News in brief - Dec. 25, 2006

Health plans must reveal Medicaid pay rates, Conn. court says - FDA chief confirmed - Most uninsured not rich enough or poor enough to get coverage

Health plans must reveal Medicaid pay rates, Conn. court says

A Connecticut trial court on Nov. 29 ordered the four HMOs running the state's Medicaid program to disclose their physician reimbursement rates. Payment levels are a "significant factor" in ensuring the availability of quality health care to low-income patients, it said.

Superior Court Judge George Levine ruled that Anthem Health Plans, Health Net, WellCare Health Plans and Community Health Network of Connecticut are performing a government function and are accountable under the state Freedom of Information Act.

The decision "bodes well for requiring transparency in all health insurance lines," said Ken Ferrucci, director of government relations for the Connecticut State Medical Society. The group did not get involved in the case but was monitoring it.

The ruling was a victory for patient advocates who sued the plans in 2004 in order to get access to their rates, after noticing that patients were having problems getting appointments with specialists.

The HMOs argued that they do not perform a government role and that their fees are trade secrets. They did not return calls for comment on whether they plan to appeal.

FDA chief confirmed

The Senate on Dec. 7 voted 80-11 to confirm Andrew C. von Eschenbach, MD, as commissioner of the Food and Drug Administration, ending a nearly year-long approval process that was marked by numerous controversies.

By forcing the final vote in one of the last days of the 109th Congress, Senate Majority Leader Bill Frist, MD (R, Tenn.), sidestepped the objections of a small number of Republican senators. Senate Finance Committee Chair Charles Grassley (R, Iowa) had placed a hold on the nomination in protest of the FDA's alleged recent failure to respond to congressional subpoenas on unrelated matters. Several Democratic senators also imposed holds in response to the FDA's delay in approving over-the-counter contraceptives.

Dr. von Eschenbach, a urologic surgeon and former National Cancer Institute director, has been acting FDA chief since September 2005.

Most uninsured not rich enough or poor enough to get coverage

Fifty-six percent of uninsured Americans can't afford private health insurance but aren't eligible for public assistance programs, according to an analysis of the 2005 Current Population Survey published on the Health Affairs Web site Nov. 30.

Of the rest of the uninsured, about 25% are eligible but not enrolled in public programs, and 20% can afford coverage.

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