News in brief - Dec. 11, 2006

Chains expand low-priced generics - CEO leaves embattled hospital group - Cigna premiers new payment program

Chains expand low-priced generics

Target Corp. on Nov. 20 expanded the availability of its $4 generic prescription program to all of its 1,287 pharmacies nationwide, revising its previous policy of offering that price only in states where Wal-Mart Stores Inc. was selling generics at that price.

Separately, Wal-Mart, which in September became the first company to sell some generics for $4 each, on Nov. 16 expanded its program to an additional 11 states, bringing the total number of states where it's available to 38. The company plans to reach all 50 states by Feb. 1, 2007.

CEO leaves embattled hospital group

After losing its three-year fight to retain tax-exemption status, Mokena, Ill.-based Provena Health announced in November it has lost its CEO. In a prepared statement, Bill Foley announced his resignation on Nov. 17 citing "personal and professional reasons." A representative for Provena declined additional comment.

While Provena said it considers Foley's greatest accomplishment to be the turnaround of the system's finances, he also lost a battle against the Illinois Dept. of Revenue that signaled growing backlash against nonprofit hospitals perceived to be providing too little charity care.

The Champaign County, Ill., board of review recommended in early 2003 that the hospital lose its tax-exempt status because it did not provide an adequate amount of charity care. The decision was upheld by the Dept. of Revenue. The department rejected the hospital's appeal in September.

Cigna premiers new payment program

Cigna is not quite to the level of real-time claims adjudication, in which physicians learn the patient's and insurer's share of the bill, thus allowing physicians to collect the patient share at the end of the visit. But the company says it is making it easier for physicians to find out what they will be paid.

Bloomfield, Conn.-based Cigna is introducing the HealthePass card. It works by reserving the patient's payment from their funding source, such as a health savings account or a line of credit provided by corporate partner American Express. However, the practice does not collect the payment until the claim has been settled.

Cigna said it will begin piloting the card in selected markets throughout 2007 with the intent of making it widely available in 2008.

Matthew Katz, executive director of the Connecticut State Medical Society, said the new card is a step in the right direction, even if it's not quite real-time claims adjudication.

"We are hopeful that it will ensure more accurate and more timely payments to the physician as well as reduce administrative hassles for physicians [and] patients as we enter the era of consumer-driven health care," Katz said.

Vote refines AMA stance on health reform
The AMA House of Delegates rejected attempts to rescind support of a U.S. House health reform bill and any new government-sponsored health insurance plan during the 2009 Interim Meeting.
Story - AMA House - Slideshow