News in brief - July 26, 2004

Senate leader lays out health plan - Ohio voters support appeals - Medicare drug discount site criticized - Health centers, public hospitals missed out on drug discounts

Senate leader lays out health plan

Speaking recently at the National Press Club, Senate Majority Leader Bill Frist, MD (R, Tenn.), laid out some new ideas for reforms designed to expand health coverage. His multipoint plan includes a Fannie Mae-type national risk pool that would allow insurance companies to offer low-cost individuals plans. He also proposed capping the tax benefit that companies get for offering health insurance, while extending a similar tax incentive to those buying individual insurance.

He also wants to encourage middle-class uninsured Americans to purchase catastrophic coverage and increase efforts to enroll all eligible children in public programs.

Ohio voters support appeals

The majority of Ohio voters polled in a recent survey said they would rather forgo suing their health plans and go through a "quick appeals process" with an independent panel of physicians not associated with their plans.

According to the survey by America's Health Insurance Plans, 75% of the 300 registered Ohio voters polled said the independent review panel was in the best interest of patients.

Twenty-one percent said giving patients the chance to sue their health plan and recover damages was the best option, and 4% said they did not know.

The survey was conducted in late March and early April, before the U.S. Supreme Court in June ruled that a Texas law giving patients the right to sue their health plans in state court was preempted by a federal law.

The poll also showed that 75% of voters want to see current medical liability rules changed to reduce frivolous medical malpractice lawsuits, while 23% said the rules should stay the same. And 88% of those surveyed said personal injury lawyers benefit more from the current medical liability system; only 7% said that patients benefit more.

"At a time when we're living in a 50-50 nation and voters are narrowly divided on so many issues, Ohio voters are sending a clear signal they do not believe more lawsuits are the solution to our health care problems," AHIP President and CEO Karen Ignagni said in a statement.

Medicare drug discount site criticized

In a recent letter to Health and Human Services Secretary Tommy Thompson, Reps. Henry Waxman (D, Calif.) and Louise Slaughter (D, N.Y.) described discrepancies their staffs found on the HHS Web site (www.medicare.gov) for Medicare drug discount cards.

They reported that several pharmacies were listed as accepting more discount cards than they actually did and that one pharmacy on the Web site had been closed for at least three years.

Health centers, public hospitals missed out on drug discounts

The federal Drug Discount Program is supposed to ensure that community health centers, public hospitals and others who serve low-income patients receive discounted prices for prescription medications. But a Dept. of Health and Human Services Office of Inspector General analysis of September 2002 data showed that wasn't the case 31% of the time.

Clinics and hospitals that should have received the discounts overpaid by about $41.1 million, according to an OIG report released in June.

The OIG says the overpayments occurred because the Health Resources and Services Administration's Pharmacy Affairs Branch doesn't have a process to confirm that qualifying hospitals and clinics are receiving the lower rates. Also, the OIG said problems occur because HRSA doesn't have the authority to enforce the 1992 law that established the discount program.

To prevent overcharging, the OIG recommends that HRSA spot check transactions and develop a legislative proposal that would create penalties against drug companies that violate the rules.