The group charged with certifying new health technologies under the administration's "meaningful use" guidelines announced its approval of 33 new products Friday.

The move by the Certification Commission for Health Information Technology (CCHIT) means that doctors and hospitals purchasing those products will be eligible for financial incentives designed to encourage their adoption of more efficient medical technologies. 

In a statement, CCHIT Chairwoman Karen M. Bell said the certifications come "in time for the 2011-2012 incentives."

The HIT incentive program, included in the Health Information Technology for Economic and Clinical Health Act, was enacted in 2009 as part of the Democrats’ economic stimulus bill. 

To govern adoption of those technologies, the Health and Human Services Department in July finalized its meaningful use rules, which are designed to ensure that healthcare providers don't just purchase new health technologies, but actually use them to benefit patients. 

A list of the 33 products is available here.

Physicians who want a single-payer government health plan will be marching at Saturday's "One Nation Working Together" rally in Washington, D.C. While the main focus of the march will be on jobs and the economy, part of the rally's theme — "demanding the change we voted for" — relates to dissatisfaction with the healthcare reform law, according to Physicians for a National Health Program.

The group's 18,000 members don't believe the new healthcare reform law will put an end to rising healthcare costs, but rather it will make things worse by entrenching the role of private insurance companies.

"Reforming our health care system is unfinished business," PNHP President Oliver Fein said in a statement. Physicians will be marching "to say we need a massive movement to press forward to the only rational remedy for our nation's health care crisis: single-payer Medicare for all."

The decision by the Des Moines-based Principal Financial Group to quit offering health insurance has nothing to do with the new healthcare reform law, Iowa's insurance commissioner clarified this week.  

Susan Voss said Thursday the company has been shifting away from medical coverage for a decade. 

"There's no correlation between health reform and Principal," Voss told Politico Thursday. "They have been slowly decreasing the medical percentage of their revenue base for 10 years now, from something like 30 percent down to 3 percent. We knew a decade ago they were focusing on a different market ... This is a strict business decision."

The New York Times on Friday reported that Principal would be leaving the health insurance market, linking the decision to the "upheaval emerging among insurers as the new federal health law starts to take effect."

The Department of Health and Human Services on Friday awarded another $9 million in grants to help root out fraud in the Medicare program.

The money will fund more than 50 Senior Medicare Patrol programs, which aim to educate beneficiaries so they can be on the lookout for billing errors and potentially fraudulent activity in their Medicare notices.

Fast food fallout: After spending Thursday responding to a Wall Street Journal story about McDonald's threat to abandon coverage for some 30,000 hourly employees, the Department of Health and Human Services announced that it intends to specifically address the issue of mini-med plans in "forthcoming regulations." 

The department points out that it has created an "expedited process" for plans to apply for a waiver from the health reform law's requirement establishing minimum annual limits "where such limits would result in decreased access or increased premiums;" HHS has already approved "dozens" of these waiver requests.

Furthermore, HHS suggests, waivers from the law's medical loss ratio requirements - the minimum portion of premiums insurers must spend on medical care - are also on the horizon even if the National Association of Insurance Commissioners must finish its work defining the ratio first.

"Although the NAIC is close to completing its work, we understand that some employers must soon make decisions regarding coverage options for 2011," Jay Angoff, director of HHS' Office of Consumer Information and Insurance Oversight, said in a statement. "As such, we fully intend to exercise (the secretary's) discretion under the new law to address the special circumstances of mini-med plans in the medical loss ratio calculations. According to the Affordable Care Act, medical loss ratio 'methodologies shall be designed to take into account the special circumstance of smaller plans, different types of plans, and newer plans.' We recognize that mini-med plans are often characterized by a relatively high expense structure relative to the lower premiums charged for these types of policies. We intend to address these and other special circumstances in forthcoming regulations."

California paves the way: California opted to move ahead with its own health insurance exchange Thursday after President Obama personally urged Gov. Arnold Schwarzenegger to do so, reports the Sacramento Bee. http://bit.ly/cTbcbd 

"The two bills signed late Thursday establish the California Health Benefit Exchange and an independent, five-member oversight board appointed by the governor and the Legislature that will be tasked with defining how the exchange will operate," the Bee explains. Anthem Blue Cross, the state's largest for-profit insurer, and the California Chamber of Commerce lobbied hard against the measure.

California is being touted as the first state to vote to create its own exchange under the healthcare reform law. However Utah and Massachusetts already had their own exchanges prior to the law's enactment in March. 

The California decision comes as the Department of Health and Human Services on Thursday announced the recipients of $49 million in grants to help states begin to look at the feasibility of operating their own exchanges versus letting HHS take over in 2014. Joel Ario, director of the Office of Health Insurance Exchanges at HHS, said 2011 would be "critical legislative year" for states to enact bills creating their exchanges. http://bit.ly/cGd6Zs

HHS to unveil new health plan information: Consumers will be able to access more information than ever before on HHS' insurance Web portal starting later today, HHS Secretary Kathleen Sebelius announced Thursday. The new information to be made available at HealthCare.gov includes: monthly premium price estimates; the percentage of people denied coverage by a particular plan; and the percentage of people who pay more than the base premium.

Sebelius outlines the new information in a post on the White House blog. http://bit.ly/9VLyqo

Now for the bad news: Following Sebelius' Sept. 9 letter to insurers warning that "there will be zero tolerance" for the "unjustified rate increases" some of them are proposing for 2011, Energy and Commerce Republicans are demanding that she provide "all written material she has proving that the premium increases are unjustified or not actuarially sound, and to provide all documents or evidence in your possession showing that state insurance commissioners are unable or unwilling to protect consumers." 

"We fear that your letter is an effort to intimidate those who reveal the negative consequences of the law and an attempt to block actuarially sound premium increases, which would put all consumers at risk," Reps. Joe Barton (Texas), John Shimkus (Ill.) and Michael Burgess (Texas) write in a letter to the secretary. http://bit.ly/aGUIx2

Hospital asks outlined: The American Hospital Association outlines its legislative agenda for the lame-duck session in a "quick reference guide" for members. These include higher Medicare and Medicaid payments and changes to federal health information technology incentives for multi-campus systems. 

Medicare DME saga continues: Medicare's bidding program for durable medical equipment will fail, 167 leading experts on auctions and competitive bidding systems tell Congress in a letter to Ways and Means Chair Pete Stark (D-Calif.). The program is due to take effect on Jan. 1 in nine of the country's largest metropolitan areas. http://bit.ly/bcm63d

The experts do not oppose the concept of using a competitive bidding system to set Medicare prices, according to the American Association for Homecare.  But they're concerned that "the bidding program designed by CMS has several flaws that will prevent it from achieving the objectives of low cost and high quality."

Doctor shortage looms: So says a new report from the Association of American Medical Colleges, which estimates that the shortage of physicians beginning in 2015 will be 50 percent worse than originally anticipated prior to healthcare reform. At fault: The 32 million extra people who will have coverage, coupled with 36 million more elderly Americans joining the Medicare rolls. http://bit.ly/c8RY2i

AHIP tracks state implementation: America's Health Insurance Plans has created a chart and map tracking state implementation of the health reform provision that prohibits pre-existing condition exclusions for children.

Top House lawmakers on Thursday accused government regulators and a major drug company of misleading Congress and the public over last year's recall of a defective pain medication.

Johnson & Johnson executives should have told the public it was pulling defective Motrin off the shelves, the lawmakers charged, while the Food and Drug Administration (FDA) should have pushed harder for the company to do so. Both groups misled Congress about their involvement in the episode, some members alleged.

But while Democrats tended to focus their criticisms on company executives for putting shareholders above public health, Republicans spent more time blasting federal regulators for not going further to protect consumers. 

"The pattern emerging at FDA is one of carelessness, deficiency, and untruthfulness," said Rep. Darrell Issa (Calif.), senior Republican on the House Oversight and Government Reform Committee. "Johnson & Johnson and its subsidiaries do not get a pass," he added, "[but] the government has failed to do its job." 

Rep. Edolphus Towns (D-N.Y.), chairman of the panel, didn't disagree, but argued the primary responsibility in drug safety cases rests with the company. 

"Even if the FDA was technically aware of it, that does not excuse what Johnson & Johnson did," Towns said. "[The company] had both the legal and moral obligation to do the right thing, and they did not."

The controversy swirls around the 2009 voluntary recall of defective Motrin tablets. To prevent the public from learning of the event, a J&J subsidiary (McNeil) hired third-party contractors to buy up defective pills from retailer shelves, rather than launching a national recall, which would have alerted the media.

Not even the retailers stocking the defective pills were told of the plan.

"Run in, find the product, make your purchase and run out," the contractors were instructed. "There must be no mention of this being a recall of the product."

The tablets weren't suspected of posing a health risk, but they contained lesser amounts of active medicine — and were therefore less effective — than the label advertised. 

As part of the committee's investigation, lawmakers learned that J&J officials told the FDA about the defect as early as November 2008, but agency officials didn't press the company for a national recall until seven months later. In the meantime, J&J informed the agency that its contractors were visiting drug stores to "assess" the situation, but failed to mention that the contractors were buying up the medication.

The company, FDA's Principal Deputy Commissioner Joshua Sharfstein testified Thursday, "did not disclose the phantom part of the phantom recall."

Appearing before the oversight panel, J&J executives at turns apologized for and pushed back against the charges that they didn't tell the FDA what they were up to. 

"We should have notified them that we would be taking these products … off the shelves," J&J CEO William Sheldon said. "You're absolutely correct that we made a mistake. But we feel we did keep people informed as to the actions we were taking."

It wasn't the only apparent discrepancy. Weldon also said he was ready to accept "full accountability" on behalf of the company, but  later added that he "can't comment for the conversations that go on across the organization."

Meanwhile, Colleen Goggins, head of J&J's consumer group, reiterated her statement — made before the panel in May — that she knew nothing of the recall at the time.

"I did not know that at the time of my testimony — I don't believe," Goggins said.

Much of Thursday's hearing, though, highlighted the different philosophies of the two parties as it pertains to government oversight. Issa maintained that the focus of the panel should be the conduct of federal agencies. 

As the committee's name suggests, Issa said, "we are overseeing government."

The remark wasn't overlooked by some Democrats, who argued that the panel's responsibility is broader than that. 

"This committee is not just oversight of the government," said Rep. Dennis Kucinich (D-Ohio). "It's [also] oversight of misconduct in the private sector."

Towns was quick to note that the FDA lacks the authority to force a company to recall a product, regardless of the threat to public health. 

"Even if the FDA had been notified about the Motrin problem, the agency did not have the legal authority to order a recall," Towns said. "This needs to be rectified." 

The debate carries echoes of other battles swirling around Capitol Hill in recent months. In the wake of deadly accidents in a West Virginia mine and on a Gulf of Mexico oil platform, for instance, Democrats have called to expand the powers of the federal regulators overseeing those industries. Republicans, though, have rejected the proposals, arguing they would force expensive new requirements on private companies, crippling their ability to hire amid an employment crisis.

Some Democrats on Thursday noticed a discrepancy between the Republicans' criticism of government regulators and their opposition to bills lending the same agencies stronger teeth. 

"On one hand, some of my colleagues would reject a beneficial role for government in people's lives," Kucinich said. "And on the other hand, when a regulatory agency does attempt to assert government responsibility for corporate misconduct, that's not recognized."

But Issa maintained that granting the agency greater power is no indication it would use it. 

"Even if we gave them additional authority for mandatory recalls, if they were complicit in a silent recall, then to what end would that new authority be?" he asked.

Alaska and Minnesota were the only two states to turn down federal grants for the development of insurance exchanges, the Department of Health and Human Services announced Thursday.

HHS announced that 48 states and the district of Columbia were receiving a total of $49 million to help them research and plan how to set up a health insurance exchange. The health reform law requires states to have exchanges up and running by 2014; the federal government will take over in states that don't set up their own exchanges.

Joel Ario, the director of the Office of Health Insurance Exchanges at HHS, said it would be "premature" to say that the states that have asked for money will be setting up their own exchanges. Rather, he explained, the grants will allow them to determine if setting up their own exchange is feasible.

On the flip side, the two states that didn't apply for the grants aren't necessarily ruling out starting their own exchange either.

Minnesota Gov. Tim Pawlenty (R), who is mulling a presidential run in 2012, has said he doesn't want to apply for federal grants tied to a law he disagrees with.

And Alaska Insurance Director Linda Hall told The Hill that the state does not want federal funds to set up an exchange that would require people to buy insurance. Alaska is a party to the 20-state lawsuit questioning the constitutionality of the individual mandate.

That's not to say that the state would reject operating its own exchange, she said: "There are a lot of things to consider."

Ario said more grants should be available in early 2011 to help states establish their exchanges. Next year, he said, will be a "critical legislative year" for states to enact bills creating their exchanges if they're going to meet the Jan. 1, 2013 deadline by which HHS will certify that they'll be ready to run their own show in 2014.

The grants announced Thursday cover such issues as: 

- Assessing current information technology (IT) systems and infrastructure and determining new requirements; 

- Developing partnerships with community organizations to gain public input into the exchange planning process;

_ Planning for consumer call centers to answer questions from their residents; 

_ Determining the statutory rules needed to build the exchanges;

_ Hiring key staff and determining ongoing staffing needs;

- Planning the coordination of eligibility and enrollment systems across Medicaid, the Children's Health Insurance Program (CHIP), and the exchanges; and 

_ Developing performance metrics, milestones and ongoing evaluation.

Reports alleging McDonald's might stop covering workers because of  reform are "flat out wrong," Secretary Sebelius said Thursday.

House Republicans are blasting the health reform law after a recent report indicated new insurance requirements might lead McDonald's Corp. to drop coverage for tens-of-thousands of employees.

Officials at the fast-food giant informed the Health and Human Services Department (HHS) this month that a provision requiring plans to spend at least between 80 and 85 percent of premiums directly on healthcare treatments would force the company to scrap its health coverage for about 30,000 workers, the Wall Street Journal reported Wednesday.

The report wasn't overlooked by Republicans on the House Ways and Means Committee, who blasted it to reporters Wednesday as evidence that the new law will harm patients. 

McDonald's, the Journal reports, offers so-called "mini-med" plans, which offer low-premium, limited-benefit coverage for workers. Due to the high-turnover rate of employees covered by such plans, the company contends, HHS should exempt those products from the medical loss ratio (MLR) rules included in the new health reform law, the Journal reports.

"[I]t would be economically prohibitive for our carrier to continue offering" mini-med coverage under the current MLR thresholds, McDonald's wrote to the administration, according to the Journal.