"Health & Medical News"

One physician’s faxed order to discontinue hydrocodone, marketed as Anexsia, was misread by the pharmacist as an order to discontinue Arixtra, an anticoagulant. Another doctor intended to electronically order clonidine, an antihypertensive, but accidentally ordered the sedative clonazepam because both appeared as “CLON” on the computer screen.

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Washington — Programs that reward employees for exercising or not smoking sound logical. But they could violate the Health Insurance Portability and Accountability Act if employers do not offer alternatives for workers unable to participate because of health factors, according to the U.S. Dept. of Labor.

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A California appeals court dealt another blow to health plans over their policy cancellation tactics.

The 4th District Court of Appeal unanimously said insurers have a responsibility to make sure patients’ policy applications are complete and accurate before issuing coverage — not after expensive claims come in the door. Judges said plans cannot revoke patients’ policies unless they fully investigate pre-enrollment forms up front or insurers show patients intentionally misled them.

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Recent publicity has led to increased scrutiny of confidential, state-run rehabilitation programs for physicians, the Associated Press reported Dec. 19.

An estimated 8,000 doctors with addiction problems are enrolled in treatment programs; most states have them, and California’s medical board made headlines last year when it voted to abolish its physician-assistance program after a review found that it didn’t help doctors recover and could put patients at risk.

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States that allow managed-care programs to limit prescriptions and access to pharmacy networks are hindering the use of naltrexone for treating alcohol addiction, according to research from the Substance Abuse Policy Research Program (SAPRP).

Researchers Carolyn Heinrich of the University of Wisconsin at Madison and Carolyn Hill of Georgetown University found that treatment providers were more likely to prescribe naltrexone in states where use of generic drugs is encouraged in Medicaid programs. In states where managed-care firms dictate prescription rules, however, naltrexone was less likely to be prescribed. Other barriers to naltrexone use were restricting use of Medicaid funds for addiction treatment and the use of restrictive preferred-drug lists for Medicaid patients.

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Washington — Thirty-three states plan to increase their Medicaid payment rates for doctors in 2008. Many also are poised to expand eligibility and to use the program to cover more of the uninsured.

Next year will mark the third consecutive year during which at least two dozen states raised Medicaid physician reimbursements, according to an annual 50-state survey of Medicaid directors. It was released in October by the Kaiser Family Foundation and Health Management Associates, a health research and consulting firm.

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Expensive and exclusive addiction treatment programs in Malibu, Calif., like Promises and Passages have more to worry about than wildfires: some critics and former patients say that the programs are more concerned with making money than treating patients, the Los Angeles Times reported Oct. 9.

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