army is beginning a program to have all soldiers—and their families—learn the symptoms of traumatic brain injury and posttraumatic stress disorder and to help service personnel seek treatment. The goal is for all active-duty and reserve military personnel to receive training by mid-October. The Army will use what it calls a “chain-teaching” method, with education coming down the chain of command. Leaders can retrieve materials—consisting of a 35-page guide and video and slide shows—at

www.army.mil

New Orleans MD Charges Dropped

A grand jury refused to indict Dr. Anna Pou, the New Orleans surgeon who was accused of murder in the wake of Hurricane Katrina. The decision by the Orleans Parish grand jury came just days after Dr. Pou sued the state attorney general over the case, and ends the year-long criminal investigation into Dr. Pou's performance at Memorial Medical Center immediately after the hurricane. Dr. Pou had been accused of giving four patients a “lethal cocktail” of painkillers and sedatives shortly before the sweltering hospital was evacuated. Dr. Pou's suit against State Attorney General Charles Foti accuses the attorney general of using the murder case against her to fuel his reelection campaign. The lawsuit, filed in state district court in Baton Rouge, also asks the court to force the state to defend Dr. Pou against wrongful death lawsuits filed by family members of three of the patients who died at Memorial.

E-Prescribing Called 'Win-Win'

Electronic prescribing could prevent nearly 2 million medication errors and save the federal government $26 billion over the next decade—even after providing funds for equipment, training, and support—if physicians were required to use the technology for their Medicare patients, according to a study released by the Pharmaceutical Care Management Association. The study found that when physicians use e-prescribing to learn their patients' medication history and prescription choices, both patient safety and savings improve dramatically. However, fewer than one in 10 physicians actually use e-prescribing, according to PCMA. The group, which represents pharmacy benefit managers, is pushing the Centers for Medicare and Medicaid Services to require e-prescribing for all Medicare Part D prescriptions by 2010, while providing incentive payments for physicians that would offset their costs for equipment, training and support.

Feds Release Medicaid Drug Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reining in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs.

N.Y. AG Fights Rankings

New York's attorney general has asked insurer UnitedHealthcare to halt the introduction of a program that would rank physicians in the state according to quality of care and cost of service. United was slated to release its New York physician rankings next month, and State Attorney General Andrew Cuomo's staff said they feared that consumers would be steered to physicians based on faulty data and criteria. In addition, the letter from Linda Lacewell, the attorney general's counsel for economic and social justice, said that consumers may be encouraged through the program to “choose doctors because they are cheap rather than because they are good.” Ms. Lacewell wrote, “UnitedHealthcare's profit motive may affect the accuracy of its quality ratings because high-quality doctors may cost UnitedHealthcare more money.”

APhA Urges Delay in Rx Rule

The American Pharmacists Association and three lawmakers have urged CMS to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions beginning Oct. 1. The mandate, included in recently approved legislation to fund the war in Iraq, requires that all Medicaid prescriptions be written on “tamper-resistant” paper to be eligible for federal reimbursement. But even though many states have similar requirements, it will take much longer than 3 months to roll out such a program across the country, said APhA executive vice president and CEO John Gans in a statement. The three lawmakers—Rep. Charlie Wilson (D-Ohio), Rep. Marion Berry (D-Ark.), and Rep. Mike Ross (D-Ark.)—say that most physicians do not currently use these types of pads, nor are supplies readily available. “The tamper-proof pad law was designed to prevent Medicaid fraud,” the legislators said in a statement. “However, the timeline for implementation could result in patients being turned away from their pharmacies as of Oct. 1, 2007, if doctors fail to write prescriptions on 'tamper-resistant' paper.” The congressmen have introduced a bill that would require only prescriptions for Class II narcotics to be written on the tamper-proof prescription pads.

Army to Educate on Mental Health

The U.S. Army is beginning a program to have all soldiers—and their families—learn the symptoms of traumatic brain injury and posttraumatic stress disorder and to help service personnel seek treatment. The goal is for all active-duty and reserve military personnel to receive training by mid-October. The Army will use what it calls a “chain-teaching” method, with education coming down the chain of command. Leaders can retrieve materials—consisting of a 35-page guide and video and slide shows—at

www.army.mil

New Orleans MD Charges Dropped

A grand jury refused to indict Dr. Anna Pou, the New Orleans surgeon who was accused of murder in the wake of Hurricane Katrina. The decision by the Orleans Parish grand jury came just days after Dr. Pou sued the state attorney general over the case, and ends the year-long criminal investigation into Dr. Pou's performance at Memorial Medical Center immediately after the hurricane. Dr. Pou had been accused of giving four patients a “lethal cocktail” of painkillers and sedatives shortly before the sweltering hospital was evacuated. Dr. Pou's suit against State Attorney General Charles Foti accuses the attorney general of using the murder case against her to fuel his reelection campaign. The lawsuit, filed in state district court in Baton Rouge, also asks the court to force the state to defend Dr. Pou against wrongful death lawsuits filed by family members of three of the patients who died at Memorial.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to data from a study in California.

The researchers studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

They noted how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, of the University of Hawaii and the Pacific Health Research Institute, said in an interview. “[But] despite the large number of plans and variation among their formularies, for most of the treatment classes we examined, we found one or more drugs that were covered by nearly 100% of Part D formularies.”

Nearly all of these widely covered drugs are generics, and the drugs covered by Part D formularies are likely to change as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

Dr. Tseng said that a Web site that tracks the list of widely covered drugs could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

In addition to the inconvenience for doctors, the variations also pose a health problem for patients “because they may not get the drug they need if it's not covered or too expensive.”

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to data from a study in California.

The researchers studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

They noted how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, of the University of Hawaii and the Pacific Health Research Institute, said in an interview. “[But] despite the large number of plans and variation among their formularies, for most of the treatment classes we examined, we found one or more drugs that were covered by nearly 100% of Part D formularies.”

Nearly all of these widely covered drugs are generics, and the drugs covered by Part D formularies are likely to change as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

Dr. Tseng said that a Web site that tracks the list of widely covered drugs could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

In addition to the inconvenience for doctors, the variations also pose a health problem for patients “because they may not get the drug they need if it's not covered or too expensive.”

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to data from a study in California.

The researchers studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

They noted how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, of the University of Hawaii and the Pacific Health Research Institute, said in an interview. “[But] despite the large number of plans and variation among their formularies, for most of the treatment classes we examined, we found one or more drugs that were covered by nearly 100% of Part D formularies.”

Nearly all of these widely covered drugs are generics, and the drugs covered by Part D formularies are likely to change as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

Dr. Tseng said that a Web site that tracks the list of widely covered drugs could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

In addition to the inconvenience for doctors, the variations also pose a health problem for patients “because they may not get the drug they need if it's not covered or too expensive.”

E-Prescribing Called 'Win-Win'

Electronic prescribing could prevent nearly 2 million medication errors and save the federal government $26 billion over the next decade—even after providing funds for equipment, training and support—if physicians were required to use the technology for their Medicare patients, according to a study released by the Pharmaceutical Care Management Association. The study found that when physicians use e-prescribing to learn their patients' medication history and prescription choices, both patient safety and savings improve dramatically. However, fewer than 1 in 10 physicians actually use e-prescribing, according to PCMA. The group, which represents pharmacy benefit managers, is pushing the Centers for Medicare and Medicaid Services to require e-prescribing for all Medicare Part D prescriptions by 2010, while providing incentive payments for physicians that would offset their costs for equipment, training, and support.

Feds Release Medicaid Drug Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reining in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs.

APhA Urges Delay in Rx Rule

The American Pharmacists Association and three lawmakers have urged CMS to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions beginning Oct. 1. The mandate, included in recently approved legislation to fund the war in Iraq, requires that all Medicaid prescriptions be written on “tamper-resistant” paper to be eligible for federal reimbursement. But even though many states have similar requirements, it will take much longer than 3 months to roll out such a program across the country, said APhA executive vice president and CEO John Gans in a statement. The three lawmakers—Rep. Charlie Wilson (D-Ohio), Rep. Marion Berry (D-Ark.), and Rep. Mike Ross (D-Ark.)—say that most physicians do not currently use these types of pads, nor are supplies readily available. “The tamperproof pad law was designed to prevent Medicaid fraud,” the legislators said in a statement. “However, the timeline for implementation could result in patients being turned away from their pharmacies as of Oct. 1, 2007, if doctors fail to write prescriptions on 'tamper-resistant' paper.” The congressmen have introduced a bill that would require only prescriptions for Class II narcotics to be written on the tamperproof prescription pads.

N.Y. AG Fights Rankings

New York's attorney general has asked insurer UnitedHealthcare to halt the introduction of a program that would rank physicians in the state according to quality of care and cost of service. UHC was slated to release its New York physician rankings next month, and State Attorney General Andrew Cuomo's staff said they feared that consumers would be steered to physicians based on faulty data and criteria. In addition, the letter from Linda Lacewell, the attorney general's counsel for economic and social justice, said that consumers may be encouraged through the program to “choose doctors because they are cheap rather than because they are good.” Ms. Lacewell wrote, “UnitedHealthcare's profit motive may affect the accuracy of its quality ratings because high-quality doctors may cost UnitedHealthcare more money.”

Army to Educate on Mental Health

The U.S. Army is beginning a program to have all soldiers—and their families—learn the symptoms of traumatic brain injury and posttraumatic stress disorder and to help service personnel seek treatment. The goal is for all military personnel to receive training by mid-October. The Army will use what it calls a “chain-teaching” method, with education coming down the chain of command. Leaders can retrieve materials—consisting of a 35-page guide and video and slide shows—at

www.army.mil

New Orleans MD Charges Dropped

A grand jury refused to indict Dr. Anna Pou, the New Orleans surgeon who was accused of murder in the wake of Hurricane Katrina. The decision by the Orleans Parish grand jury came just days after Dr. Pou sued the state attorney general over the case, and ends the year-long criminal investigation into Dr. Pou's performance at Memorial Medical Center immediately after the hurricane. Dr. Pou had been accused of giving four patients a “lethal cocktail” of painkillers and sedatives shortly before the sweltering hospital was evacuated. Dr. Pou's suit against State Attorney General Charles Foti accuses the attorney general of using the murder case against her to fuel his re-election campaign. The lawsuit also asks the court to force the state to defend Dr. Pou against wrongful death lawsuits filed by family members of three of the patients who died at Memorial.

E-Prescribing Called 'Win-Win'

Electronic prescribing could prevent nearly 2 million medication errors and save the federal government $26 billion over the next decade—even after providing funds for equipment, training and support—if physicians were required to use the technology for their Medicare patients, according to a study released by the Pharmaceutical Care Management Association. The study found that when physicians use e-prescribing to learn their patients' medication history and prescription choices, both patient safety and savings improve dramatically. However, fewer than 1 in 10 physicians actually use e-prescribing, according to PCMA. The group, which represents pharmacy benefit managers, is pushing the Centers for Medicare and Medicaid Services to require e-prescribing for all Medicare Part D prescriptions by 2010, while providing incentive payments for physicians that would offset their costs for equipment, training, and support.

Feds Release Medicaid Drug Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reining in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs.

APhA Urges Delay in Rx Rule

The American Pharmacists Association and three lawmakers have urged CMS to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions beginning Oct. 1. The mandate, included in recently approved legislation to fund the war in Iraq, requires that all Medicaid prescriptions be written on “tamper-resistant” paper to be eligible for federal reimbursement. But even though many states have similar requirements, it will take much longer than 3 months to roll out such a program across the country, said APhA executive vice president and CEO John Gans in a statement. The three lawmakers—Rep. Charlie Wilson (D-Ohio), Rep. Marion Berry (D-Ark.), and Rep. Mike Ross (D-Ark.)—say that most physicians do not currently use these types of pads, nor are supplies readily available. “The tamperproof pad law was designed to prevent Medicaid fraud,” the legislators said in a statement. “However, the timeline for implementation could result in patients being turned away from their pharmacies as of Oct. 1, 2007, if doctors fail to write prescriptions on 'tamper-resistant' paper.” The congressmen have introduced a bill that would require only prescriptions for Class II narcotics to be written on the tamperproof prescription pads.

N.Y. AG Fights Rankings

New York's attorney general has asked insurer UnitedHealthcare to halt the introduction of a program that would rank physicians in the state according to quality of care and cost of service. UHC was slated to release its New York physician rankings next month, and State Attorney General Andrew Cuomo's staff said they feared that consumers would be steered to physicians based on faulty data and criteria. In addition, the letter from Linda Lacewell, the attorney general's counsel for economic and social justice, said that consumers may be encouraged through the program to “choose doctors because they are cheap rather than because they are good.” Ms. Lacewell wrote, “UnitedHealthcare's profit motive may affect the accuracy of its quality ratings because high-quality doctors may cost UnitedHealthcare more money.”

Army to Educate on Mental Health

The U.S. Army is beginning a program to have all soldiers—and their families—learn the symptoms of traumatic brain injury and posttraumatic stress disorder and to help service personnel seek treatment. The goal is for all military personnel to receive training by mid-October. The Army will use what it calls a “chain-teaching” method, with education coming down the chain of command. Leaders can retrieve materials—consisting of a 35-page guide and video and slide shows—at

www.army.mil

New Orleans MD Charges Dropped

A grand jury refused to indict Dr. Anna Pou, the New Orleans surgeon who was accused of murder in the wake of Hurricane Katrina. The decision by the Orleans Parish grand jury came just days after Dr. Pou sued the state attorney general over the case, and ends the year-long criminal investigation into Dr. Pou's performance at Memorial Medical Center immediately after the hurricane. Dr. Pou had been accused of giving four patients a “lethal cocktail” of painkillers and sedatives shortly before the sweltering hospital was evacuated. Dr. Pou's suit against State Attorney General Charles Foti accuses the attorney general of using the murder case against her to fuel his re-election campaign. The lawsuit also asks the court to force the state to defend Dr. Pou against wrongful death lawsuits filed by family members of three of the patients who died at Memorial.

E-Prescribing Called 'Win-Win'

Electronic prescribing could prevent nearly 2 million medication errors and save the federal government $26 billion over the next decade—even after providing funds for equipment, training and support—if physicians were required to use the technology for their Medicare patients, according to a study released by the Pharmaceutical Care Management Association. The study found that when physicians use e-prescribing to learn their patients' medication history and prescription choices, both patient safety and savings improve dramatically. However, fewer than 1 in 10 physicians actually use e-prescribing, according to PCMA. The group, which represents pharmacy benefit managers, is pushing the Centers for Medicare and Medicaid Services to require e-prescribing for all Medicare Part D prescriptions by 2010, while providing incentive payments for physicians that would offset their costs for equipment, training, and support.

Feds Release Medicaid Drug Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reining in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs.

APhA Urges Delay in Rx Rule

The American Pharmacists Association and three lawmakers have urged CMS to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions beginning Oct. 1. The mandate, included in recently approved legislation to fund the war in Iraq, requires that all Medicaid prescriptions be written on “tamper-resistant” paper to be eligible for federal reimbursement. But even though many states have similar requirements, it will take much longer than 3 months to roll out such a program across the country, said APhA executive vice president and CEO John Gans in a statement. The three lawmakers—Rep. Charlie Wilson (D-Ohio), Rep. Marion Berry (D-Ark.), and Rep. Mike Ross (D-Ark.)—say that most physicians do not currently use these types of pads, nor are supplies readily available. “The tamperproof pad law was designed to prevent Medicaid fraud,” the legislators said in a statement. “However, the timeline for implementation could result in patients being turned away from their pharmacies as of Oct. 1, 2007, if doctors fail to write prescriptions on 'tamper-resistant' paper.” The congressmen have introduced a bill that would require only prescriptions for Class II narcotics to be written on the tamperproof prescription pads.

N.Y. AG Fights Rankings

New York's attorney general has asked insurer UnitedHealthcare to halt the introduction of a program that would rank physicians in the state according to quality of care and cost of service. UHC was slated to release its New York physician rankings next month, and State Attorney General Andrew Cuomo's staff said they feared that consumers would be steered to physicians based on faulty data and criteria. In addition, the letter from Linda Lacewell, the attorney general's counsel for economic and social justice, said that consumers may be encouraged through the program to “choose doctors because they are cheap rather than because they are good.” Ms. Lacewell wrote, “UnitedHealthcare's profit motive may affect the accuracy of its quality ratings because high-quality doctors may cost UnitedHealthcare more money.”

Army to Educate on Mental Health

The U.S. Army is beginning a program to have all soldiers—and their families—learn the symptoms of traumatic brain injury and posttraumatic stress disorder and to help service personnel seek treatment. The goal is for all military personnel to receive training by mid-October. The Army will use what it calls a “chain-teaching” method, with education coming down the chain of command. Leaders can retrieve materials—consisting of a 35-page guide and video and slide shows—at

www.army.mil

New Orleans MD Charges Dropped

A grand jury refused to indict Dr. Anna Pou, the New Orleans surgeon who was accused of murder in the wake of Hurricane Katrina. The decision by the Orleans Parish grand jury came just days after Dr. Pou sued the state attorney general over the case, and ends the year-long criminal investigation into Dr. Pou's performance at Memorial Medical Center immediately after the hurricane. Dr. Pou had been accused of giving four patients a “lethal cocktail” of painkillers and sedatives shortly before the sweltering hospital was evacuated. Dr. Pou's suit against State Attorney General Charles Foti accuses the attorney general of using the murder case against her to fuel his re-election campaign. The lawsuit also asks the court to force the state to defend Dr. Pou against wrongful death lawsuits filed by family members of three of the patients who died at Memorial.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes. The classes were angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

The investigators examined how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, explained in an interview.

Nevertheless, “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng added. Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006.

Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. However, by Dec. 8, 2006, after both drugs had generic equivalents, the study's authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng suggested that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians to determine which medications are most likely to be covered, and therefore more affordable, for their patients.

“While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive,” Dr. Tseng concluded.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes. The classes were angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

The investigators examined how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, explained in an interview.

Nevertheless, “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng added. Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006.

Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. However, by Dec. 8, 2006, after both drugs had generic equivalents, the study's authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng suggested that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians to determine which medications are most likely to be covered, and therefore more affordable, for their patients.

“While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive,” Dr. Tseng concluded.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes. The classes were angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics.

The investigators examined how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

“Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, explained in an interview.

Nevertheless, “despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies,” Dr. Tseng added. Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006.

Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. However, by Dec. 8, 2006, after both drugs had generic equivalents, the study's authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng suggested that a Web site that tracks the list of these “widely covered” drugs potentially could help physicians to determine which medications are most likely to be covered, and therefore more affordable, for their patients.

“While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive,” Dr. Tseng concluded.

Food Companies Limit Ads

Eleven of the country's largest food companies have announced plans to voluntarily limit advertisements and promotions to children younger than 12 years old. The steps were announced at a forum held by the Federal Trade Commission. The limits embraced by each company varied; McDonald's, for example, said all advertising aimed at those 12 years and under would further the goal of healthy dietary choices, and PepsiCo Inc. said it would promote only two products to children, and that the ads would emphasize active lifestyles. The efforts drew praise from consumer advocates. Margo Wootan, director of nutrition policy at the consumer advocacy group Center for Science in the Public Interest, said at a press conference that although CSPI was skeptical initially that the food companies would announce true limits, “We're thrilled the companies have done the right thing.”

Most U.S. Babies Receive Screening

Nearly 88% of all babies born in the U.S.–more than double the percentage in 2005–live in states that require screening for at least 21 life-threatening disorders, according to the most recent March of Dimes newborn screening report card. A 2004 report of the American College of Medical Genetics called for every baby born in the United States to be screened for 29 genetic or functional disorders, ranging from sickle cell anemia to long-chain 3 hydroxyacyl CoA dehydrogenase deficiency (LCHAD). Two years ago, only 38% of infants were born in states that required screening for at least 21 of these 29 conditions.

Teens Steady on Drug Use, Sex

The percentages of 8th, 10th and 12th grade students reporting illicit drug use in the past 30 days remained stable from 2005 to 2006, although use among all three grades has declined since 1997, according to a report by the Federal Interagency Forum on Child and Family Statistics. In addition, the percentage of high school students reporting having had sexual intercourse (47%) stayed steady from 2003, although the percentage has declined from 54% since 1991. In other family statistics, the report said more family members are reading to toddlers: 60% of children aged 3-5 years were read to daily by a family member. But it also showed the percentage of low-birth-weight infants was up, as was the proportion of children aged 6-17 years who were overweight

Feds Release Medicaid Drug Rule

The Centers for Medicare and Medicaid Services has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reigning in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest mark-up, creating an incentive to dispense those drugs.

U.S. Lacks Pediatric Rheumatologists

There is a serious shortage of pediatric rheumatologists in the United States and a 75% increase in their numbers is needed to meet patient needs, according to a report from the Health Resources and Services Administration. There are fewer than 200 certified pediatric rheumatologists practicing in the United States and about 13 states have no pediatric rheumatologists. Children must travel 57 miles on average to see the nearest pediatric rheumatologist, compared with less than 25 miles for other pediatric specialists such as pediatric cardiologists or pediatric endocrinologists, according to the HRSA report. The HRSA findings confirm the existence of a shortage of pediatric rheumatologists and demonstrate the need for legislation to address the issue, according to the Arthritis Foundation. The group supports the Arthritis Prevention Control and Cure Act (S. 626/H.R. 1283), which would authorize loan repayment programs for pediatric rheumatology and increase institutional training grants to support pediatric rheumatology. The HRSA report includes data from the American Board of Pediatrics, membership data from the American College of Rheumatology, the U.S. Census Bureau, a survey of pediatricians and rheumatologists, and a survey of pediatric residency directors.

Food Companies Limit Ads

Eleven of the country's largest food companies have announced plans to voluntarily limit advertisements and promotions to children younger than 12 years old. The steps were announced at a forum held by the Federal Trade Commission. The limits embraced by each company varied; McDonald's, for example, said all advertising aimed at those 12 years and under would further the goal of healthy dietary choices, and PepsiCo Inc. said it would promote only two products to children, and that the ads would emphasize active lifestyles. The efforts drew praise from consumer advocates. Margo Wootan, director of nutrition policy at the consumer advocacy group Center for Science in the Public Interest, said at a press conference that although CSPI was skeptical initially that the food companies would announce true limits, “We're thrilled the companies have done the right thing.”

Most U.S. Babies Receive Screening

Nearly 88% of all babies born in the U.S.–more than double the percentage in 2005–live in states that require screening for at least 21 life-threatening disorders, according to the most recent March of Dimes newborn screening report card. A 2004 report of the American College of Medical Genetics called for every baby born in the United States to be screened for 29 genetic or functional disorders, ranging from sickle cell anemia to long-chain 3 hydroxyacyl CoA dehydrogenase deficiency (LCHAD). Two years ago, only 38% of infants were born in states that required screening for at least 21 of these 29 conditions.

Teens Steady on Drug Use, Sex

The percentages of 8th, 10th and 12th grade students reporting illicit drug use in the past 30 days remained stable from 2005 to 2006, although use among all three grades has declined since 1997, according to a report by the Federal Interagency Forum on Child and Family Statistics. In addition, the percentage of high school students reporting having had sexual intercourse (47%) stayed steady from 2003, although the percentage has declined from 54% since 1991. In other family statistics, the report said more family members are reading to toddlers: 60% of children aged 3-5 years were read to daily by a family member. But it also showed the percentage of low-birth-weight infants was up, as was the proportion of children aged 6-17 years who were overweight

Feds Release Medicaid Drug Rule

The Centers for Medicare and Medicaid Services has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reigning in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest mark-up, creating an incentive to dispense those drugs.

U.S. Lacks Pediatric Rheumatologists

There is a serious shortage of pediatric rheumatologists in the United States and a 75% increase in their numbers is needed to meet patient needs, according to a report from the Health Resources and Services Administration. There are fewer than 200 certified pediatric rheumatologists practicing in the United States and about 13 states have no pediatric rheumatologists. Children must travel 57 miles on average to see the nearest pediatric rheumatologist, compared with less than 25 miles for other pediatric specialists such as pediatric cardiologists or pediatric endocrinologists, according to the HRSA report. The HRSA findings confirm the existence of a shortage of pediatric rheumatologists and demonstrate the need for legislation to address the issue, according to the Arthritis Foundation. The group supports the Arthritis Prevention Control and Cure Act (S. 626/H.R. 1283), which would authorize loan repayment programs for pediatric rheumatology and increase institutional training grants to support pediatric rheumatology. The HRSA report includes data from the American Board of Pediatrics, membership data from the American College of Rheumatology, the U.S. Census Bureau, a survey of pediatricians and rheumatologists, and a survey of pediatric residency directors.

Food Companies Limit Ads

Eleven of the country's largest food companies have announced plans to voluntarily limit advertisements and promotions to children younger than 12 years old. The steps were announced at a forum held by the Federal Trade Commission. The limits embraced by each company varied; McDonald's, for example, said all advertising aimed at those 12 years and under would further the goal of healthy dietary choices, and PepsiCo Inc. said it would promote only two products to children, and that the ads would emphasize active lifestyles. The efforts drew praise from consumer advocates. Margo Wootan, director of nutrition policy at the consumer advocacy group Center for Science in the Public Interest, said at a press conference that although CSPI was skeptical initially that the food companies would announce true limits, “We're thrilled the companies have done the right thing.”

Most U.S. Babies Receive Screening

Nearly 88% of all babies born in the U.S.–more than double the percentage in 2005–live in states that require screening for at least 21 life-threatening disorders, according to the most recent March of Dimes newborn screening report card. A 2004 report of the American College of Medical Genetics called for every baby born in the United States to be screened for 29 genetic or functional disorders, ranging from sickle cell anemia to long-chain 3 hydroxyacyl CoA dehydrogenase deficiency (LCHAD). Two years ago, only 38% of infants were born in states that required screening for at least 21 of these 29 conditions.

Teens Steady on Drug Use, Sex

The percentages of 8th, 10th and 12th grade students reporting illicit drug use in the past 30 days remained stable from 2005 to 2006, although use among all three grades has declined since 1997, according to a report by the Federal Interagency Forum on Child and Family Statistics. In addition, the percentage of high school students reporting having had sexual intercourse (47%) stayed steady from 2003, although the percentage has declined from 54% since 1991. In other family statistics, the report said more family members are reading to toddlers: 60% of children aged 3-5 years were read to daily by a family member. But it also showed the percentage of low-birth-weight infants was up, as was the proportion of children aged 6-17 years who were overweight

Feds Release Medicaid Drug Rule

The Centers for Medicare and Medicaid Services has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule, which will take effect Oct. 1, is aimed at reigning in inflated drug product payments, CMS said. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest mark-up, creating an incentive to dispense those drugs.

U.S. Lacks Pediatric Rheumatologists

There is a serious shortage of pediatric rheumatologists in the United States and a 75% increase in their numbers is needed to meet patient needs, according to a report from the Health Resources and Services Administration. There are fewer than 200 certified pediatric rheumatologists practicing in the United States and about 13 states have no pediatric rheumatologists. Children must travel 57 miles on average to see the nearest pediatric rheumatologist, compared with less than 25 miles for other pediatric specialists such as pediatric cardiologists or pediatric endocrinologists, according to the HRSA report. The HRSA findings confirm the existence of a shortage of pediatric rheumatologists and demonstrate the need for legislation to address the issue, according to the Arthritis Foundation. The group supports the Arthritis Prevention Control and Cure Act (S. 626/H.R. 1283), which would authorize loan repayment programs for pediatric rheumatology and increase institutional training grants to support pediatric rheumatology. The HRSA report includes data from the American Board of Pediatrics, membership data from the American College of Rheumatology, the U.S. Census Bureau, a survey of pediatricians and rheumatologists, and a survey of pediatric residency directors.

Nursing Home Fees to Increase

The Centers for Medicare and Medicaid Services has proposed increasing the work relative value units–and therefore the physician fees–for services provided in the nursing home setting. If the increase is included when CMS publishes its final fee schedule on Nov. 1, physicians will see new reimbursement rates beginning on Jan. 1, 2008. Under CMS' proposal, fees for nursing home visits would increase 9%-50%, depending on the service. The changes come after 4 years of work by the American Medical Directors Association and other physician groups aimed at persuading CMS that the work involved in caring for a nursing home patient is similar to the work involved in caring for a hospital patient. “Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician,” said Dr. David Dale, president of the American College of Physicians in a statement. “These work values are a reflection of this extraordinary responsibility.”

CMS Releases Medicaid Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.

Joint Commission Announces Goals

The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) will require health care institutions to take specific actions to reduce the risks of patient harm associated with the use of anticoagulant therapy as part of its 2008 National Patient Safety Goals. The new requirement–which applies to hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations–addresses a widely acknowledged safety problem with anticoagulant therapy, the accrediting organization said. The 2008 safety goals also include a new requirement that addresses the recognition of and response to unexpected deterioration in a patient's condition. Under this requirement, hospitals must select a suitable method for enabling caregivers to directly request and obtain assistance from specially trained individuals if and when a patient's condition worsens. Full implementation of both requirements is targeted for January 2009.

Americans Buy Drugs Overseas

More than 5 million Americans adults, or more than 2% of the U.S. population, have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription for the drugs they wanted, the survey found. Importers were more likely to be under age 35 years, be Hispanic, live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”

HHS Expands Vaccine Capacity

The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a potential influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts provide funding for renovation of manufacturing facilities and for manufacturing operations for 2 years, with options for an additional 3 years of operations. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. In addition, the facilities will expand vaccine availability for the national stockpile.

Patients Want to Shake Hands

Most patients want physicians to shake their hands when they first meet, but only about half want their first names used in greetings, according to a report in the Archives of Internal Medicine. The authors surveyed adults and also analyzed videotapes of new patient visits. They found physicians and patients shook hands in four out of five visits, but that physicians didn't mention names at all in about half the visits. “Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names,” the authors wrote.

Nursing Home Fees to Increase

The Centers for Medicare and Medicaid Services has proposed increasing the work relative value units–and therefore the physician fees–for services provided in the nursing home setting. If the increase is included when CMS publishes its final fee schedule on Nov. 1, physicians will see new reimbursement rates beginning on Jan. 1, 2008. Under CMS' proposal, fees for nursing home visits would increase 9%-50%, depending on the service. The changes come after 4 years of work by the American Medical Directors Association and other physician groups aimed at persuading CMS that the work involved in caring for a nursing home patient is similar to the work involved in caring for a hospital patient. “Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician,” said Dr. David Dale, president of the American College of Physicians in a statement. “These work values are a reflection of this extraordinary responsibility.”

CMS Releases Medicaid Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.

Joint Commission Announces Goals

The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) will require health care institutions to take specific actions to reduce the risks of patient harm associated with the use of anticoagulant therapy as part of its 2008 National Patient Safety Goals. The new requirement–which applies to hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations–addresses a widely acknowledged safety problem with anticoagulant therapy, the accrediting organization said. The 2008 safety goals also include a new requirement that addresses the recognition of and response to unexpected deterioration in a patient's condition. Under this requirement, hospitals must select a suitable method for enabling caregivers to directly request and obtain assistance from specially trained individuals if and when a patient's condition worsens. Full implementation of both requirements is targeted for January 2009.

Americans Buy Drugs Overseas

More than 5 million Americans adults, or more than 2% of the U.S. population, have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription for the drugs they wanted, the survey found. Importers were more likely to be under age 35 years, be Hispanic, live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”

HHS Expands Vaccine Capacity

The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a potential influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts provide funding for renovation of manufacturing facilities and for manufacturing operations for 2 years, with options for an additional 3 years of operations. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. In addition, the facilities will expand vaccine availability for the national stockpile.

Patients Want to Shake Hands

Most patients want physicians to shake their hands when they first meet, but only about half want their first names used in greetings, according to a report in the Archives of Internal Medicine. The authors surveyed adults and also analyzed videotapes of new patient visits. They found physicians and patients shook hands in four out of five visits, but that physicians didn't mention names at all in about half the visits. “Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names,” the authors wrote.

Nursing Home Fees to Increase

The Centers for Medicare and Medicaid Services has proposed increasing the work relative value units–and therefore the physician fees–for services provided in the nursing home setting. If the increase is included when CMS publishes its final fee schedule on Nov. 1, physicians will see new reimbursement rates beginning on Jan. 1, 2008. Under CMS' proposal, fees for nursing home visits would increase 9%-50%, depending on the service. The changes come after 4 years of work by the American Medical Directors Association and other physician groups aimed at persuading CMS that the work involved in caring for a nursing home patient is similar to the work involved in caring for a hospital patient. “Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician,” said Dr. David Dale, president of the American College of Physicians in a statement. “These work values are a reflection of this extraordinary responsibility.”

CMS Releases Medicaid Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.

Joint Commission Announces Goals

The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) will require health care institutions to take specific actions to reduce the risks of patient harm associated with the use of anticoagulant therapy as part of its 2008 National Patient Safety Goals. The new requirement–which applies to hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations–addresses a widely acknowledged safety problem with anticoagulant therapy, the accrediting organization said. The 2008 safety goals also include a new requirement that addresses the recognition of and response to unexpected deterioration in a patient's condition. Under this requirement, hospitals must select a suitable method for enabling caregivers to directly request and obtain assistance from specially trained individuals if and when a patient's condition worsens. Full implementation of both requirements is targeted for January 2009.

Americans Buy Drugs Overseas

More than 5 million Americans adults, or more than 2% of the U.S. population, have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription for the drugs they wanted, the survey found. Importers were more likely to be under age 35 years, be Hispanic, live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”

HHS Expands Vaccine Capacity

The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a potential influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts provide funding for renovation of manufacturing facilities and for manufacturing operations for 2 years, with options for an additional 3 years of operations. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. In addition, the facilities will expand vaccine availability for the national stockpile.

Patients Want to Shake Hands

Most patients want physicians to shake their hands when they first meet, but only about half want their first names used in greetings, according to a report in the Archives of Internal Medicine. The authors surveyed adults and also analyzed videotapes of new patient visits. They found physicians and patients shook hands in four out of five visits, but that physicians didn't mention names at all in about half the visits. “Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names,” the authors wrote.

Nursing Home Fees to Increase

The Centers for Medicare and Medicaid Services has proposed increasing the work relative value units—and therefore the physician fees—for services provided in the nursing home setting. If the increase is included when CMS publishes its final fee schedule on Nov. 1, physicians will see new reimbursement rates beginning on Jan. 1, 2008. Under CMS's proposal, fees for nursing home visits would increase 9%–50%, depending on the service. The changes come after 4 years of work by the American Medical Directors Association and other physician groups aimed at persuading CMS that the work involved in caring for a nursing home patient is similar to the work involved in caring for a hospital patient. “Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician,” said Dr. David Dale, president of the American College of Physicians in a statement. “These work values are a reflection of this extraordinary responsibility.”

ACP Criticizes SCHIP Funding

Funding levels are too low in a Senate bill to reauthorize the State Children's Health Insurance Program, the American College of Physicians told the Senate Finance Committee in July. In addition, the bill to reauthorize SCHIP does not address pending cuts in Medicare physician fees, Dr. Joel Levine, chair of the ACP's board of regents, told lawmakers in a five-point letter. Dr. Levine urged lawmakers to repeal the Medicare physician fee cuts by mandating “at least 2 years of stable, predictable, and positive updates, reflecting increases in physicians' practice costs.” He also said that Congress should provide federal grants to support states that redesign their Medicaid and SCHIP programs around the patient-centered medical home, a concept he said already is working in states such as North Carolina. Debate on whether and how to expand SCHIP is expected to intensify prior to expiration of the program's authorization on Sept. 30.

CMS Releases Medicaid Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.

Joint Commission Announces Goals

The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) will require health care institutions to take actions to reduce the risks of patient harm associated with the use of anticoagulant therapy as part of its 2008 National Patient Safety Goals. The new requirement—which applies to hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations—addresses a widely acknowledged safety problem with anticoagulant therapy, the accrediting organization said. The 2008 safety goals include a new requirement that addresses the recognition of and response to unexpected deterioration in a patient's condition. Under this requirement, hospitals must select a method for enabling caregivers to obtain assistance from specially trained individuals if and when a patient's condition worsens. Full implementation of both requirements is targeted for January 2009.

Americans Buy Drugs Overseas

More than 5 million Americans adults have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription, the survey found. Importers were more likely to be under age 35 years, be Hispanic, live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”

HHS Expands Vaccine Capacity

The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts fund manufacturing operations and renovation of manufacturing facilities for 2 years, with options for an additional 3 years. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. The facilities also will expand vaccine availability for the national stockpile.

Nursing Home Fees to Increase

The Centers for Medicare and Medicaid Services has proposed increasing the work relative value units—and therefore the physician fees—for services provided in the nursing home setting. If the increase is included when CMS publishes its final fee schedule on Nov. 1, physicians will see new reimbursement rates beginning on Jan. 1, 2008. Under CMS's proposal, fees for nursing home visits would increase 9%–50%, depending on the service. The changes come after 4 years of work by the American Medical Directors Association and other physician groups aimed at persuading CMS that the work involved in caring for a nursing home patient is similar to the work involved in caring for a hospital patient. “Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician,” said Dr. David Dale, president of the American College of Physicians in a statement. “These work values are a reflection of this extraordinary responsibility.”

ACP Criticizes SCHIP Funding

Funding levels are too low in a Senate bill to reauthorize the State Children's Health Insurance Program, the American College of Physicians told the Senate Finance Committee in July. In addition, the bill to reauthorize SCHIP does not address pending cuts in Medicare physician fees, Dr. Joel Levine, chair of the ACP's board of regents, told lawmakers in a five-point letter. Dr. Levine urged lawmakers to repeal the Medicare physician fee cuts by mandating “at least 2 years of stable, predictable, and positive updates, reflecting increases in physicians' practice costs.” He also said that Congress should provide federal grants to support states that redesign their Medicaid and SCHIP programs around the patient-centered medical home, a concept he said already is working in states such as North Carolina. Debate on whether and how to expand SCHIP is expected to intensify prior to expiration of the program's authorization on Sept. 30.

CMS Releases Medicaid Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.

Joint Commission Announces Goals

The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) will require health care institutions to take actions to reduce the risks of patient harm associated with the use of anticoagulant therapy as part of its 2008 National Patient Safety Goals. The new requirement—which applies to hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations—addresses a widely acknowledged safety problem with anticoagulant therapy, the accrediting organization said. The 2008 safety goals include a new requirement that addresses the recognition of and response to unexpected deterioration in a patient's condition. Under this requirement, hospitals must select a method for enabling caregivers to obtain assistance from specially trained individuals if and when a patient's condition worsens. Full implementation of both requirements is targeted for January 2009.

Americans Buy Drugs Overseas

More than 5 million Americans adults have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription, the survey found. Importers were more likely to be under age 35 years, be Hispanic, live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”

HHS Expands Vaccine Capacity

The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts fund manufacturing operations and renovation of manufacturing facilities for 2 years, with options for an additional 3 years. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. The facilities also will expand vaccine availability for the national stockpile.

Nursing Home Fees to Increase

The Centers for Medicare and Medicaid Services has proposed increasing the work relative value units—and therefore the physician fees—for services provided in the nursing home setting. If the increase is included when CMS publishes its final fee schedule on Nov. 1, physicians will see new reimbursement rates beginning on Jan. 1, 2008. Under CMS's proposal, fees for nursing home visits would increase 9%–50%, depending on the service. The changes come after 4 years of work by the American Medical Directors Association and other physician groups aimed at persuading CMS that the work involved in caring for a nursing home patient is similar to the work involved in caring for a hospital patient. “Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician,” said Dr. David Dale, president of the American College of Physicians in a statement. “These work values are a reflection of this extraordinary responsibility.”

ACP Criticizes SCHIP Funding

Funding levels are too low in a Senate bill to reauthorize the State Children's Health Insurance Program, the American College of Physicians told the Senate Finance Committee in July. In addition, the bill to reauthorize SCHIP does not address pending cuts in Medicare physician fees, Dr. Joel Levine, chair of the ACP's board of regents, told lawmakers in a five-point letter. Dr. Levine urged lawmakers to repeal the Medicare physician fee cuts by mandating “at least 2 years of stable, predictable, and positive updates, reflecting increases in physicians' practice costs.” He also said that Congress should provide federal grants to support states that redesign their Medicaid and SCHIP programs around the patient-centered medical home, a concept he said already is working in states such as North Carolina. Debate on whether and how to expand SCHIP is expected to intensify prior to expiration of the program's authorization on Sept. 30.

CMS Releases Medicaid Rule

CMS has unveiled a new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments. As part of the new regulation, states will be required to collect information from physicians about prescription drugs administered in their offices so that the state can collect any rebates offered by drug manufacturers on those products. The final rule will take effect Oct. 1. The regulation is expected to save states and the federal government $8.4 billion over the next 5 years, but even with the change, the Medicaid program still is expected to spend $140 billion for drugs over the same time period. The change is in part a reaction to a series of reports showing that Medicaid payments to pharmacies for generic drugs were much higher than what pharmacies actually were paying for the drugs. Pharmacies, the reports showed, made the most profit on those generic drugs with the highest markup, creating an incentive to dispense those drugs.

Joint Commission Announces Goals

The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) will require health care institutions to take actions to reduce the risks of patient harm associated with the use of anticoagulant therapy as part of its 2008 National Patient Safety Goals. The new requirement—which applies to hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations—addresses a widely acknowledged safety problem with anticoagulant therapy, the accrediting organization said. The 2008 safety goals include a new requirement that addresses the recognition of and response to unexpected deterioration in a patient's condition. Under this requirement, hospitals must select a method for enabling caregivers to obtain assistance from specially trained individuals if and when a patient's condition worsens. Full implementation of both requirements is targeted for January 2009.

Americans Buy Drugs Overseas

More than 5 million Americans adults have recently purchased prescription drugs from another country, such as Canada or Mexico, according to a survey by the Pharmaceutical Research and Manufacturers of America. The vast majority of consumer importers said they were looking for the best price for medicines, but about half decided to buy their drugs in another country because they didn't have a physician's prescription, the survey found. Importers were more likely to be under age 35 years, be Hispanic, live in a southern border state, and to spend more out-of-pocket money on prescription drugs than do nonimporters, PhRMA reported. Most of the drugs imported were to treat chronic ailments. PhRMA President and CEO Billy Tauzin said in a statement that importation increases a patient's risk of being exposed to “dangerous counterfeit medicines.”

HHS Expands Vaccine Capacity

The Department of Health and Human Services has awarded two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a influenza pandemic. The 5-year contracts were awarded to Sanofi Pasteur ($77.4 million) and MedImmune Inc. ($55.1 million). The contracts fund manufacturing operations and renovation of manufacturing facilities for 2 years, with options for an additional 3 years. Upon completion, these facilities will expand domestic pandemic vaccine manufacturing capacity by 16%, according to HHS. The facilities also will expand vaccine availability for the national stockpile.