United We Fall?
UnitedHealth Group officials lower company earnings estimates by about 16% because of reduced commercial businesses and higher-than-expected Medicare-related costs and announce plans to restructure the company to increase focus on regional coverage. According to UnitedHealth officials, the company expects earnings to decrease by about $1.1 billion, which includes $400 million related to problems with commercial businesses and $500 million related to problems with a Medicare prescription drug plan. UnitedHealth officials estimate that the company will lose 800,000 members from fully insured plans this year and say that competition has forced the company to discount premiums more than expected for new and renewed customer accounts. Meanwhile, California Public Employees' Retirement System officials announce that the pension fund and others have negotiated an $895 million settlement in a class-action lawsuit against UnitedHealth over stock-option backdating reported in 2006.
American Health Line will not publish on Friday, July 4, in observance of Independence Day. Publication will resume on Monday, July 7.
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Kennedy's Universal Fight
The office of Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) has begun to hold a series of meetings with a number of health care experts as a part of an effort to develop a proposal to expand health insurance to all U.S. residents. Kennedy aides have held two meetings to date, one with health care advocacy groups and one with physician groups, with eight more scheduled for this month. Participants in the meetings say that Kennedy believes in the need to address major health care reform legislation early in the term of the next president. Staff members in the Senate office of presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) have participated in the discussions. In addition, participants in the meetings say that the discussions in part seek to educate Senate staff members on health care issues. Democratic and Republican Senate staff members have attended the meetings, according to Craig Orfield, a spokesperson for Sen. Mike Enzi (R-Wyo.).
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E-Merge
Electronic prescription networks SureScripts and RxHub will announce plans to merge in an effort to promote greater adoption of electronic prescribing by physicians. The merger will combine SureScripts' electronic drugstore routing system and RxHub's insurance information database of more than 200 million insured patients. The merged network, called SureScripts-RxHub, will allow doctors to send prescriptions electronically and review insurance coverage and patients' drug histories. There is no per-prescription cost for physicians or patients under the service. The announcement of the merger comes as legislation moves through Congress that will give financial incentives to doctors who invest in and use the technology and the Drug Enforcement Administration considers ending its ban on e-prescriptions for many controlled substances.
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Different Kind of Delay
HHS Secretary Mike Leavitt says that CMS will maintain the current Medicare payment rate for physicians because Congress was unable to pass legislation before lawmakers left for the July 4 recess to avert a 10.6% cut scheduled to go into effect on Tuesday. Congressional aides say the freeze to payment rates could last 10 days. Leavitt says he intends to "minimize the impact" of the fee reduction. CMS officials say Medicare will hold all new claims for 10 days. As a result, physicians will not experience reduced fees until mid-July. According to congressional aides, a 10-day extension would give senators three days after they return on July 7 from their recess to approve legislation to curb the fee reduction. Leavitt says that, if lawmakers are unable to pass legislation blocking the fee cut by the end of the extension, he hopes to pay physicians retroactively after the issue is resolved. Senate Majority Leader Harry Reid (D-Nev.) says Democrats will reintroduce the House bill when lawmakers return from the recess.
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So Close, Yet So Far
The Senate fails to pass by one vote a House-passed bill (HR 6331) that would delay a 10.6% reduction to Medicare physician fees. The bill is similar to a measure (S 3101) proposed by Senate Finance Committee Chair Max Baucus (D-Mont.) that also failed to receive enough votes to invoke cloture. Senate Majority Leader Harry Reid (D-Nev.) tells senators to prepare for another cloture vote on Sunday. Baucus says that the House measure is the Senate's only option to avert the fee cut before the July 4 recess because the House has already left for recess. Reid says that the Senate is "going to finish Medicare" before it adjourns for the recess. The White House again threatens to veto the measure because it makes cuts to indirect medical education payments and imposes limitations on so-called private fee-for-service plans under Medicare Advantage.
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