News in brief - May 18, 2009

Senators urge e-prescribing policy change

A bipartisan group of 11 senators has asked the Dept. of Health and Human Services to install federal regulations quickly that would allow electronic prescribing of controlled substances.

"This issue is particularly important with broader health care reform looming on the horizon," the senators wrote in a May 7 letter to HHS Secretary Kathleen Sebelius and Attorney General Eric Holder. "While e-prescribing is by no means the key to reform, it is an important piece of the puzzle."

Current federal rules require that doctors write paper prescriptions for controlled pharmaceuticals, such as pain medications, antidepressants and even some drugs used to treat asthma in children, the senators said.

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HHS names reform office personnel

Health and Human Services Secretary Kathleen Sebelius on May 11 announced key personnel appointments to head up the newly created HHS Office of Health Reform.

Both the HHS office and the White House Office of Health Reform were created by an April 8 executive order to help push President Obama's top health care priorities.

Jeanne Lambrew, PhD, will direct the HHS Office of Health Reform. She previously was an associate professor at the Lyndon B. Johnson School of Public Affairs in Austin, Texas, and worked on health policy in the Clinton administration. Meena Seshamani, MD, PhD, a health economist and former resident physician in otolaryngology-head and neck surgery at Johns Hopkins University in Baltimore, will serve as director of policy analysis.

Sebelius said the two new offices will work in tandem "to advance legislation and take immediate actions to cut costs, assure quality and affordable health care for all Americans."

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WellCare to pay $80 million to resolve alleged Florida Medicaid fraud

WellCare Health Plans Inc. agreed to pay $80 million to avoid federal charges for allegedly defrauding Florida's Medicaid programs.

The health insurer will pay $40 million in restitution to the state's Medicaid and Healthy Kids programs under the three-year deferred prosecution agreement reached in May. WellCare will forfeit another $40 million in civil fines.

To avoid a fraud conviction, WellCare also agreed to:

• Accept responsibility for the conduct that led to the government investigation.
• Continue cooperating in the federal probe of former WellCare executive employees.
• Hire an independent monitor to review its business practices.
• Update procedures for reporting federal and state health care program information.

Dept. of Health and Human Services Inspector General Daniel R. Levinson said the agreement should serve as a "clear warning that those who steal from Medicaid will be aggressively pursued."

WellCare executives said in a statement that the company is cooperating fully in the probe and that compliance with all laws and regulations is a top priority for the company.

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Colorado hospital tax to help cover uninsured

A bill signed April 21 by Colorado Gov. Bill Ritter is expected to cover more than 100,000 of the state's approximately 750,000 uninsured residents by securing about $600 million in additional federal Medicaid matching funds.

The bill accomplishes the goal by creating a Medicaid tax on hospitals. "At no increased cost to taxpayers, the Colorado Healthcare Affordability Act will allow us to provide critical health services to people who need those services the most," Ritter said.

Colorado Hospital Assn. President and CEO Steven Summer said the association supported the measure. "Colorado hospitals are pleased to have been a part of this important policy effort to improve access to affordable health care services for those most at risk," he said. More than 40 states have adopted similar taxes.

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