Friday, February 15, 2008

Who co-sponsored the bill to eliminate GPO/WEP discrimination AND WHO DIDN'T!

From John Curry, February 15, 2008
Subject: Who co-sponsored the bill to eliminate GPO/WEP discrimination AND WHO DIDN'T!
A click on this link will divulge which Ohio House (federal) of Representatives co-sponsored HB 82...a bill which would repeal the current unfair and discriminatory Government Pension Offset/Windfall Elimination Provisions which penalize all Ohio state pension recipients who are also eligible to receive Social Security. Please scroll down this Ohio list to see the 15 out of 18 U.S. House members from Ohio who "signed on" to eliminate this discrimination to Ohio's public employee retirees. NOW, WHO ARE THE THREE OHIO U.S. REPRESENTATIVES WHO DID NOT SIGN ON AS A CO-SPONSOR? I THINK IT'S IMPERATIVE THAT WE REMEMBER TO FORGET THEM THE NEXT TIME THEY WANT YOUR VOTE! HERE THEY ARE:
......515 Cannon HOB
......Washington, DC 20515-3504
......Phone: (202) 225-2676
......1203 Longworth HOB
......Washington, DC 20515-3505
......Phone: (202) 225-6405
1011 Longworth HOB
......Washington, DC 20515-3508
......Phone: (202) 225-6205
To contact these Congressmen online, go to: saw it here (with CORE) five years ago

From John Curry, February 15, 2008
Subject: FLASHBACK...5 Years Ago -- CORE'S Nancy Hamant fought the good fight in we have a small victory!
With today's headlines reading like these.....
CVS Caremark settles deceptive-practices complaint for $38.5 million (Chicago Tribune)
Settlement in Alleged Drug Company Kickback Scheme (XETV FOX6 San Diego, CA) is no small wonder how CORE's Nancy Hamant fought same the battle for transparency from a pharmacy benefits manager and lost because of a legal tenet known as "trade secrets." All of this was playing out on stage four years ago in a Franklin County Courtroom in Columbus, Ohio.
Well, the trade secrets still remain a secret but the company Nancy was after (Advance PCS- now owned by Caremark) parted with some of their pennies yesterday in an embarrassing out of court settlement involving the same kind of accusations that Warren County Retired Teachers Association set forth. Once again thank you, Nancy Hamant, from the bottom of our hearts. You were right "on the money" with this fiasco!
John and CORE members everywhere
Teachers’ pension drug administrator wants info private
Canton Repository, December 9, 2003
Copley Columbus Bureau chief
COLUMBUS — A public records request has landed the State Teachers Retirement System in court.
AdvancePCS Health sued the teachers pension fund to prevent release of information that the Alabama-based drug-benefit manager considers protected by state and federal trade-secrets law.
The company got a temporary restraining order Nov. 10 preventing the release of data about the rebates the company and pension system get from drug manufacturers. On Thursday, AdvancePCS and the pension fund will go before Franklin County Magistrate Tim McCarthy, who will determine whether to issue a permanent injunction to prevent release of the material.
Hoping to have a say in influencing McCarthy’s decision is Nancy B. Hamant of Pleasant Plain, and the Warren County Retired Teachers’ Association. They initially sought the rebate information from the state pension fund, and the fund was prepared to release it until the court stopped it.
AdvancePCS, which manages the prescription drug program for STRS, is one of the largest pharmacy benefits managers in the nation. It handles more than 500 million prescription orders a year for nearly half of the Americans with a prescription drug benefit.
Hamant said she wanted to do side-by-side comparisons of drug costs so she and other retirees can determine where they could get the best prices. No such comparison can be made, she said, if they don’t know how much STRS and AdvancePCS benefit from rebates.
She said they’re trying to save STRS money.
Pharmacy benefit managers act on behalf of employers, including state agencies, pension systems, insurance companies, unions and other health care payers, to get discounts by negotiating prices with drug companies.
A manager creates a list of drugs, called formularies, for which it provides full reimbursement. It then negotiates with pharmacies to set prices, can institute mandatory generic substitutions, and can negotiate volume purchase agreements with manufacturers.
Physicians prescribe drugs in part based on whether the drug is on the formulary. Thus, a pharmaceutical company has an incentive to be on the list, even if their drugs cost more than another brand or a generic version.
“Some of the formularies are more expensive than the brand drug,” Hamant said. “Some generic drugs are as much or more than the formulary. Some local pharmacies provide 90 days (of drugs) cheaper than the group rate.”
Getting the documents she wants is just half of Hamant’s problem. She’s concerned her position won’t be heard Thursday because she’s not a party to the suit. AdvancePCS sued the teachers’ retirement system, not Hamant or the Warren County Retired Teachers’ Association. Hamant has, however, without a lawyer, filed a memorandum in court opposing a permanent injunction.
Hamant said she’s not confident the pension fund will argue strongly to keep its records open, though it has been helpful in keeping her informed about the case. Hamant delayed a three-month trip to Texas, which was to begin Wednesday, so she can appear in court.
She said the Warren County retirees are at a disadvantage taking on a company as big as AdvancePCS.
“None of us have money for a lawyer,” she said. “We just wanted a simple list so we could see whether to use AdvancePCS or a local plan or go to Canada. We wanted to save (the STRS) plan money.”
Cynthia E. Hvizdos, a lawyer for STRS, said the retirement system assumed the material Hamant sought was public record.
“The burden is on PCS” to prove it isn’t, she said. “Our position is that the Warren County Retired Teachers Association asked for it and asserted a right to it. It’s up to a court to judge. We resolve any doubt in favor of public records.”
“If STRS is an agent for all its members, then why isn’t (the data) members’ information?” Hamant asked. “We’re the rightful owners of the information.
“If drugs costs aren’t controlled and health-care costs aren’t controlled, it’s going to bankrupt people and put them on welfare.”
Pamela N. Hultin, a Cleveland attorney representing AdvancePCS, said the argument is over one sheet of paper. The company, she said, released the other material sought.
“STRS has an agreement with AdvancePCS to keep the information confidential,” she said. “It’s financial information that is a trade secret. I’d like to have the secret formula of Coca-Cola, but I’m not going to get it.”
Hultin said the AdvancePCS contract with the teachers’ retirement system requires the pension system to notify the pharmacy benefits manager whenever someone requests or gets a court order for release of information pertaining to it. When Hamant filed her public records request, the system notified AdvancePCS.
AdvancePCS is in federal court in Alabama after two independent pharmacies accused it and three other top pharmacy benefit managers of “anti-competitive practices.”
That case said the companies used their status as middlemen to artificially fix prices and force “unconscionable” reimbursement rates on community pharmacies.
The suit alleges secret deals with drug manufacturers to push prescriptions on doctors and pharmacies in return for “kickbacks” and other “undisclosed incentives.”
Meanwhile, U.S. Sen. Byron Dorgan, D-North Dakota, has accused pharmacy benefit managers of refusing to tell congressional investigators how much money was being paid by drug companies to list drugs on formularies.
The Associated Press contributed to this story.
You can reach Copley Columbus Bureau chief Paul E. Kostyu at (614) 222-8901 or e-mail:
Just remember...Providing health care to all Iraqis is sound policy, but providing health care to all Americans is socialism. PBM's and insurance companies have the best interests of the public at heart. Tongue in cheek! John

Mary Ellen Angeletti: Minutes of CORE meeting 2/14/08

Minutes of the CORE Meeting of Thursday, February 14, 2008
CORE met at 11:45 on Thursday, February 14, 2008 in the cafeteria room behind the Sublett Room at STRS. Officers present were: Dave Parshall, President; Mary Ellen Angeletti, Vice President; Bruce Hodges substituting for Glenna Barr, Secretary; and Mary Thomas substituting for C.J. Myers, Treasurer. Trustees present were: Chuck Angeletti, Betty Bell, Lloyd Knudsen substituting for Chuck Chapman, Liz Ebbing substituting for Nancy Hamant, and Kathie Bracy substituting for Nancy Boomhower.
Lou DiOrio of OCHER was also present, as was Herschel Grim of OFT.
Guest speaker was Mr. Tim Myers, a candidate for the active teacher seat on the STRS Board, who had requested the opportunity to speak and share his reasons for running for the position.
Next, President Dave Parshall called the CORE meeting to order. The January CORE meeting minutes were approved. In the Treasurer's absence, Dave gave the Treasurer's report, which included the payment of some bills for the CORE website work.
Committee Reports:
A. CORE Website: Dave reported that information on CORE's endorsed candidate for the STRS Board, Mr. Dan Vincent, is available to all on the website as well as Kathie Bracy's blog.
B. Contacts and Regional Reps: Molly Janczyk was not present but it was shared that she is maintaining via email the count of signatures and petitions from different districts around the state for Dan Vincent. Many petitions were handed in today to STRS for Dan.
Old Business:
A. STRS Board. Election Campaign: Dave reminded those present that all petitions for Dan Vincent must be in Laura Ecklar's hands no later than February 29. He suggested getting them to her a week earlier (Feb. 22) if possible in order to assure receipt.
B. House Bill 315: Mary Ellen shared news from the Special Health Care Committee meeting held this morning at 9 a.m. in the Sublett Room at STRS. Terri Bierdeman, STRS contact for the Ohio legislature, reported that the slow pace of HB 315 is being caused by a term limited environment in which the congressional members are reluctant to make waves by supporting or not supporting bills. She spoke of the problem term limits produces in that no long term relationships are established and that many of the new representatives have little or no experience. She doubts whether HB 315 will be considered during the 2008 election year but she encouraged us to continue to work on its behalf by continuing visits to representatives and school boards. She recalled that HB 190 moved in just six months, which was a great improvement on the previous bill, which required seven years. She reminded us that we may not end up with exactly what we start out with. One third of the representatives in the new legislative assembly will be NEW members. Regarding the Ohio Retirement Study Council, she said of the 9 members that 3 were positive for HB 315 but 2 more were needed. She lauded Warren County Retired Teacher Association for having an effect on a complete turn-around regarding Michelle Schneider's consideration of 315. She now seems supportive of the bill. She said much work must be done behind the scenes to get favorable votes prior to any hearing. She feels that 315 can progress but will not work its way through the House and Senate till the next General Assembly.
HCA member Bill Leibensperger, representing OEA, then reported that a meeting had been set with the school board association and reminded us that the Health Care Advocates are in this effort for the long haul. He said that OEA would be doing screening for all candidates running for office in the Legislature in order to identify those who support HB 315.
HCA member Ann Hanning, representing ORTA, ensured support from that group.
Dennis Leone spoke addressed Ann regarding on the need to contact and encourage the retired teachers associations to support HB 315. He praised Warren County RTA for their efforts in effecting change and support.
Craig Brooks added that if there has been no progress in a year, we may need to reassess and consider a Plan B. Sandy Knoesel assured him that planning would continue to occur.
Mary Ann Cervantes suggested that we need to get to the candidates before they get elected in order to obtain their support for HB 315.
Mary Ellen Angeletti asked Laura Ecklar for suggestions regarding the best way to approach a school board to seek inclusion of HB 315 (by STRS) on board agendas. She suggested starting with the school district for which the retiree taught. Many times fellow teachers who are still active can share the name of someone on the school board who might be supportive of the idea of helping to add 5 minutes to a school board agenda for discussion of 315. Another idea is to contact the Superintendent to add 5 minutes to a board agenda for this purpose. Many times superintendents are close to retirement and very concerned about health care in their retirement. [End of report on Health Care Committee meeting]
A. Handout: A new handout was distributed [in the CORE meeting] that provides information for retirees with regard to contacting legislators to enlist their support of HB 315. It includes a sample letter and is also posted on Kathie Bracy's Blog.
B. Trustee Voting: Members present were asked to volunteer to vote in place of absent (ill) trustees and officers. Dave suggested the possibility of assigning permanent substitutes, if needed, for future CORE meetings.
New Business:
A. Dave and Mary Ellen reported on recent meetings with Sue Taylor of OFT. At the first meeting, we sought OFT support for our CORE endorsed candidate, Dan Vincent. She promised consideration. At our most recent meeting, she reported that she had brought our request for candidate support to her Executive Committee, and they had decided NOT to support any candidate, including Mr. Vincent. When we asked why they could not support Dan Vincent, she said they would have preferred a classroom teacher rather than an administrator (curriculum director). We do not know why this was not mentioned to us at our earlier meeting with her. She did give us permission to distribute candidate flyers in OFT schools.
Mary Ellen reported on her recent conversation with Rhonda Johnson, President of CEA (Columbus Education Association). Dave and Mary Ellen had had an earlier meeting with Rhonda also seeking CEA support for Dan Vincent. We had also had a meeting with the former president of CEA, John Grossman. He was encouraging and mentioned possible use of CEA mail system for our candidate flyers. Rhonda also promised consideration of support but when Mary Ellen spoke with her recently, she informed us that CEA was not supporting any candidate this election.
When she was told of John Grossman's reference to support using the CEA mail system, she reminded us that John had not been president for four years. Mary Ellen mentioned that this would entail retirees physically going into schools to disperse campaign flyers and seeking signatures for petitions. She informed Mary Ellen that this would not be allowed. The only way that petitions could be signed was to give them to an active teacher to pass around to the staff. She said retirees could get signatures in the parking lot when teachers left for the day. She said that this was the Columbus City School district policy and that if it was violated, it would come back to her and be a big problem. CORE plans to investigate further.
B. Report on the January, 2008 STRS Board Retreat: Dave and Mary Ellen reported that notes had already been sent out as a CORE Email Alert regarding Day 2 of the Retreat. The only review of Day 1 was reliance on the CDs sent out by STRS. The recordings were of such poor quality that they were rendered almost useless. The one bright spot on the CDs which was audible was Craig Brooks' moving and inspiring assessment of his first year on the STRS Board in which he commended all members as good people who were committed to their job. He said it was important that members speak respectfully to each other and be respectful of other points of view (by putting themselves in the other person's shoes) and try to see things from that person's viewpoint. He emphasized active listening and encouraged his fellow board members to not forget past problems, but that it was important to learn from the past and then move on to building a stronger and better STRS Board, one that was able and ready to tackle the problems ahead. [In defense of the recording engineer, it should be noted that tremendous progress has been made in making Board meetings much more audible for all; but at the same time, having many microphones out there (one for each person at the table, and there were many, plus a lapel mike for the moderator) poses monstrous problems; some people do not speak into the mikes; others forget they're there and shuffle papers near them, etc.; if someone has a bad cold, you're going to hear a lot of coughing, etc. All of this is magnified because of the sensitivity of the mikes and the recording engineer's efforts to get every word that is spoken. KBB]
C. CORE Executive Session: Dave Parshall announced a CORE retreat for the officers and trustees of CORE on March 20, 2008 to discuss the terms of CORE officers and trustees. Some may not want to serve until the next Annual Meeting in September of 2008. Many had understood they were to serve only one year this first term even though the CORE constitution calls for a two year term. Replacements can be appointed until the next election if needed. Ideas about how to get members to become more active in the organization will be discussed. Also the officers and trustees need to brainstorm possible directions for the future of CORE. Ideas will be presented to the membership for discussion, consideration and approval at the March 27 CORE meeting. The membership will, of course, make final decisions.
D. Flower Fund & Cards: Mary Ellen shared that a get well card had been sent from CORE to Treasurer C.J. Myers and a sympathy card and note to Judy Kimmel whose late husband, Jim, had been a strong supporter of CORE and the Warren County Retired Teachers Association. Dennis Leone and John Lazares plan to attend his memorial service this Saturday, Feb. 16. Valentines were sent on behalf of CORE to Dennis Leone, John Lazares, and the STRS staff. In a gesture of appreciation, each STRS Board member found a box of candy conversation hearts marked from CORE at today's STRS Board meeting. Cards will be sent on behalf of CORE to ill members: Paul Boyer, Glenna Barr, and Herman Fisher. A sympathy card and note will also be sent on behalf of CORE to STRS staff member, Joyce Baldwin, who recently lost her sister.
It had been suggested that CORE consider establishing a flower fund. Following discussion, it was moved by Mary Thomas that CORE send out notices of any illnesses, deaths, etc. via email chains and alerts. The motion was seconded and passed unanimously. Mary Ellen will continue to send cards on behalf of CORE but when obituaries request donations in lieu of flowers, then this information will be sent out to the membership via email for members to contribute on their own. If members wish to contribute to CORE in memory of the deceased, then this should be noted on the check so that CORE can send this information to the family of the deceased. Please see item E below, concerning a memorial for Jim Kimmel and another good friend of CORE, Mr. Fred Bien.
E. James O. Kimmel Memorial: Judy Kimmel has suggested that memorials be made in Jim's name to: The Mayerson Center for Safe and Healthy Children, 3333 Burnet Avenue, MLC 3008, Cincinnati, OH 45229, Attention: Holly Hursong.
Many may remember Mr. Fred Bien, CORE's good friend and CPA who spoke to us 5 years ago regarding a fiduciary audit of the STRS pension fund. He volunteered to do this audit for CORE at a very reasonable sum; however, STRS turned down the offer. Fred attended many of our meetings, and we asked him for advice many times. He is suffering from leukemia and receiving home hospice; we would like to encourage our members to participate in a card shower for him. His address is: Mr. Fred A. Bien, 969 Augusta Glen Drive, Columbus, OH 43235-5015
F. Open/Closed CORE Meetings: The idea of closing our CORE meetings has been brought to our attention recently. The pros and cons of the idea were discussed at today's meeting, and it was decided that we should be encouraging all possible participation by anyone interested in attending. Holding closed meetings, for whatever purpose, would really be very difficult, as all educators [members of STRS] are considered members of CORE. We have no dues, asking only for donations. All are welcome.
G. Agenda Requests: The idea of sending out the CORE agenda to members via email and prior to our CORE meetings has been suggested. This idea was discussed, and we were reminded that usually the agenda is not finalized until the day before the meetings so this idea would be impossible. However, it was suggested that when the first of the month CORE Email Alert meeting reminder is sent out that it include a request to send to Dave Parshall any topic or concern that the person would like to see addressed at the CORE meeting. It would include a deadline date for getting agenda items to Dave at
H. Better communication with the STRS Staff & Board regarding issues of concern to the STRS membership: Suggestions have been given to CORE regarding better communication with the members of the STRS Board and staff. This idea suggested by Molly Janczyk and also Herschell Grimm of OFT was for consideration of regular, small group meetings of Board members and staff. It was mentioned that Molly has had good response from Board members just recently when she emailed them seeking inquiry about the vacant board seat. Several of the Board members emailed her a response and expressed a willingness to bring up the topic at a Board meeting. This happened at today's Board meeting when Craig Brooks brought it up, and the Board instructed Damon Asbury to follow through on finding out why one Board seat [for an appointed member] has been vacant so long. Likewise, Mr. Grimm shared that OFT's Retirement Committee has held an annual breakfast with the Executive Director and his executive staff members which has been very conducive to improving relations and encouraging a closer working relationship. These ideas were well received at today's CORE meeting and consideration of them will be part of the brainstorming session at the March 20 CORE retreat.
Respectfully submitted,
Mary Ellen Angeletti,
Substituting for Glenna Barr

Report from STRS on February Board meeting

From STRS, February 15, 2008
Subject: [News] February Board News Details Retirement Board Actions and Discussions
This week, the State Teachers Retirement Board held its monthly meeting. Following the regularly scheduled meetings, a report titled "Board News" is posted on the STRS Ohio Web site, as well as mailed to a number of members and education organization representatives who have requested it. As a member of STRS Ohio with an e-mail address on file, you will also receive this report each month. The February report follows.
The February 2008 meeting of the State Teachers Retirement Board included the annual actuarial valuation report of the system's Health Care Stabilization Fund from the board's actuarial consultant, PricewaterhouseCoopers (PwC). Health care costs for the STRS Ohio Health Care Program are paid out of this fund. Currently, monies for the fund come from premiums charged to STRS Ohio retirees and their dependents who are enrolled in the program, 1% of payroll from employer contributions and investment earnings on these funds.
The valuation report tells the Retirement Board the solvency period of the fund, and what percentage of contributions would be needed to fund the health care program on a full-reserve basis.
This year's report again confirmed what the Retirement Board and staff have been sharing with members for several years: The funded status of the health care program, which has about $4 billion as of Jan. 1, 2008, is considerably higher than most other public pension systems in the United States. However, projections continue to show that the principal in the fund will begin to be tapped in just a few years.
The report also showed that House Bill 315, which calls for a 5% increase in combined member and employer contributions (phased in over a five-year period), will adequately address this funding challenge. Based on current figures and assumptions made in the valuation, this ongoing, dedicated revenue stream would cover the cost of current health care liabilities, as well as future liabilities, and move the Health Care Stabilization Fund toward a fully funded basis. However, as noted above, the time period that this level of contribution increase is a viable solution is limited. Once the principal in the health care fund begins being drawn down, the annual required contribution starts to increase.
In presenting the health care actuarial valuation for Jan. 1, 2008, the Retirement Board was reminded by PwC that the Governmental Accounting Standards Board (GASB) requires a retiree health care program to use a different assumed investment return rate for its health care monies if the program is not fully funded. So, rather than STRS Ohio using an 8% rate (the same rate it assumes for its pension fund), it must lower that rate to 5.5% based on the current funding status of the health care fund when calculating liabilities.
Consequently, PwC reported that the annual required contribution (ARC) for health care liabilities -- with a 5.5% rate -- is 5.92%. But, if H.B. 315 passes and an annual contribution of 5% of payroll is ultimately contributed to the health care fund, GASB allows the investment return rate to return to 8%. As the accompanying chart shows, the ARC drops to about 4%, confirming that the proposed 5% contribution increase is still adequate.
In short:
• If STRS Ohio can fully fund the ARC (which it could do if H.B. 315 passes), the ARC is lower because it is based on an 8% investment return rate.
• If STRS Ohio is only able to partially fund the ARC (if 5% isn't allocated to the health care fund), the ARC is higher because it is based on a 5.5% investment return rate.
JANUARY 2007 (5.5%) Funded Status (ratio of assets to accrued liability) -- 28% Annual Required Contribution (ARC) -- 6.55% Fund Solvent Until (with continuation of 1% employer contribution) --
JANUARY 2008 (5.5%) Funded Status (ratio of assets to accrued liability) -- 33% Annual Required Contribution (ARC) -- 5.92% Fund Solvent Until (with continuation of 1% employer contribution) --
JANUARY 2008 (8% with passage of H.B. 315) Funded Status (ratio of assets to accrued liability) -- 46% Annual Required Contribution (ARC) -- 3.92% Fund Solvent Until (with continuation of 1% employer contribution) -- 2026
(This information is also available on the STRS Ohio Web site in a chart format at the following URL:
During a Special Health Care Committee meeting on Feb. 14, 2008, Retirement Board members and representatives from the Health Care Advocates for STRS (HCA) received an update on House Bill 315. Looking to the future, the committee discussed that it is not unusual for a bill to take several years to pass, especially if it entails both cost and less than unanimous support. It was agreed that both STRS Ohio and the HCA would continue to do the following:
• Encourage dialogue among all major stakeholders;
• Keep STRS Ohio members and retirees engaged and working actively on behalf of the bill;
• Educate school boards about the issue;
• Contact candidates who are running for seats in the General Assembly and inform them about the importance of this issue to STRS Ohio retirees and members; and, most importantly,
• Stay the course.
The Retirement Board approved the following retirements and investment transactions:
• 134 active members were approved for service retirement, 90 inactive retirements were approved.
• In January, fixed-income purchases totaled $862 million, domestic equity purchases totaled $4.36 billion and real estate purchases totaled $141 million.
The Public Sector Healthcare Roundtable board of directors met in Washington, D.C., recently to develop its strategic plan for 2008 and 2009. STRS Ohio is a charter member of this group. Health care is expected to be at the top of the agenda for the next president, barring a violent setback in Iraq that would increase the pressure for the foreign policy agenda, or a more serious turn for the economy.
The Roundtable's legislative focus for 2008 will be on health care information technology, generics and comparative effectiveness. Within those three broad categories will be a push for electronic medical records, electronic prescribing of prescription drugs, more money allocated to comparative effectiveness databases and eliminating restrictions on bringing generics to market. By midyear the focus will fine-tune attention to the directions laid out by the two presidential contenders in preparation for hitting the ground running in January
In regard to the Sudan Divestment Law passed by Congress at the end of 2007 and signed by the president on Dec. 31, 2007, several organizations in which STRS Ohio holds membership, including NCTR and NASRA, have reached out to the Securities and Exchange Commission concerning companies in which divestment may be required. The federal statute does not require divestment. It does require any legislation passed by individual states to comply with the standards set forth in the federal law.
Finally, two new organizations in Washington, the National Institute on Retirement Security and the National Public Pension Coalition, are joining forces to advance the debate in favor of defined benefit plans. There continues to be a push around the country to scale back or eliminate defined benefit plans in the private sector. The push is moving to the public sector -- much of it fueled by growing envy by private sector employees who no longer have a defined benefit. That growing dissatisfaction from taxpayers, combined with political philosophy that private is better and cheaper, puts all public sector benefits at risk. These two organizations will work at the national level and in individual states to proactively promote the value of the defined benefit model before any attempts are made to scale back benefits.
Standard & Poor's (S&P) has affirmed STRS Ohio's "AAA" issuer credit rating. This rating is S&P's highest possible rating for an organization's ability to pay its financial obligations. STRS Ohio has maintained the AAA standard since first requesting a rating in 1999.

RH Jones re: HB 315

From RH Jones, February 15, 2008
Subject: Fw: Trust me!
How about the OSBA & the OASBO who want to deny retired teachers their health care funding increase provided for us in HB 315. Thanks to their opposition, it is tied up in the FIRES Committee.
It is about time Ohio met it's moral obligation and gets our Ohio moving toward prosperity. For without fine teachers in our classrooms, education suffers, business suffers and our state goes even further downhill. Education = prosperity. A retired teacher's health care increase is part of attracting the nation's finest teachers to Ohio. The OSBA & OASBO seem, therefore, not to have the best interests of the public at heart either. I just wonder why they cannot see this?
Thanks; my opinion,

From John Curry, February 14, 2008
Subject: Trust me!
"Why sure you can trust me...I used to be a pharmaceutical benefits manager consultant!"
Just remember...Providing health care to all Iraqis is sound policy, but providing health care to all Americans is socialism. PBM's and insurance companies have the best interests of the public at heart. (Tongue in cheek!)

Thursday, February 14, 2008

Dennis Leone re: February 14, 2008 STRS Board meeting

Dennis Leone to Molly Janczyk, February 14, 2008
Subject: STRS Governance
So you know, at the very end of today’s STRS Board meeting, I asked – since we soon will be interviewing executive director candidates – when will the board be seriously addressing governance issues. (Many on the board feel we already have.) Earlier in the meeting, I expressed my disappointment over: (1) The board adopting, with no interest in hearing from me on the matter (it was MY proposed amendment that was tabled), a resolution giving Damon absolute power, again, to represent the board is “ALL matters” pertaining to personnel compensation and “ALL matters” pertaining to expenditures; and (2) the board NOT revisiting my other policy objection – the one where Damon is empowered to determine “all further policies.” While this second proposed amendment was officially tabled, it never has been revisited or discussed a second time. It is simply astonishing to me that the board majority is okay with the executive having such power. These 2 policies (coupled with no board oversight) are the foundation for 90% of the problems that have occurred at STRS in the past. The policies, for example, would permit the executive director to decide tomorrow, unilaterally, to give all employees a $5,000 gift if they have perfect attendance. John Patterson knows this. It’s crazy.
Before adjournment, Craig Brooks said that “in the spirit of collaboration and working together,” he’d have no problem with the board discussing governance at a future meeting. I suggested the March regular meeting. There appeared to be board consensus that “governance issues” would on the agenda in March.
Regarding the unappointed board member problem…………while there was no formal vote (for a variety of reasons) there definitely was a board consensus, resulting (in my opinion) from your communication efforts, for Damon to directly express the board’s desire to have the person appointed as soon as possible.
Dennis Leone

Caremark to pay $38.5M over drug-switching practices

Note from John: the AG link below will take you to an Adobe download of the Official State of Ohio complaint against Caremark for alleged "deceptive practices" and other alleged nefarious actions. Sure, Caremark settled out of court without admitting don't think they really wanted to air dirty laundry in a court of law, did you?

From John Curry, February 14, 2008
Subject: Damon Asbury and Gary Russell...please consider this!
Damon and Gary...below is what we retirees have been talking about concerning our previous PBM during all those trials and tribulations that both you and we suffered through. Rx problems were not a figment of retirees' imaginations. I would place more faith and trust in a pack of used car salesmen than I would a PBM....maybe now all 5 state retirement systems will put a little more effort into planning and developing our very own state-run PBM. Would you please share this with others who may be involved with the study of a state-run PBM? Thank you.
John Curry
"The states participating in the settlement with Illinois and Maryland are Arizona, Arkansas, California, Connecticut, Delaware, the District of Columbia, Florida, Iowa, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia and Washington."
"The complaint also alleges that Caremark restocked and reshipped previously dispensed drugs that had been returned to Caremark’s mail-order pharmacies."
Caremark agrees to pay $38.5M over drug-switching practices
Feb 14, 2008
CHICAGO - An investigation led by Illinois Attorney General Lisa Madigan and Maryland Attorney General Douglas Ganslar has resulted in a 28-state, $38.5 million settlement agreement with Caremark Rx LLC, one of the nation’s largest drug-benefit management companies, Madigan’s office announced today in a news release.
Caremark processes prescription-drug claims and negotiates pharmaceutical-volume discounts for employer and government health plans. Under the settlement, Caremark must significantly change the practices it uses to ensure that patients, physicians and health plans have the information needed to make the most cost-effective buying decisions.
Madigan and Gansler led the investigation into Caremark’s drug-switching practices that resulted in today’s settlement announcement.
Under the agreement, Illinois will receive $1,263,977.77 of $22 million paid to the states for use to benefit low-income, disabled or elderly consumers of prescription medications, to promote lower drug costs for state residents, or to educate consumers concerning the cost differences among medications.
Caremark also will pay $16.5 million to the states for investigative costs, fees and consumer education, including $1.75 million for Illinois to use in consumer fraud enforcement.
Also as part of the agreement, Caremark will set aside an additional $2.5 million to reimburse patients who submit claim forms for expenses related to certain switches between cholesterol-controlling drugs. Affected consumers should expect to see a claim form in the mail from Caremark, Madigan’s release said.
The complaint against Caremark Rx LLC, and two of its subsidiaries — Caremark LLC and CaremarkPCS LLC, formerly AdvancePCS — alleges that Caremark engaged in deceptive business practices by encouraging doctors to switch patients to different brand-name prescription drugs and representing that the patients and/or health plans would save money.
According to the complaint, Caremark did not adequately inform doctors of the effect this switch would have on costs to patients and health plans. Further, Caremark allegedly did not clearly disclose to their client plans that rebates accrued from the drug-switching process would be retained by Caremark and not passed directly to the client plan.
The complaint also alleges that Caremark restocked and reshipped previously dispensed drugs that had been returned to Caremark’s mail-order pharmacies.
The states participating in the settlement with Illinois and Maryland are Arizona, Arkansas, California, Connecticut, Delaware, the District of Columbia, Florida, Iowa, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia and Washington.

Lloyd Knudsen's speech to STRS Board, February 14, 2008

My name is Lloyd Knudsen. I was a 30-year teacher in the Woodridge Local Schools of Summit County. I did not attend the two day STRS January retreat but did receive several e-mail summaries of the proceedings. I would like to offer a few retiree observations on the governance issues that were discussed.
On recurring theme of the retreat presenters was that the STRS Board should be "policy-focused" rather than "operationally-focused." That philosophy sounds good; however, oftentimes the two are intertwined. Let me give you an example.
Board members are asked by the Executive Director to approve an "operating" expense (like paying for an STRS associate's legal fees). A Board member questions whether this is a proper "operating" expenditure according to established Board "policy" or expresses his uncertainty whether this expense is even covered under established Board policy. Is this Board member doing his fiduciary duty to our STRS system or is he just being a "micromanager"?
The retreat presenters emphasized that Board members need to be ACTIVE OVERSEERS of Board policies by asking the right questions of STRS staff; that Board members must act at the level of prudent experts in all STRS matters; and that Board members cannot abdicate their duties to the STRS staff. One presenter summarized it all by saying Board members are "ultimately responsible for everything" done at STRS.
So let me ask the question again. Is the Board member who questions an STRS action or expenditure that he believes to be wrong doing his fiduciary duty to our STRS system or is he just being a micromanager?
A second theme of the retreat noted the acrimonious relationship among Board members and the adversarial tone many STRS meetings have taken. We've had Boards in the past where "never was heard a discouraging word" among members. Please don't mistake Board meetings that are quiet and friendly for effectiveness.
Some of our past Boards quietly spent our pension money on lavish parties and trips for themselves; some of our past Boards quietly accepted gifts for themselves from our STRS vendors and then quietly had to defend themselves in court; many of our past Boards quietly did nothing to head off our impending health care fund crisis; another past Board quietly hired former Executive Director Herb Dyer, who quietly proclaimed STRS needed to get out of the health care business altogether; and finally, another past Board had to quietly show Mr. Dyer the door. However, not before handing him his half million dollar going away present that yet another past Board had quietly negotiated. I repeat: don't mistake quiet and friendly with effectiveness.
If a Board member is fighting for me and my fellow retirees, I expect at times voices to be raised and feelings to get hurt. As your retreat presenters emphasized, your job is to be ACTIVE OVERSEERS of all things STRS. Sometimes active oversight is neither quiet nor friendly.
Hopefully this Board will hire the next Executive Director who is not threatened by a major challenge such as restoring our health care program or a minor challenge such as having a few active overseers on this Board. The candidate who balks at these challenges is not the right man or woman to lead STRS.
Another governance issue I would like to comment on is this idea of our STRS Board needing to present a "unified public face" or, as OEA puts it, "speak with one voice". I agree it would be an extremely positive action for this Board to unanimously approve our next Executive Director. However, on all other Board votes I don't see the importance of everybody agreeing. Who speaks for this Board? The majority vote on each particular topic speaks for this Board whether the vote is 10-0 or 6-4.
One point of comparison, our United States Supreme Court has nine justices on it. They vote on far more important national issues than STRS Board members do. Yet when the final court vote is 5-4, for example, the majority publishes their rationale for voting AND the minority publishes theirs, too. STRS Board members do not need to apologize for how they cast their vote.
Let me conclude by saying this Board spent a good part of your retreat listening to presenters who advised you to work together, to respect one another and to foster an atmosphere of collaboration. I'm sure you all nodded your heads in agreement and promised to try harder. Yet that very afternoon, after Dr. Leone left your meeting early, the remaining Board members passed a resolution that made a mockery of that promise. It's easy to talk the talk. But this board failed miserably in its first test of actually walking the walk.
Thank you for letting me speak to you today.

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Happy Valentine's Day!
For all the wonderful "worker bees" at STRS........
....THANK YOU!!!!!

Wednesday, February 13, 2008

Express Scripts and the Land of Tron

From Duane Tron, February 13, 2008
Subject: Re: Expressly the Land of Tron!
Dear Active & Retired Educators,
In the "Land of Tron" I have met the enemy of sanity and normalcy and they aren't mine yet! Expressly stated, I am in awe at the level of incompetence that we encounter, endure, and tolerate all in the name of being expressly older. The express purpose of this e-mail is to apprise you of the adventures I have encountered with our new PBM provider, "Express Scripts." As I told many prior to the change from Caremark, be careful what you wish for as we might get it. It? It? It is expressly here and "IT" is called Express Scripts.
For starters there isn't anything express about Express Scripts. When I sent my first prescription for my essential and life sustaining blood pressure medication, "The Land of Tron" expressly encountered the enemy to health and mental well-being for the first time, Express Scripts. To try and explain the horror story I encountered is too lengthy and difficult to expressly and fully explain here. Suffice to say I paid for a 15 day prescription of my blood pressure medication at a cost of $33.29 for 15 pills to get me through until Express Scripts which is anything but express sent me my refills.
I expressly contacted Express Scripts to try and find a remedy for the confusion and mess that I found myself mired down in. I wisely contacted Dennis Leone and he went to work for me and as my 15 day supply was running out my essential medications arrived. The intervention by the fine support staff at STRS came to the rescue. Between Dennis and Brenda Foster, at STRS, they worked to get the derailed Express Scripts train back on the tracks.
This morning a gentleman named, Phil, called from Express Scripts to inform me that he had contacted CVS and I could go and receive a full refund for the 15 pills I paid $33.29 for during the Express Scripts lack of express deliverance of my essential medications. I was flattered that they were going to pay CVS so I could receive a full refund since an Express associate told me they couldn't pay for the 15 pills as they had already started filling my prescription, which incidentally didn't arrive for almost two weeks. Mr. Phil, pardon the pun, informed me they couldn't quite figure out where my prescriptions had been for weeks. He asked me if everything was all right and I told him, "Yes!"
Of course that was expressly before I received the mail with my next prescription which I had to pick up at the post office. I told everyone involved that things were fine and we had it all worked out. I expressly over spoke. You see when I opened the package containing my nasal spray I embarked on my next Express Scripts adventure. Did they send me the correct medication? Yes! Do the medication bottles provide the correct name? Yes! Ah! Then I looked at the statement and it was billed to someone I don't even know and listed the last four digits of my Visa card number on the statement. If any of you know a Stephen Linebaugh please notify him that he probably has my statement with the last four digits of his credit card number on my bill as I have his statement with the last four digits of my credit card on his statement. Only in the "Land of Tron." In addition, The billing statement has his Member ID # so his statement probably contains my Member ID #.
Folks, if you want an adventure please feel free to follow me in this newest adventure from the "Land of Tron." This puppy is going to get really interesting! Dennis I know you're reading this and I will call Brenda the first thing in the morning and let her know what happened this time. I expressly started to get really angry and then I thought, "this is so bizarre that it is becoming funny. It's like a bad express script from a lousy B-movie."
I think they are expressly trying to provide so much unnecessary stress in my daily life as to place my physical well-being on the express track to the next life. I think this might be a well thought out program to reduce PBM expenditures and expressly create greater profits. I'm sitting here looking at this bill with the express thought that Express Scripts isn't express in anything. They aren't on the express track in much of anything as far as I'm concerned. Upon looking at this mess I expressly REFUSE to die! I intend to be around for the express purpose of making their lives as miserable as they seem to be trying to make mine. This is expressly a promise. The scary part in all of this? I don't think they're doing any of this on purpose and that makes things expressly more scary! My best advice to all is make sure and check each and every prescription you receive and double check the bills and everything. If you want to live an abundant and quality life in your older years I expressly suggest you expressly and carefully check each and every prescription you receive from Express Scripts.
Folks, please understand that this is all too bizarre to expressly try and make up. If you know Stephen Linebaugh please ask him to contact me as he might not realize what has happened. I am actually sitting here laughing right now! The next time someone raises the question as to why so many Americans expressly experience hypertension just refer them to this correspondence and let them read it. It will answer any silly questions that people might expressly pose regarding the high number of people expressly experiencing hypertension.
Sincerely & Expressly Yours,
Duane E. Tron, CCR

Blue Cross now requesting data from MDs so they can cancel patients' policies

Sent to John Curry, from Elfrieda Ramseyer, February 13, 2008
Must reading for anyone concerned with the health care delivery system. Blue Cross asking docs to review patients’ applications for coverage, looking for errors/omissions, and to report back to the insurer. To those in office who fear a huge government-run system — my question is, What is your alternative plan to fix it? JC
February 12, 2008
Doctors balk at request for data

Physicians object to a letter from Blue Cross seeking information that could lead to policy cancellations.
By Lisa Girion / Los Angeles Times Staff Writer February 12, 2008
See the letter from Blue Cross here. (PDF file, 1 page)
The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage.
Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies."
"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.
The letter wasn't going down well with physicians.
"We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said Dr. Richard Frankenstein, president of the California Medical Assn.
Patients "will stop telling their doctors anything they think might be a problem for their insurance and they don't think matters for their current health situation," he said. "But they didn't go to medical school, and there are all kinds of obscure things that could be very helpful to a doctor."
WellPoint Inc., the Indianapolis-based company that operates Blue Cross of California, said Monday that it was sending out the letters in an effort to hold down costs.
"Enrolling an applicant who did not disclose their true condition (and the condition is chronic or acute), will quickly drive increased utilization of services, which drives up costs for all members," WellPoint spokeswoman Shannon Troughton said in an e-mail.
"Blue Cross feels it is our responsibility to assure all records are accurate and up to date for HMO providers," she said. "We send these letters to identify members early on in the process who may not have been honest in their application."
Blue Cross is one of several California insurers that have come under fire for issuing policies without checking applications and then canceling coverage after individuals incur major medical costs. The practice of canceling coverage, known in the industry as rescission, is under scrutiny by state regulators, lawmakers and the courts.
Patients in a raft of lawsuits accuse the insurers of canceling coverage over honest mistakes and minor inconsistencies on applications that they contend are purposely confusing. Victims of cancer and other serious medical problems often are unable to get new coverage once their insurance has been rescinded and they may go without treatment when they need it most. Suddenly swamped by medical debt, some people have lost homes and businesses.
Insurers say the cancellations are an important weapon against fraud and occur rarely.
Physician groups and doctors who received the letter told The Times they never had seen anything like it. Also unfamiliar with such letters was Don Crane, executive director of the California Assn. of Physician Groups, which represents many of the large HMO-style medical groups.
"I have not heard any dialogue on this business of underwriting or ferreting out existing" conditions, Crane said.
But WellPoint's Troughton said this was nothing new. "This is something that has been in place for several years and to date we have not received any calls or letters of concern for this service," she said.
It was important, Troughton added, "to note that participation in this outreach effort is voluntary on the part of the physicians."
The California Medical Assn. sent a letter to state regulators Friday urging them to order Blue Cross to stop asking doctors for the patient information, saying it was "deeply disturbing, unlawful, and interferes with the physician-patient relationship."
The letters go out to some physicians who care for Blue Cross' share of the state's estimated 3 million people with individual policies.
Troughton said Blue Cross sent the letters to medical groups that operate, in effect, as health maintenance organizations. Blue Cross pays such groups a set amount per patient each month. With a few exceptions, the groups are then responsible for arranging and providing patients' medical care and take on a substantial piece of the risk.
Troughton said "in the past" physicians in such medical groups had requested information on patients' pre-existing medical conditions because anything that had not been disclosed could affect the medical group's finances.
She disputed the notion that the letters could improperly breach patient confidentiality. She said the sharing of medical information with medical groups was within federal law because it fell under "patient, treatment and operations" guidelines.
Blue Cross doesn't always cancel the policies of patients with discrepancies in their applications, Troughton noted. Sometimes it may offer them another plan, she said.
Lynne Randolph, a spokeswoman for the state Department of Managed Health Care, said the agency would review the letter. Blue Cross is fighting a $1-million fine the department imposed in March over alleged systemic problems the agency identified in the way the company rescinds coverage.
A spokesman for state Insurance Commissioner Steve Poizner said the Insurance Department had not received any complaints about Blue Cross' letter. But because the medical association had sent a copy of its complaint to the department, the letter is "on our radar now," spokesman Byron Tucker said.
The letter is "extremely troubling on several fronts," Tucker said. "It really obliterates the line between underwriting and medical care. It is the insurer's job to underwrite their policies, not the doctors'. Doctors deliver medical care. Their job is not to underwrite policies for insurers."
Anthony Wright, executive director of HealthAccess California, a healthcare advocacy organization, said the letter had put physicians in the "disturbing" position of having to weigh their patients' interests against a directive from the company that, in many cases, pays most of their bills.
"They are playing a game of 'gotcha' where they are trying to use their doctors against their patients' health interests," Wright said. "That's about as ugly as it gets."
Larry KehresMount Union Collge
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