OVERNIGHT HEALTH: Barbour pitches Medicaid flexibility

Opaque prices: One of the mantras of conservative health policy — putting patients in charge — takes a hit on the chin from a new Government Accountability Office report. GAO found that “several health care and legal factors may make it difficult for consumers to obtain price information for the health care services they receive, particularly estimates of what their complete costs will be.”

These include “difficulty of predicting health care services in advance, billing from multiple providers, and the variety of insurance benefit structures.” GAO recommends that the Department of Health and Human Services determine the feasibility of making estimates of complete costs of healthcare services available to consumers.

{mosads}Fiscal look-out: GAO also released the Fall 2011 update to the government’s long-term fiscal outlook. Surprise, surprise: “Rising health care costs and the aging of the U.S. population continue to create budgetary pressure.” Here’s the report.

IRS on track: The IRS appears to be meeting the technological challenges sparked by the overhaul of the U.S. healthcare system, a new federal audit has found. Read The Hill’s story.

Obamacare: More supporters of the healthcare reform law are embracing the name “ObamaCare.” The new website “thanks, Obamacare” highlights the law’s benefits, and its founders say there’s no reason to run away from the term. Read the Healthwatch post on the new campaign.

Pharma’s trade dream: Consumer advocates are lambasting the White House after reviewing leaked trade-negotiation documents they say show that a pending regional deal is more generous to drug companies than free-trade agreements passed under former President George W. Bush.

The U.S. is in the ninth round of negotiations relating to the Trans-Pacific Partnership with eight Asian and Latin American countries. Consumer advocates say Obama administration trade negotiators appear willing to give brand-name drugs stronger patent protections and pricing power than a 2007 bilateral trade deal with Peru. Healthwatch’s Julian Pecquet has the story.

Medicaid drugs: Not one of 14 states recently audited had adequate controls in place to ensure that all of its Medicaid drug expenditures complied with federal law, according to a new Health and Human Services Office of Inspector General report. The potential cost to state and federal taxpayers: almost $260 million. Read the Healthwatch post.

Merger misgivings: Fourteen House members recently sent a bipartisan letter to the Federal Trade Commission objecting to the proposed Express Scripts / Medco PBM merger. Healtwatch has more.

Tuesday’s agenda

The White House will announce plans to create new jobs for veterans, apparently in healthcare. Mary Wakefield, administrator of the Health Resources and Services Administration, is joining a White House press briefing on jobs for veterans. The National Association of Community Health Centers will also participate.

Tighter health law: The House Rules Committee decides how to proceed this week with legislation from Rep. Diane Black (R-Tenn.) that tightens the eligibility standard for Medicaid and insurance exchange subsidies under the healthcare reform law.

The Annual Symposium on Biomedical and Health Informatics features a panel on the Institute of Medicine’s ‘Future of Nursing’ report and its implications for informatics. Here’s the agenda.

The House Judiciary Committee holds a hearing on Rep. Lamar Smith’s (R-Texas) “Regulatory Accountability Act of 2011”

The Italian embassy hosts a conference promoting international collaboration to thwart the global obesity epidemic. CDC Director Thomas Frieden is slated to speak, along with his Italian counterpart, Enrico Garaci of the Italian National Institute of Health.

State by state

The federal government reauthorized Arizona’s newly scaled-back Medicaid program for another five years.

The $83 million price tag on North Dakota’s health exchange will make it a tough sell for state lawmakers when they reconvene for a special session next month.

Louisiana Insurance Commissioner Jim Donelon was reelected despite his insurance company’s donations.

Bill tracker

Rep. Tom Marino (R-Pa.) introduced legislation creating safe harbors for Medicare and Medicaid providers regarding the adoption of certified health information technology (H.R. 3239).

Sen. Richard Blumenthal (D-Conn.) has a bill to incentivize antibiotics research (S. 1734).

Sen. Al Franken (D-Minn.) introduced legislation to establish a Home Care Consumer Bill of Rights and a State Home Care Ombudsman Program (S. 1750).

Fraud fight

Pharmaceutical giant Pfizer agreed to pay $14.5 million to resolve False Claims Act allegations related to its marketing of the drug Detrol for overactive bladder conditions for which the drug had not been approved as safe and effective. The settlement resolves the last of 10 lawsuits for which Pfizer has already agreed to pay $2.3 billion. 

Twenty-four people — including doctors, medical clinic employees, medical equipment suppliers and patients — were indicted in an alleged New York billing scam that defrauded Medicare, Medicaid and private insurers of millions of dollars. 

Two Atlanta nursing home chains agreed to pay out $14 million to the federal government and several states for soliciting kickbacks from Omnicare, the nation’s largest pharmacy specializing in dispensing drugs to long-term-care facilities. Omnicare entered into a $98 million settlement agreement in 2009.

Lobbying registrations

AUX Initiatives / Novartis Vaccines

Bell Heroux & Zelden / Sickle Cell Disease Association of America

King & Spalding / Bone Growth Stimulator Group (ad hoc coalition)

DLA Piper / Human Genome Sciences (biologics)

Fabiani & Company / Flexion Therapeutics (osteoarthritis treatments)

John Bode / American Council of Independent Laboratories (food safety / labeling regulations)

John Bode / American Fruit and Vegetable Processors and Growers Coalition (food safety / labeling regulations)

McDonald & Harden / Humility of Mary Health Partners

Potomac Strategic Development Company / National Association of Community Health Centers

Trimpa Group / Allergan (global specialty pharmaceutical company)

Park Strategies / Richmond University Medical Center 

Capitol Partners / American Association of Veterinary Laboratory Diagnosticians

Reading list

CNN reports that Mitt Romney said his Democratic successor — not Romney’s healthcare law — is responsible for illegal immigrants gaining access to healthcare.

Kaiser Health News asks whether an insurance exchange for small businesses can work in Florida.

Veterans’ groups are upset about proposed cuts to their health benefits, the AP reports.

The Health Affairs blog has a detailed analysis of last week’s final rules on accountable care organizations.

What you might have missed on Healthwatch

HHS to award $42M in primary care bonuses

Week ahead: CLASS Act dead, but not gone

Tax law could hinder quick Supreme Court decision on healthcare mandate

GOP Senate candidate Thompson’s Vatican speech creates stir in Wisconsin

Comments / complaints / suggestions? Please let us know:

Julian Pecquet: jpecquet@digital-staging.thehill.com / 202-628-8527

Sam Baker: sbaker@digital-staging.thehill.com / 202-628-8351

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