Author Archive

Newer Entries »

CT Investigates CVS Rx Plan Termination Threat

Tuesday, July 6th, 2010

At the end of June, Richard Blumenthal – our Connecticut Attorney General – announced he would be investigating CVS Caremark pharmacy for threatening to end their discount drug program known as Health Savings Pass. The discount program asks customers to pay $10 per year for access to 3 month supplies of 400 different generic drugs at reduced prices ($9.99 per refill), in addition to other benefits. The Attorney General’s office argues that state law obligates pharmacies to charge Medicaid the lowest drug price they offer (which in CVS’s case would be this programs $10 per year per customer fee). Therefore, Blumenthal contends that CVS must offer this discount drug program to Medicaid customers too. In a company statement released Wednesday June 23 CVS disagreed and threatened to end the program in Connecticut if it were required to give this discount to Medicaid recipients because doing so would make the program “economically unfeasible to continue.”

CVS Pharmacy Subpoenaed Regarding Discount Drug Program

CVS Pharmacy Subpoenaed Regarding Discount Drug Program

CVS and the Connecticut Attorney General’s office have sparred on this issue once before. Last session, when CVS officials disagreed with the state’s interpretation of the law the General Assembly passed a bill which clarified the requirement that pharmacies charge CT Medicaid the lowest price offered to consumers. But even now, with little ambiguity left in the law, CVS claims it should not be required to fulfill this obligation because the program was originally developed for uninsured and underinsured individuals, not with Medicaid recipients in mind. Because CVS on its member enrollment forms reserves the right to cancel the voluntary program for any reason, and because it is not required to continue the program by law, the company may indeed terminate the program if Blumenthal continues to push CVS.

CVS has until July 9 to comply with the Attorney General’s subpoena for information on CVS’s threat to cancel the program in Connecticut, which Blumenthal claims is inconsistent with the company’s practices in other states where CVS and other pharmacies have extended their discount drug program to Medicaid beneficiaries. Blumenthal – currently a candidate for Senate to replace retiring Senator Christopher Dodd (D-CT) – hopes his office will be able to force CVS to comply with the law and its practices in other states, as extending this program to Medicaid enrollees would save thousands of pharmaceutical cost dollars, helping to rein in out of control health care costs.

If Blumenthal is unsuccessful, the thousands of uninsured under-65′s and Medicare beneficiaries who rely on the program to stay out of the donut hole coverage gap may find their discount prescription drugs in jeopardy.

Tags: , , , , , ,
Posted in Politics | No Comments »

Patients Often Not Informed About Abnormal Test Results

Tuesday, June 23rd, 2009

A recent study finds that people who visit their primary care doctor for routine blood tests or screening are frequently not informed of the results of those tests, even if they come back abnormal. To come to these conclusions the researchers looked at the medical records of 5434 people ages 50 to 59 years old. Their primary focus were those patients who had abnormal test results on 1 of 11 blood tests or 1 of 3 screening tests in the past year at Midwest and West Coast primary care facilities. They also reviewed 176 survey responses from physicians designed to asses the test result management procedures at each office. The authors of this study showed that even when the results are troublesome, the results of approximately 1 of every 14 abnormal tests are not reported to the patient. In 135 cases (of 1889 abnormal test results) either the patient was not informed of the results or the facility had kept no record or having told the person: more than a 7% failure rate in communicating abnormal test results. Most of the offices involved in the study did not follow basic protocols where they existed for informing patients, and even fewer had a defined policy on communicating the results to patients at all.

The researchers recommend that patients should always know whether their test results were normal or not. If you haven’t received the results of the test, call the doctor’s office and ask for them. Even if they come back normal, you should still be aware. This is particularly important, physicians note, when changing doctors or moving from an in-patient hospital stay to outpatient treatment. Patients should not accept when a doctor or lab tech says they will let you know if something is wrong. The result of this study indicate that even if something is wrong, you may never find out. Physicians recommend patients ask for their test results every time, whether or not the results are of concern, in order to always stay informed.

Tags: , , ,
Posted in Senior Health & Wellness | 4 Comments »

FDA Warns Zicam Poses Serious Health Risk

Tuesday, June 16th, 2009

The Food and Drug Administration has warned consumers to stop using three of the Zicam nasal cold symptom remedies because they have been shown to cause users to permanently lose their sense of smell. The FDA reports

that since 1999, it has received over 130 reports of loss of smell associated with Zicam use. The type of smell-loss they cause is called anosmia, and in some cases occurred after only one dose. Though long-term scientific studies into the effects of Zicam are not available, the FDA is concerned that consumers will use the product which could unknowingly cause themselves serious harm, hence the warning to immediately stop using these products. The FDA has notified Matrixx Initiatives (makers of Zicam) that the products can no longer be marketed without FDA approval. Matrixx argues that the allegations that Zicam is dangerous (resulting in a number of lawsuits) are false and unsubstantiated. The FDA asks consumers experiencign any loss of smell or taste after using nasal products containing zinc should see their physician.

Tags: , ,
Posted in Politics | No Comments »

Type of Insurance Matters in Bariatric Surgery Success Rates

Tuesday, June 2nd, 2009

US researchers announced Monday that patients with private health insurance lose more weight after having gastric bypass surgery than those covered by Medicare do. The study which surveyed data on 750 gastric bypass patients showed Medicare patients tend to weigh more before the surgery than those one private insurance, and that they are most likely to be depressed, have high blood pressure, heart disease, diabetes, and sleep apnea. Gastric bypass has risen in popularity in the past few years as a treatment option for severe obesity. This type of bariatric surgery works by reconstructing the digestive tract to reduce the amount of food that can be eaten by a patient. It is most frequently used to treat

patients whose BMI (body mass index) is over 30. Patients with BMIs of 40 to 49 are considered morbidly obese, while those with a score of 50 or above fall in the category of the super obese. The researchers in this study say that morbid obesity is the leading public health crisis in the US and that bariatric surgery is often the only effective treatment option for these people. Both large private insurers and Medicare (covering 44 million elderly and disabled Americans) cover the surgery in severely obese people. The surgery usually costs between $15000 and $35000.

The researchers showed that a year after surgery, though all patients studied had significant weight loss, the private insurance patients lost more weight. Those on Medicare lost 57% of their excess weight while those with private insurance lost about 82% of their excess weight. Although the Medicare group had the biggest reductions in bad cholesterol (low-density lipoprotein, which causes heart disease) and showed bigger improvements in fasting insulin (a measure of diabetes severity), the Medicare group also had slightly higher complication rates post-surgery, though none of the study subjects died. Researchers argue that these results are because patients in the Medicare group started out much heavier than those in the private insurance group. Those in Medicare’s average BMI was nearly 50, making them super obese. Researchers argue that if this study can be extrapolated to represent the entire population of bariatric surgery patients, it shows that many Medicare patients are going into bariatric surgery with more profound disadvantages, and that they may need additional support in exercise and nutrition to succeed.

Tags: , , , ,
Posted in Senior Health & Wellness | 5 Comments »

Medicare Bankrupt in 2017, Social Security in 2037

Thursday, May 28th, 2009

Advisers to the Obama administration announced this month that the economic crisis has put both Medicare and Social Security on the fast track to bankruptcy. Economists predicted more than a decade ago that Medicare and Social Security would face bankruptcy in the near future, but reports issued by the government show that both programs – the primary health care and income sources for millions of retirees – have felt the effects of the economic downturn and will be running out sooner than expected. Treasury Secretary Timothy Geithner projected that Medicare will run out of money in 2017, followed by Social Security in 2037.

Though market conditions now appear to be stabilizing, many forty-somethings and younger find themselves questioning whether either program will exist when they retire and are planning for worst-case scenario. Financial advisers are trying to address the most immediate of these concerns, Medicare, by helping clients arrange ways to self-fund their healthcare after retirement. They are encouraging those under fifty to be more conservative in their spending during their remaining working years and to establish larger cash reserves to cover unanticipated healthcare costs in their elder years. Few think that Medicare will ever completely disappear, rather it will probably assume some other form as it would be political suicide for any elected official to allow the system to fail.

This kind of uncertainty has led many to prepare for health expenses during retirement differently. For a married couple retiring in 2009, the total medical costs during retirement (beyond Medicare) would average around $240,000 according to Fidelity Investments. Some people are saving for these kinds of expenses through health savings accounts, which function like a 401(k) for health care costs. It is tax-free to withdraw the money for medical costs, and if these costs end up being less than anticipated, the remainder acts like an ordinary retirement account.

Tags: , , , , , ,
Posted in Politics | 4 Comments »

Newer Entries »