Termination of 1945 Merck Consent Agreement And Medco History

Below, there is a bit of history between Merck and Medco which came about from the 1945 wartime seizure agreement with the Department of Justice.
MEMORANDUM OF THE UNITED STATES IN RESPONSE TO THE MOTION OF MERCK & CO., INC. TO TERMINATE THE CONSENT DECREE

Where is Medco stock traded and what is its ticker symbol and CUSIP number?
	We trade on the New York Stock Exchange under the ticker symbol: MHS. Medco's CUSIP number is 58405U102.

When did Medco go public?
	Medco stock started trading on August 20, 2003.

What is the relationship between Merck and Medco?

Medco was a wholly owned subsidiary of Merck & Co., Inc., a global pharmaceutical company, from 1993 until Medco was spun-off as an independent publicly traded entity in August 2003. Merck is one of the many major pharmaceutical manufacturer's with whom Medco has a customary rebate agreement. On February 28, 2006, following arms-length negotiations, the managed care agreement that the Company had entered into with Merck while it was a wholly-owned subsidiary of Merck was terminated as of April 1, 2006. The liquidated damages provisions contained in the managed care agreement, under which the Company could have been required to pay liquidated damages if the Company's Merck-related market share declined below specified levels, will no longer apply.

Why did Merck separate Medco from its business?

The board of directors of Merck believes that the separation of Medco from Merck will enhance the success of both Merck and Medco, and thereby maximize stockholder value over the long term for each company, by: enabling each company to continue to pursue its unique and focused strategy; and enabling investors to evaluate the financial performance, strategies and other characteristics of Merck and Medco separately in comparison to companies within their respective industries

Does Medco plan to pay dividends?
	Medco currently does not pay dividends and does not plan to pay dividends in the foreseeable future.

Can I purchase or sell shares directly through Medco?
	Medco does not have a direct purchase or sales plan.

How many shares of Medco did I receive as a result of the Spin-Off from Merck?
	Merck's board of directors set a record date of August 12, 2003 for the transaction. If you owned Merck shares as of this date, you automatically received .1206 shares of Medco common stock for every one share of Merck common stock held on the record date.

What are the U.S. federal income tax consequences of the distribution to Merck stockholders (cost basis)?

For Important U.S. Federal Income Tax Information concerning the Medco Health Solutions, Inc. Stock Distributionplease click here for the shareholder letter. Based on the ruling that Merck received from the U.S. Internal Revenue Service, or IRS, you will not recognize a gain or loss on the receipt of shares of Medco common stock in the spin-off, except to the extent you receive cash in lieu of fractional shares. Your tax basis in your Merck common stock will be apportioned between your Merck common stock and the Medco common stock received in the distribution in accordance with their relative fair market values.

States Cry Foul With Health Care Mandate

States Cry Foul With Health Care Mandate

Ever wanted to know why there was so much opposition to the health care reform?  Well here it is.

It's called fraud.  Yes, contained within health care reform is also regulation.  Here is a great little rant from the State of Florida.  Why are they ranting?  It is because they are not compliant.

Florida is so bad, the U.S. Department of Justice teamed up with the U.S. Department of Health and Human Resources to establish the Health Care Fraud Enforcement Task Force (H.E.A.T.)  The worst part of the levels of health care fraud in these states that are crying the unconstitutional foul is that the levels of Medicaid fraud, once the federal moritoria on the suspension of the rules are lifted, will make Medicare pail in comparison to the ugly beast called Medicaid fraud.

U.S. DHHS OIG and DOJ Health Care Fraud Prevention Enforcement Team
The lack of Medicaid and Medicare regulation in the states will substantially cut the federal funding to their programs.  In essence, coming into federally funded, mandated compliance to end Medicaid and Medicare fraud will kill jobs because these fraud scheme, racketeering operations will be shut down.Department of Justice and Department of Health and Human Services response to Senator Grassley's inquiry on...

The people who will really decide whether health-care reform succeeds or fails

By Ezra Klein

The New Yorker isn't allowing Atul Gawande's latest article out from behind the paywall, but you can read the abstract here. The basic point is well worth keeping in mind amid all the arguments over the Affordable Care Act: Health-care costs -- and thus our paychecks, and the federal budget -- won't be decided by how we deliver and structure health-care insurance. They'll be decided by how we deliver and structure health care. And though national policy has a role in that, it's not always a huge role, and it's not usually a controversial one.

Gawande relates a series of stories showing innovation in the toughest corners of the care-delivery system. The most inspiring is about Jeffrey Brenner, a Camden-based physician who began playing with his city's hospital claims data and making maps of where the money was being spent. It turned out that there were two city blocks, containing two particular buildings, where 900 people were responsible for "more than four thousand hospital visits and about two hundred million dollars in health-care bills" over the past seven years. So that's where he focused.

Insurers try to run from the costliest patients. They try to kick them out for having preexisting conditions, or they rescind their coverage, or they price coverage beyond their reach. That just makes them costlier, of course. Inconsistent access to medical care means more medical emergencies, and more medical emergencies mean higher medical costs. Brenner, by contrast, is lavishing them with attention. He's calling them daily. He's checking up on their medications, their lifestyles, their habits. He wants to open a doctor's office in their building. His patients averaged "sixty-two hospital and E.R. visits per month before joining the program and thirty-seven visits after — a forty-per-cent reduction. Their hospital bills averaged $1.2 million per month before and just over half a million after — a fifty-six-percent reduction."

We don't really know if his success can be replicated. But somebody'scan be. And that'll be where policy -- in particular, where Medicare -- comes in. The administration's vision sees things running something like this: A promising experiment or pilot program will come to the attention of the newly established Center for Medicare and Medicaid Innovation. The center will fund it on a larger scale and study it more intensely if. If it proves promising, the Independent Payment Advisory Board will force Medicare to implement it fairly quickly. And history shows that if something works in Medicare -- and, quite often, even if it doesn't -- it's soon adopted by private insurers.

That's if all goes well, of course. And all may not go well. But it's important to keep in mind that we know who costs the system money: Sick people. And we know what costs the system money: Their health care, particularly when it involves catastrophic or chronic conditions. So from a cost and quality perspective, this is where health-care reform will live and die: In doctor's offices, in community health centers, in operating rooms and in people's homes.

Insurers can play a role here, as can Medicare. But for the next few years, cost control is going to be less about setting national policy than about setting up the experiments that allow us to test what national policy should be. The Affordable Care Act's contribution to this is money, a center dedicated to bringing these experiments up to scale and a reform process that makes it easier to seed them in Medicare. But for all that to work, the component pieces need to remain in place, and some of the experiments actually need to pan out.

Photo credit: By Pat Sullivan/Associated Press

The Top Five Branches Of Health Law GOP Wants To Prune

by LEXIE VERDON, BARA VAIDA AND JORDAN RAU

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January 24, 2011

The Republican effort to repeal the health care law is going nowhere in the Democratic-controlled Senate, but that doesn't mean that the GOP is backing down. House Republicans are already beginning work in committees to lop off and possibly replace some of the law's individual provisions.

Party leaders have released few specifics, but some of the changes that have been urged by Republicans and a few Democrats could affect Americans' health care spending and coverage under the law.

Ways and Means Committee Chairman Dave Camp of Michigan was blunt about the strategy when addressing reporters last week: "If the tree is rotten, you cut it down." If that doesn't work, "we'll prune it branch by branch."

Here is a quick look at five "branches" of the health law "tree" Republicans are eyeing.

1. Reporting Business Payments on 1099 Forms

What the law says: Businesses that make payments of $600 in a year for goods or services to a single provider must file a 1099 form to the Internal Revenue Service identifying the company or person receiving the payment.

Purpose: The reporting requirement is expected to raise $19 billion over 10 years to help pay for the cost of expanded insurance coverage under the health law. It is intended to help increase taxpayers' compliance with income reporting rules.

Where it stands: This provision quickly raised concerns from business groups, which argue that the $600 trigger is too low and will create an administrative nightmare, especially for small businesses. That prompted bipartisan support to change or repeal the provision; the White Houseagreed that it should be amended.

Both Republican and Democratic lawmakers have offered proposals, but none passed last year. The new GOP majority in the House is determined to take up the issue again and have made a bill repealing the reporting requirement a priority. Three Democratic senators have written Speaker John Boehner to urge quick passage of the bill.

2. Individual Mandate

What the law says: U.S. citizens and legal residents are required to have health insurance by 2014 or pay a penalty. A number of people are exempted from the mandate, including those for whom the coverage would cost more than 8 percent of their income, American Indians and those who have religious objections.

Purpose: The mandate is designed to discourage consumers from waiting to apply for coverage until they are sick and need costly treatments. Backers say that's important because insurers will be required to provide coverage to people with pre-existing medical conditions.

The Congressional Budget Office has estimated that if the provision were struck from the law, fewer healthy people would purchase insurance and the result would be a 15 to 20 percent increase in premiums in the individual insurance market. It also predicted that the number of uninsured Americans would rise to 39 million from 23 million by 2019 if the mandate is repealed or overturned by courts.

Where it stands: Republicans argue it is unconstitutional to force individuals to purchase a product and about two dozen states are challenging the provision in court.

The issue is expected to go all the way to the Supreme Court.

Even some Democrats who supported the law, such as Sens. Claire McCaskill of Missouri and Ben Nelson of Nebraska, have backed away. Various groups are promoting alternatives like limiting insurance plan enrollment to specific times or imposing penalties on those who do not enroll when they first become eligible; or replacing the mandate with an incentive to buy health insurance, such as a tax credit.

3. Independent Payment Advisory Board

What's in the law: This 15-member board is tasked with curbing the per capita rate of growth in Medicare spending. The board's recommendations will be automatically implemented in the 2015 fiscal year unless Congress comes up with its own solution.

Congress may also vote, by a supermajority, to reject the recommendations and send the bill to the president, who can sign or veto the measure. Both Congress and the board face statutory deadlines for action.

Purpose: Efforts by Congress to rein in Medicare spending have been met by repeated resistance from special interests, making it politically difficult for lawmakers to slow health care spending. The board is supposed to make the hard decisions on spending that Congress has been unable to implement.

Where it stands: Republicans see the board as another expansion of government over health care, and many House Democrats oppose an independent board exercising control over Medicare. Many powerful interests, including doctors, drug companies, hospitals and patients-rights groups have begun lobbying Congress to get rid of the provision. They say they're worried the cuts will be draconian, disrupting the health care system.

4. Health Care Flexible Spending Accounts

What's in the law: Starting this year, people who put money into pre-tax flexible spending accounts (FSAs) can no longer use those funds to buy over-the-counter medications or health care products without a prescription. Starting in 2013, the maximum contributions to those accounts will be capped at $2,500 a year.

Purpose: The change is intended to help the government pay for the broader health overhaul. Many economists also argue that FSAs encourage consumers to make needless purchases because they fear forfeiting their account balances at the end of the year.

Where it stands: Companies that administer these accounts are pressing Congress to rescind the restriction on over-the-counter medications and products. They also hope that if Congress won't raise the $2,500 annual limit, lawmakers will at least allow people to roll unspent money into the next year's account or have it returned to them as taxable income.

5. The CLASS Act

What's in the law: This insurance program would allow people to volunteer for a payroll deduction to help them finance long-term care in their own homes if they become disabled.

Purpose: The payments of at least $50 a day can be used for a variety of expenses, including paying for a home health aide or family member who provides care, household modifications, respite care, special transportation or technology needs or to help pay for assisted living expenses. There is no lifetime limit on benefits.

Where it stands: Conservatives argue that the program will quickly outpace its funding and become an entitlement that the country cannot afford. Some of these experts, including theHeritage Foundation, have urged Congress to repeal the provision before CLASS begins operation.

Last year, Rep. Charles Boustany, R-La., introduced a bill requiring Congress to reconsider whether the program was self-sustaining but lawmakers did not act on it.

This story was produced through collaboration between NPR and Kaiser Health News (KHN), an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan health care policy organization that isn't affiliated with Kaiser Permanente.

Fraud Prevention Efforts Recover $4 Billion

Medicare, Medicaid, CHIP Final Rules 2011

Medicare, Medicaid, CHIP Final Rules 2011

Final rules with opportunity for public comment only on fingerprinting requirement.

These regulations are effective on March 25, 2011

Medicare, Medicaid, CHIP Additional Screening Requirements, Application Fees, Temporary Enrollment Moratori...

AstraZeneca, The Policy Pimps Of Medicaid Fraud

AstraZeneca, The Policy Pimps Of Medicaid Fraud

A precious gem I have discovered!

This is an excellent specimen of pathological propaganda. In 2004, AstraZeneca, LP, a pharmaceutical corporation, sponsors a symposium with a university to reshape Medicaid. The main focus was on mental health and children, not on quality of life but to increase funding to expand eligibility for drugs.

That's right, boys and girls, a drug company pays off a university to get Congress to pay more money for their drugs. This is tangent to the practice of  ghostwriting in medical literature.

These cats were so good at manipulating public policy to make more money that they even got former Michigan Governor John Engler, the king of privatization, to come and support their agenda. For those of you who may not know, Governor Engler was the individual who established the nation's first  privatized child welfare system. As a result, Medicaid fraud has been astronomical. Here is a sample of his work.

Without further adieu, I present to you, a hallmark in the history of Medicaid fraud child welfare!  The Future of Medicaid: What Will Medicaid Look Like in 2010?

What makes this so-called "Medicaid vision" so entertaining is that it is now 2010 and look at what the Department of Health and Human Services Office of Inspector General caught AstraZeneca, LP doing... "wrongfully and illegally marketing" their drugs

I am not sure as I have yet to investigate, but I believe the U.S. Food and Drug Administration was allowing Medicaid to pay for the experimental drug trials on foster kids for AstraZeneca, LP. Even so, Medicaid pays for using  foster kids as lab rats.

In the end, the only lesson I am trying to teach is that it is time for transparency and accountability. No more secrets. CORPORATE INTEGRITY AGREEMENT BETWEEN THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN...

AstraZeneca's policy pimping only gets funnier. Utah's Attorney General Shurtleff wants his money back. I wish the other States would follow suit. Utah Seroquel Risperdal Complaint

Stop Child Medicaid Fraud

Stop Child Medicaid Fraud

HHS and DOJ Health Care Fraud and Abuse Annual Report 2010

HHS and DOJ Health Care Fraud and Abuse Annual Report 2010

The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Contr...

Mythbusting on Health Care Reform

Myth Buster Health Reform Destroys Jobs FINAL

First Medicare and Medicaid Fraud Enforcement Testimony

Enforcement of the Criminal Laws Against Medicare and Medicaid Fraud Hearing Before the Subcommittee on Cri...