David O'Donnellan, an administrator for a group of Berks County, PA, eye doctors, negotiates with both Highmark and Independence Blue Cross. O'Donellan spoke during a hearing on the proposed merger between the two companies that would create the state's largest health insurer. O'Donellan asked that if the two insurers were allowed to merge, would their best practices be "catching," leading to cost savings and better service, or will they infect each other with their worst tendencies? He described an incident where Independence Blue Cross paid for a corneal transplant, but not the cornea.
A ban on drug companies providing gifts and meals to physicians was stripped out of proposed legislation a Massachusetts House committee had approved. The panel also removed requirements that drug and medical device companies report payments they make to doctors for consulting and speaking to other physicians and that the Department of Public Health post that information on its website. A proposed $5,000 fine per violation was also dropped from the bill. Instead, the measure would simply require drug companies to adopt a marketing code of conduct, such as the one the pharmaceutical industry's trade association announced while negotiations on the Massachusetts bill were in progress.
The number of prescriptions dispensed by U.S. pharmacies is growing at its worst rate in at least a decade as consumers are squeezed by both a troubled economy and the growing burden of out-of-pocket healthcare costs. The development comes as employers and insurers have shifted a larger share of healthcare costs to consumers in a bid to tame growth of the $2 trillion healthcare system. Consumers appear to be skimping on medicines as a result: A recent poll from the Kaiser foundation showed 23% of patients didn't fill a prescription in the last year because of cost, up from 20% in 2005; 19% split pills or skipped doses, up from 16% in 2005.
Actors Susan Sarandon and Tim Robbins weighed in on the medical-tower aspirations of St. Vincent's Hospital Manhattan during a New York City Landmarks Preservation Commission meeting. At issue is the hospital's "hardship-status" application before the commission in support of the institution's $1.6-billion development plan. St. Vincent's has said that it will have to shut its doors if it cannot build a new hospital, representatives said that the hospital has no choice but to build on its current property. The hospital project seeks to demolish five buildings in the Greenwich Village Historic District to permit the construction of a 299-foot-tall medical building and a 233-foot-tall luxury condominium.
President Bush has vetoed a bill designed to protect doctors from a 10.6% cut in their reimbursement rates when treating Medicare patients. The White House supports rescinding the pay cut, but objects to the way the legislation would finance the plan by reducing spending on private health plans. Lawmakers are under pressure from doctors and the elderly patients they serve to void the rate cut, which kicked in on July 1. As a result, both chambers of Congress are expected to move quickly to try to override the veto.
The California Assembly has approved a bill to toughen the state's power to fine insurers for failing to pay medical bills. The issue is whether the state needs extra legal powers to penalize health maintenance organizations and preferred provider organizations that are found to regularly underpay their bills to doctors, radiologists, anesthesiologists and other specialists. Assemblyman Jared Huffman said his bill was needed to put "teeth into our state's healthcare watchdog." But the measure now goes to Gov. Arnold Schwarzenegger, who is under pressure from HMOs and his own regulators to issue a veto.