How America got hooked on a deadly drug

This article was published on June 14, 2018 on BenefitsPro, written by Fred Schulte, Kaiser Health News (Maria Fabrizio for KHN) . Photo Source: BenefitsPro.

opioid-abuse

Purdue Pharma left almost nothing to chance in its whirlwind marketing of its new painkiller OxyContin.

From 1996 to 2002, Purdue pursued nearly every avenue in the drug supply and prescription sales chain — a strategy now cast as reckless and illegal in more than 1,500 federal civil lawsuits from communities in Florida to Wisconsin to California that allege the drug has fueled a national epidemic of addiction.

Kaiser Health News is releasing years of Purdue’s internal budget documents and other records to offer readers a chance to evaluate how the privately held Connecticut company spent hundreds of millions of dollars to launch and promote the drug, a trove of information made publicly available here for the first time.

All of these internal Purdue records were obtained from a Florida attorney general’s office investigation of Purdue’s sales efforts that ended late in 2002.

I have had copies of those records in my basement for years. I was a reporter at the South Florida Sun-Sentinel, which, along with the Orlando Sentinel, won a court battle to force the attorney general to release the company files in 2003. At the time, the Sun-Sentinel was writing extensively about a growing tide of deaths from prescription drugs such as OxyContin.

We drew on the marketing files to write two articles, including one that exposed possible deceptive marketing of the drug. Now, given the disastrous arc of prescription drug abuse over the past decade and the stream of suits being filed — more than a dozen on some days — it seemed time for me to share these seminal documents that reveal the breadth and detail of Purdue’s efforts.

Asked by Kaiser Health News for comment on the OxyContin marketing files and the suits against the company, Purdue Pharma spokesman Robert Josephson issued a statement that reads in part:

“Suggesting activities that last occurred more than 16 years ago, for which the company accepted responsibility, helped contribute to today’s complex and multi-faceted opioid crisis is deeply flawed. The bulk of opioid prescriptions are not, and have never been, for OxyContin, which represents less than 2% of current opioid prescriptions.”

Purdue first marketed OxyContin for cancer pain but planned to expand that use to meet its multimillion-dollar sales goals.

The marketing files show that about 75 percent of more than $400 million in promotional spending occurred after the start of 2000, the year Purdue officials told Congress they learned of growing OxyContin abuse and drug-related deaths from media reports and regulators. These internal Purdue marketing records show the drugmaker financed activities across nearly every quarter of medicine, from awarding grants to health care groups that set standards for opioid use to reminding reluctant pharmacists how they could profit from stocking OxyContin pills on their shelves.

Purdue bought more than $18 million worth of advertising in major medical journals that cheerily touted OxyContin. Some of the ads, federal officials said in 2003, “grossly overstated” the drug’s safety.

The Purdue records show that the company poured more than $8 million into a website and venture called “Partners Against Pain,” which helped connect patients to doctors willing to treat their pain, presumably with OxyContin or other opioids. Continue reading

It’s PCORI Filing Time Again!

IRS ACA Patient Centered Outcomes Research Institute (PCORI) Fees Due July 31st.

For 2018, the annual fee to fund the federal Patient-Centered Outcomes Research Institute (PCORI), paid by employers that sponsor self-insured health plans and by commercial group health insurance providers, will go up by about 10 cents per employee or dependent enrolled in the health plan. The fees are due by July 31. The chart below shows the fees to be paid in 2018, which rose slightly from the fees owed in 2017.

The chart below shows the fees to be paid in 2018, which rose slightly from the fees owed in 2017:

Jan. 1, 2017, through Sept. 30, 2017 $2.26 (up from $2.17) per Covered Life (including spouse & children)
Oct. 1, 2017, through Dec. 31, 2017 (including calendar year plans) $2.39 (up from $2.26) per Covered Life (including spouse & children)

For self-funded plans, the self-insured employer is responsible for submitting the fee and accompanying paperwork to the IRS. PCORI fees are reported on IRS Form 720, Quarterly Federal Excise Tax Return. On page two of Form 720, under Part II, the employer needs to designate the average number of covered lives under its applicable self-insured plan. Although the fee is paid annually, employers should indicate on the Payment Voucher (720-V)—located at the end of Form 720—that the tax period for the fee is the second quarter of the year. Failure to properly designate ‘2nd Quarter’ on the voucher will result in the IRS’s software generating a tardy filing notice.

The PCORI fee will not be assessed for plan years ending after Sept. 30, 2019, which means that for a calendar-year plan, the last year for assessment is the 2018 calendar year.

ATTENTION DIVERSIFIED GROUP CLIENTS:

Clients who have elected to have Diversified Group assist with PCORI fee calculation can expect an email by June 25th that will include a copy of the completed Form 720 along with the PCORI calculation worksheet with supporting documentation. Clients will need to file Form 720 with payment by July 31, 2018.

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The Phia Group Recognizes Diversified Group with 2018 Empowered Plan Award

MyHealthGuide Source: The Phia Group, 6/8/2018, http://www.PhiaGroup.com

phia-mvp-awardbadgeFoxboro, MA — The Phia Group, LLC, at its annual MVP (Most Valuable Partners) event, was pleased to recognize this year’s winner of The Phia Group “Trophy of Empowerment.” It is with appreciation that they now publically announce the name of their 2018 Empowered Plan Award winner, Diversified Group.

After analyzing all of their MVPs based on a number of parameters including, but not limited to, collaboration with The Phia Group, a willingness to innovate, as well as application of a forward thinking methodology – reflected through efforts taken to secure the future of our industry – Diversified Group of Marlborough, CT – was a clear winner.

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Phia Group’s 2018 Empowered Plan Award Winner, Diversified Group

The Phia Group’s CEO Adam V. Russo, Esq. remarked, “More than a decade and a half ago, Diversified Group took a chance on us… and since then both of our organizations have grown and thrived, in large part thanks to the friendship and partnership we have in force. We’re grateful for that relationship, as well as the work Diversified Group does on behalf of our entire industry.”

“We are so very honored to have earned this recognition from The Phia Group. Empowering plans is the core value we bring to our customers seeking effective alternatives to the traditional carrier based ASO and fully insured plans – the market is hungry for empowerment! Over the last 15 years, their team of experts have provided prompt and efficient resources; they are dedicated to understanding and adapting, and having them as a reliable partner is a huge asset,” Diversified Group’s President & Principal Partner, Brooks Goodison said. “When we receive recognition from a trusted partner like Phia, completely in line with the promise we make to our clients, it is like receiving a standing ovation!”

About Diversified Group
Like The Phia Group, Diversified Group is comprised of numerous organizations, all working toward a common goal. Comprised of Diversified Group Brokerage, Diversified Administration Corporation, Corporate Managed Health Services, and Corporate Fitness & Health – Diversified Group focuses on customer service and a customized approach to improving health; maximizing benefits and minimizing costs. Through their family of companies, they provide a wide variety of services, ensuring their vast portfolio of offerings addresses all the needs of the entities they aid. This emphasis on variety as well as their customer first mentality – along with a daring focus on innovation and selfless advocacy for the entire industry – are what makes Diversified Group this year’s winner. For more information about Diversified Group, please visit www.dgb-online.com.

About The Phia Group
The Phia Group, LLC, headquartered in Braintree, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets. By providing industry leading consultation, plan drafting, subrogation and other cost containment solutions, The Phia Group is truly Empowering Plans. Contact Garrick Hunt, Sales Executive, at 781-535-5644, Info@PhiaGroup.com and visit www.PhiaGroup.com.

Drug Overdose Deaths Rising

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According to preliminary government data, U.S. deaths involving fentanyl and other synthetic opioids fueled a 21% jump in annual drug overdose deaths during 2017. The increase from 9,945 opioid deaths in 2016 to 20,145 during 2017 reflected the sharpest one-year increase since the U.S. began experiencing a widespread opioid addiction. CDC data shows that deaths involving heroin and prescription painkillers such as oxycodone, are also increasing.

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ACA Affordability Percentage for 2019

On May 21, 2018, the Internal Revenue Service (IRS) issued Revenue Procedure 2018-34 which indexes the contribution percentages for 2019 for purposes of determining affordability of an employer’s plan under the Affordable Care Act (ACA).  For plan years beginning in 2019, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed 9.86 percent of the employee’s household income for the year for purposes of the employer shared responsibility rules. This is an increase from the 2018 affordability threshold percentage of 9.56%. The 2019 increase in the affordability percentage for employer shared responsibility purposes means that employers will be able to charge employees a slightly higher price for their health benefits and still  meet the “affordability” test.

Since an employer would not know an employee’s household income, IRS Notice 2015-87 confirmed that ALEs using an affordability safe harbor may rely on the adjusted affordability contribution percentages if they use one of three affordability safe harbor methods. The three safe harbors to measure affordability are Form W-2 wages from that employer, the employee’s rate of pay or the federal poverty line (FPL) for a single individual. The affordability test applies only to the portion of the annual premiums for self-only coverage and does not include any additional cost for family coverage. Also, if an employer offers multiple health coverage options, the affordability test applies to the lowest-cost option that also satisfies the minimum value requirement.

Below is an example of how the percentage change impacts an employer’s monthly affordable amount using the three safe harbor tests.  The example assumes an employee earns $10/hour.

Safe Harbor

$10 / hour

2018

2019

W-2 Income

$165.71

$170.91

Rate of Pay

$124.28

$128.18

Federal Poverty Line*

$96.72

$99.75

*Based on Jan. 2018 FPL of $12,140

Under the ACA, employees (and their family members) who are eligible for coverage under an affordable employer-sponsored plan are generally not eligible for the premium tax credit from the Exchange. This is significant because the ACA’s employer shared responsibility penalty for applicable large employers (ALEs) is triggered when a full-time employee receives a premium tax credit for coverage under an Exchange.

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New York, Connecticut among worst in hospital safety, survey finds

This article was published on May 23, 2018 on Westfaironline, written by Aleesia Forni. Photo Source: Westfaironline.

New York and Connecticut ranked among the worst states in the nation in terms of hospital safety, according to a recent survey.

According to the Leapfrog Hospital Survey covering the 50 states plus the District of Columbia, New York ranked 48th in the nation, coming in ahead of Alaska, Delaware and North Dakota, which were tied for last in 49th place. New York’s ranking at 48 marks a drop from last year’s rank of 47th in the country. Connecticut fared similarly, ranking 46th in the nation; the state fell 16 spots from its 2017 ranking of 30th.

As part of the survey, Leapfrog assigned letter grades to hospitals based on their record of patient safety. States were then ranked based on the number of “A” hospitals they have compared with the total number of graded hospitals.

Hospital providers in Westchester and Fairfield counties were given mixed grades.

While no hospitals in Westchester earned an A, Northern Westchester Hospital was one of two in the county to receive a B grade. Leapfrog noted that the hospital had a lower number of MRSA infections than expected given its number of patients. However, the hospital had a higher number of infections in the urinary tract and the blood than expected given its patient count. The hospital’s grade remained flat from its fall rating, which fell from a consistent A grade it had received since 2016.

White Plains Hospital was also awarded a B and reported lower than expected numbers of MRSA, blood and urinary tract infections. The hospital’s marks improved from last year’s grade of a C.

Elsewhere, Phelps Memorial Hospital in Sleepy Hollow, Westchester Medical Center in Valhalla, Montefiore New Rochelle Hospital, New York-Presbyterian Hudson Valley Hospital in Cortlandt Manor, and New York-Presbyterian Lawrence Hospital were each awarded a C, as were St. John’s Riverside Hospital in Yonkers and the St. John’s Riverside Hospital Dobbs Ferry Pavilion.

Unity Hospital in Rochester, Northern Dutchess Hospital in Rhinebeck, HealthAlliance of the Hudson Valley-Broadway Campus in Kingston, and MidHudson Regional Hospital of Westchester Medical Center in Poughkeepsie each earned a C grade.

In Fairfield County, Stamford Health earned a B rating, while Bridgeport Hospital, Danbury Hospital, Greenwich Hospital, Norwalk Hospital, St. Vincent’s Medical Center, and Yale-New Haven Hospital earned C grades.

Five hospitals in New York state received an A grade. Those hospitals were Catholic Health-Kenmore Mercy Hospital, Highland Hospital of Rochester, Mather Hospital in Port Jefferson, NYC Health Hospitals-Metropolitan, Oneida Healthcare Center, St. Francis Hospital in Roslyn, and St. Joseph’s Hospital Health Center in Syracuse. Putnam Hospital Center in Carmel was the only hospital in the Lower Hudson Valley to receive the top grade.

In Connecticut, only two hospitals received the top grade: Bristol Hospital and The William W. Backus Hospital in Norwich.

The worst grades in New York were saved for five hospitals. Interfaith Medical Center, Brookdale Hospital Medical Center and Maimonides Medical Center in Brooklyn, Brookhaven Memorial Hospital Medical Center in Patchogue, and Richmond University Medical Center in Staten Island each earned an F.

Founded in 2000, The Leapfrog Group is a nonprofit that collects and reports hospital performance. More than 2,600 hospitals were issued a grade, which is derived from an analysis of publicly available data.

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