News in brief - Aug. 16, 2004

Mississippi abortion ban lifted - Parental consent law struck down - Drugmaker will pay millions to resolve Claritin pricing lawsuit - Medicare pay increases announced for hospitals and other facilities - Medicaid waivers questioned

Mississippi abortion ban lifted

A federal judge in Mississippi ordered a temporary injunction last month against a Mississippi law that banned abortions after the first trimester unless they were performed at a licensed hospital or ambulatory surgery center. U.S. District Judge Tom S. Lee in the Southern District of Mississippi said the law, which went into effect July 1, didn't do anything new to protect patients' health.

Jackson Women's Health Organization, one of only two clinics in Mississippi that provides second-trimester abortions, sued the state over the abortion measure. The health organization is not a licensed hospital or ambulatory surgery center, and neither is the other facility.

The state "knew that the effect of the amendment would be to make second-trimester abortions unavailable in Mississippi ... a regulation that has the effect of unduly burdening a woman's right to choose an abortion," Lee wrote in his opinion.

Parental consent law struck down

The 9th U.S. Circuit Court of Appeals struck down an Idaho parental consent law for teenagers seeking abortions because it didn't create an adequate exception for cases in which pregnancy endangers the teen's life or health. The statute required teens younger than 18 to get written consent from a parent or permission from a judge to obtain an abortion. The 9th Circuit said that Idaho's exception for "medical emergency" was too narrow.

"The statute will unconstitutionally allow Idaho to interfere with a woman's choice to undergo an abortion procedure if continuing her pregnancy would constitute a threat to her health, which the essential holding of Roe [v. Wade] forbids," the court said.

Drugmaker will pay millions to resolve Claritin pricing lawsuit

Schering-Plough Corp. will pay $345 million to resolve government charges over the way it marketed and priced its allergy medication Claritin. The company pleaded guilty to violating federal anti-kickback laws when it paid an HMO to maintain preferred treatment for Claritin, according to the United States Attorney for the Eastern District of Pennsylvania and the Pennsylvania Attorney General. The company will pay a $52.5 million criminal fine.

Schering-Plough also will pay $293 million in civil damages to settle claims that it violated the False Claims Act by overcharging Medicaid and other programs by not reporting its true best price for Claritin.

Medicare pay increases announced for hospitals and other facilities

The federal government issued a final rule that will increase Medicare inpatient payments to acute-care hospitals and create a link between quality of services and reimbursement.

Between the payment update and other changes, urban hospitals are expected to see an average increase of 5.7% and rural hospitals 6.2% in fiscal year 2005, according to the Centers for Medicare & Medicaid Services.

The agency also announced a 3.1% Medicare payment increase for inpatient rehabilitation facilities and 2.8% for skilled nursing facilities.

Medicaid waivers questioned

The Dept. of Health and Human Services ignored its own criteria in approving Medicaid waivers that allow states to provide pharmacy benefits to low-income seniors who don't qualify for the program, according to a Government Accountability Office report.

These Pharmacy Plus demonstration projects are supposed to be budget neutral, meaning that any added initial cost to the federal government is later recouped. But the GAO found the programs would end up adding $416 million to $1 billion over five years.

The report also faults HHS officials for not documenting their rationale in approving these programs.