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House picks up on FSA debate, but will Supreme Court make it moot?

BY Michael Johnsen

WHAT IT MEANS AND WHY IT’S IMPORTANT — This is one of the tweaks health reform needs to make it meaningful and to appropriately align all of the incentives in the right direction — and that’s toward overall healthcare cost reduction. Because mandating a prescription in order that nonprescription medicines would be eligible expenses under either flexible spending accounts or health savings accounts just never made sense, intuitive or otherwise. That mandate doesn’t serve to lower the cost of healthcare or improve access; it just creates an additional layer of cost and builds a barrier to savings.

(THE NEWS: House to consider repealing prescription mandate on OTCs purchased through FSAs. For the full story, click here.)

DSN wholeheartedly approves reinstating OTC reimbursements under FSAs and HSAs sans any restrictions. Fact is, if you really want to be cost-savings-oriented, the benefit should not only be reinstated but also expanded to include dietary supplements. But we may be a little ahead of the curve on that.

Unfortunately, even though it’s been added to the docket, there is a question as to whether or not it will actually be debated on the House floor, at least until after June. The monkey wrench here is the Supreme Court deliberation over the entire Affordable Care Act. Any legislative movement to change the healthcare reform at this stage could all become moot after any Supreme Court decision.

And if the Supreme Court rules against the Affordable Care Act, that opens a whole new can of worms. Because what happens if the Supreme Court rules the Affordable Care Act unconstitutional and renounces the entire piece of legislation? Would all resort to what was the status quo before the legislation went into effect — meaning prescriptions would no longer be required for OTC reimbursement eligibility under FSAs/HSAs? And if that ruling comes in the middle of a plan year, will plan administrators be able to incorporate OTC reimbursements with no disruption to the patient? Or will the patients have to wait until the next plan year? How about disruption to the retailers? Would that necessitate some quick overhauls of their pharmacy point-of-sale systems so that nonprescription items would be recognized whenever an FSA debit card was swiped?

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Taking confusion out of healthcare reform

BY Antoinette Alexander

WHAT IT MEANS AND WHY IT’S IMPORTANT — So research indicates that the majority of consumers who would be eligible for new healthcare coverage under the Patient Protection and Affordable Care Act have never heard of the state-based healthcare exchanges, and many believe they will need help in understanding healthcare insurance terms and descriptions. Really?

Of course! That’s because it’s confusing!

(THE NEWS: CVS Caremark research: Many consumers confused about potential changes to U.S. healthcare system. For the full story, click here)

Only about 6% of seniors who are eligible for a free Medicare Wellness Visit benefit Medicare received one last year, according to the Centers for Medicare and Medicaid Services. And now with the fate of the individual mandate hanging in the balance as the Supreme Court takes the debate to the "nth" degree and back, it’s only bound to become more confusing for consumers. DSN believes that in the next two years health reform — The Affordable Care Act or Obamacare, or whatever name you give it — will be simplified rather than repealed altogether.

DSN has a suggestion for the individual mandate: consumers have the right NOT to purchase insurance; they also get to live with the result of that decision. So, if you have no health insurance and you wind up getting sick or injured and get stuck with $100,000 or more worth of medical bills, you get to own that debt. Want to go to the ER for strep throat? Fine. But then you foot the bill — not the rest of America. And everyone else gets access to an affordable insurance plan and they pay for it. Then people might understand these health insurance exchanges a little better.

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Diplomacy works: Diplomat Specialty Pharmacy among companies laying groundwork for growth

BY Alaric DeArment

WHAT IT MEANS AND WHY IT’S IMPORTANT — The city of Flint, Mich., is probably most famous for two things: being the birthplace of General Motors and the prolonged economic decline that followed the automaker’s departure from the city.

But Diplomat Specialty Pharmacy is looking to reverse that trend. Despite starting out as a single store owned by CEO Phil Hagerman and his father, the privately owned company has grown to be so big that it now has a swanky new headquarters and is well on its way to having 800 employees.

(THE NEWS: Diplomat CEO to attend White House business summit. For the full story, click here)

The secret to the company’s success is the quality of service it delivers to patients, especially in terms of patient assistance. And the result is strong growth and lots of job creation.

The employment numbers released last week were far from spectacular — they were disappointing and likely to keep more than a few people up at night. But what may be a slump that’s part of a global economic downturn stretching from here to Europe to Asia or just a hiccup resulting from an unseasonably warm winter — that’s ultimately up to economists to determine — doesn’t belie the fact that something is stirring in the American economy, specifically the groundwork for sustainable economic growth, and it’s business leaders like Hagerman and companies like Diplomat that are laying it and leading it.

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