News in brief - May 10, 2004

Bush wants electronic health records - CMS addresses enrollment delays - Telehealth legislation proposed - Mass. tort reform bill gets panel's endorsement - Judge moves to stop Texas Medicaid restrictions - AIDS patients file class-action suit over Norvir price hike - Medicaid jumps into drug pool

Bush wants electronic health records

President Bush has set a goal of assuring that most Americans have an electronic medical record within 10 years. Speaking before the American Assn. of Community Colleges in Minneapolis, the president said the records would be designed to share information privately and securely between health practitioners.

"Medicine ought to be using modern technologies in order to better share information, in order to reduce medical errors, in order to reduce cost to our health care system by billions of dollars," Bush said.

The administration earmarked $100 million in funding in the proposed fiscal 2005 budget to pay for health information demonstration projects and will work to complete standards for electronic records by year's end. Bush is creating a new post at the Dept. of Health and Human Services to oversee the initiative.

CMS addresses enrollment delays

The Centers for Medicare & Medicaid Services has authorized carriers to hire temporary employees and recommended carriers add an evening shift to help sift through the backlog of Medicare physician enrollment applications.

Carriers in a number of states have experienced problems logging into a new computerized enrollment system, forcing physicians to wait months in some cases to begin billing for Medicare services. CMS officials said another shift of workers would help reduce the number of carriers trying to access the system at one time, alleviating pressure on the server. The officials predicted they could work through the remaining backlog by the summer.

Telehealth legislation proposed

Sen. John Edwards (D, N.C.) has introduced a measure designed to extend the reach of primary care and specialist physicians through an expanded use of telehealth programs in underserved areas. The bill would remove bureaucratic obstacles to practicing across state lines via telehealth.

The proposal would also allow Medicare reimbursement for telehealth visits at assisted living centers and skilled nursing facilities.

Mass. tort reform bill gets panel's endorsement

The Massachusetts Legislature's Joint Committee on Insurance in late April endorsed a bill that physicians believe will help address some of their medical liability insurance problems. The legislation would hold physicians responsible only for their degree of fault in medical malpractice lawsuits, require that expert witnesses are licensed and board-certified in the same or a similar specialty as the accused physician, and implement a lower interest rate that, in the case of a plaintiff victory, is assessed on the award dating back to the time the claim was filed.

Judge moves to stop Texas Medicaid restrictions

A federal judge in Texas issued a preliminary injunction last month against the state's move to keep people from receiving Medicaid benefits if they do such things as use illegal drugs, fail to immunize their children or allow children to skip school. U.S. District Court Judge Sam Sparks, in the Western District of Texas, said that the measure violates federal laws and regulations that narrowly restrict when Medicaid sanctions can be used.

AIDS patients file class-action suit over Norvir price hike

Two AIDS patients filed a proposed class-action lawsuit against the makers of the protease inhibitor Norvir. They claim that Abbott Laboratories leveraged monopoly power when, in December 2003, it raised the wholesale price of the drug to $1,028.71 for 120 capsules of 100 mg, up from $205.74.

The 400% price increase outraged doctors and patients. The lawsuit, filed in the U.S. District Court for the Northern District of California in April, is believed to be the first seeking class-action status on behalf of patients nationwide who have had to pay the higher prices.

"It's one thing for a pharmaceutical company to make money, but Abbott's unjustified price increase has taken unfair advantage of the very people it should be trying to help," said Joseph Tabacco Jr., the attorney representing the patients.

Abbott has said its pricing decision was not made lightly and that the increase was justified because the drug's role has changed since its 1996 introduction. The company also notes that Norvir "represents a fraction, typically one-fifth, of the daily cost of therapy" for HIV patients.

Medicaid jumps into drug pool

The Dept. of Health and Human Services recently gave approval for the Medicaid programs in Alaska, Michigan, Nevada New Hampshire and Vermont to pool their purchasing power to buy cheaper prescription drugs. "The ability to purchase drugs at lower cost will help states continue to provide medications to the millions of low-income citizens who depend on the Medicaid program," said HHS Secretary Tommy Thompson.

States are not required to offer drug benefits under the Medicaid statute, but all of them do. Drug companies already offer government-required discounts, but many states have also negotiated even lower prices or turned to private pharmacy benefit managers to bring down their drug costs.