Author: Serkadis

Congress is at an impasse over how to fix a perennial problem in Medicare.

Just about every year a formula glitch threatens to cut payments to doctors who treat seniors and the disabled. And just about every year Congress cancels the cut. This year lawmakers are complaining about the bill because it’s not paid for. But, despite what both Republicans and Democrats are claiming, that’s nothing new.

Permanent Fix Falls Short

Rather than do another one or two year patch for the Medicare doctor pay cut problem, Senate Democrats had wanted to fix the problem permanently. But their bill couldn’t even make it to the Senate floor — it fell short on its first procedural test last Wednesday by 13 votes. The reason cited by virtually every opponent was that the bill’s $250 billion, ten-year cost wasn’t paid for with other spending cuts or increased taxes.

New Hampshire Republican Senator Judd Gregg is among the opponents of the bill. “We’ve only done yearly fixes in this area, the doctor fix, because it’s a pretty difficult number to always pay for, but we have always paid for it,” he said on CNN last Sunday.

Except that Congress hasn’t always paid for it. In fact, when Republicans were in charge, they did cancel the Medicare cuts to doctors, but rarely paid for them. Just before turning control of Congress back to the Democrats at the end of 2006, Republicans actually tucked legislation to cancel the next year’s doctor pay cut into a catch-all tax bill that wasn’t paid for either. And then-Senate Budget Committee Chairman Judd Gregg was one of the people who complained the loudest.

“You just have to ask yourself how we, as a party, got to this point, where we have a leadership which is going to ram down the throats of our party the biggest budget buster in the history of the Congress under Republican leadership,” said Gregg back in 2006.

Bipartisan Memory Loss

But Republicans don’t have a lock on short-term memory problems. Here’s how White House Press Secretary Robert Gibbs responded when he was asked about the issue last Thursday: “The cut in payments to doctors is something that is to be implemented every year; and gets fixed every year for the past six years. The president included in his budget fixing for and paying for that fix,” said Gibbs.

Except Gibbs was only half-right. President Obama’s budget does propose to fix the payment problem in that it would cancel next year’s Medicare cut for doctors and cuts into the future. But it doesn’t propose to pay for the added costs.

In fact, back in March, White House Budget Director Peter Orszag testified before a House Committee that the proposed fix could cause the federal deficit to be as much as $400 billion higher over the next decade.

TULSA, Okla. — An hour into knee replacement surgery — with U2’s I Still Haven’t Found What I’m Looking For playing in the background — Dr. Yogesh Mittal smiles as he raises the left leg of his patient, 76-year-old Frank Morrow.

While holding Morrow’s thigh, the surgeon lets the bottom half of the leg fall. “Look at that,” he says, pointing to the wide range of motion permitted by the metallic-colored implant. “He’s going to love this new knee.”

Medicare, the government program that is paying for Morrow’s surgery, likes it, too.

The surgery at the 691-bed Hillcrest Medical Center here is part of an experiment testing a new “bundled” payment system. Medicare makes a single reimbursement for all the hospital and doctor care for heart and joint procedures, rather than making separate payments to the facility and physicians.

Such combined payments are getting close attention during the health care debate as a way to encourage hospitals and doctors to work together to hold down costs and improve care.

Bundling payments moves medical charges away from the traditional fee-for-service system that pays providers separately for individual services — an arrangement critics of the current system say leads to doctors and hospitals delivering more care, but not better care.

“The current payment system is not designed to drive efficiency,” says Harold Miller, chief executive of the Network for Regional Healthcare Improvement in Pittsburgh. For example, he says, it rewards providers for making mistakes that require additional procedures or result in hospital readmissions.

Health-overhaul bills being debated in Congress would promote bundling by calling for more Medicare pilot projects such as the one at Hillcrest and allowing Medicare to expand the concept if they are successful. Any success in the Medicare arena could have far-reaching implications because the health program for the elderly makes up 20% of the nation’s total health spending.

Some physicians have raised concerns about the bundling experiment. Larry Martinelli, an infectious disease specialist in Lubbock, Texas, and past chairman of the Infectious Disease Society of America’s clinical care committee, says he fears that bundling payments would pressure hospitals to try to save money by bringing on fewer specialists to consult on patients. “The idea is worrisome,” he says.

Hillcrest’s Dobbs acknowledges that surgeons are looking more closely at when to bring in specialists or order tests.

“I see more focus than I saw in the past,” he says, adding that patient care has improved under the program because of closer attention to quality.

Patients paid up to $1,157 

Under the pilot project, Medicare is saving 4.4 percent on the base rates for heart and joint surgeries at Hillcrest because the hospital is offering a discount. For Morrow’s knee replacement, for example, the government is paying $13,211, about $450 less than it normally would.

Meanwhile, Morrow, who is eager to get back to playing basketball, gets a portion of the savings from Medicare — $271 as an incentive for going to a hospital that participates in the program.

The three-year experiment, which began in May, is occurring at five hospitals identified by Medicare for high-quality, cost-efficient care. All competed to get in to program by offering discounts to Medicare.

Besides Hillcrest, Baptist Health System in San Antonio is taking part, while hospitals in Denver, Albuquerque and Oklahoma City are expected to begin participating later this year. Patients who use the hospitals for most heart and orthopedic procedures are paid up to $1,157 for participating, with the bigger amounts pegged to more complicated cardiac surgeries, such as heart-valve replacements.

The incentive payment is supposed to help drive higher admissions to the hospitals in the program, and the pilot is designed to test whether paying Medicare beneficiaries from $250 to $1,157 sways their choice of facilities.

For Frances Carman, 79, of Pawhuska, Okla., who had knee-replacement surgery in July, the $271 payment helped “seal the deal” to go to Hillcrest. “I live on a fixed income, so that extra money will come in useful in helping get my car fixed,” she says.

But Morrow says he didn’t know about the incentive payment until after he registered for the surgery. He says he chose Hillcrest because that’s where Mittal wanted to operate. “Getting money back will be nice,” he says, “but that is not the main reason I came here.”

François de Brantes, CEO of Bridges to Excellence, a national program focused on rewarding physicians for better quality care, credits Medicare for trying a new strategy.

He doubts whether Medicare beneficiaries will be swayed by the limited incentive payment. However, he says, “at least this sends a good signal” that the Centers for Medicare & Medicaid Services “is trying to change the status quo away from fee-for-service to integrated care.”

‘We can save a lot of money’

The health care bill that the Senate Finance Committee approved earlier this month calls on Medicare to start a “bundling” project by 2013 that could involve many different types of health providers, including hospitals, doctors, home health agencies, rehabilitation facilities and nursing homes.

President Obama also supports bundling. In a June speech to the American Medical Association, he said the Medicare payment system should be changed so “you aren’t paid for every single treatment you offer a patient with a chronic condition like diabetes, but instead are paid for how you treat the overall disease.”
Even so, the strategy faces challenges. Because hospitals disburse the “bundled” Medicare dollars, Martinelli and some other doctors worry about the hospital being responsible for their payments.

“Hospitals are going to take care of themselves and their employed doctors first and then at the end of the day comes the doctors in private practice,” he says.

Hillcrest doctors, including Mittal, say that has not been an issue. The hospital says it pays its doctors under the program within 21 days, just as it did before the pilot project.

Some health experts are skeptical that bundling will have a major impact on rising costs any time soon.

“Changing the payment system and changing the delivery system is very hard,” says Bruce Vladeck, who ran the Medicare program during the Clinton administration and is now a senior advisor at Nexera Inc., a consulting service owned by the Greater New York Hospital Association. “Medicare will be broke long before we get there.” Medicare in 2017 will be paying out more money than it takes in, government projections show.

Yet proponents say bundling could make a big difference. “If we can deliver care more efficiently, we can save a lot of money,” Miller says.

Win, win, win

In the surgical pilot project, the five participating hospitals give the government discounts of 1 to 6 percent off Medicare rates for some common inpatient orthopedic and cardiac procedures. The hospitals hope to more than make up for the price cuts by lowering costs and luring more patients with the incentive payment.

At Hillcrest, hospital officials and doctors say that the project is forcing them to pay closer attention to costs. By driving tougher deals with makers of implants and other devices, for example, the hospital has cut costs for knee replacement and heart-valve surgery by 5 percent, says CEO Steve Dobbs, adding, “We see the program as a win, win, win.”

The hospital has made a slight profit on the 415 patients — 295 cardiac and 120 orthopedic — that it treated through Sept. 30, Dobbs says. Hillcrest officials say their orthopedic cases are up 2 percent this year and cardiac cases are up 27 percent, but they don’t know whether that’s because of the bonuses or the fact that the hospital just spent millions to improve its facilities.

Hillcrest’s doctors were guaranteed their regular surgical fees as part of the pilot project. But they also get a an additional 25 percent bonus payment from Medicare if they keep costs down while maintaining high-quality scores in areas such as low infection and readmission rates.

“Before, I had no incentive to get costs down,” says Mittal, chief of orthopedic surgery. “Now, I do.”

He says he helped persuade the medical staff to stop using costly antibiotic cement for hip and knee implants rather than the standard version, saying there was no evidence the more expensive adhesive worked better in preventing infections.

Hillcrest doctors also have reduced the number of surgical drapes and disposable drill pins they use and have worked with the hospital to negotiate bigger discounts on certain brands of implants, stents and other supplies.

However, some costs have gone up under the project. Hillcrest, which is owned by the for-profit Ardent Health Services, based in Nashville, estimates it has spent $480,000 on the program for claims processing, printing brochures and advertising on television and radio.

“We’ve learned a lot from this program and we are more efficient and safer than we were before,” says Wayne Leimbach, Hillcrest’s chief of cardiology. “But all the extra manpower to get there is not worth the benefit if we are only a little better financially.”

Medicare tried the bundling concept with coronary bypass surgery in the mid-1990s. The program saved $42.3 million over three years, with costs decreasing from 10 to 37 percent at the four hospitals participating in the test. But the hospitals saw no increase in business. That experiment didn’t include an incentive payment for Medicare beneficiaries to use the test hospitals.

Five weeks after his knee replacement surgery, Morrow is still in frequent pain as he waits for the swelling in his knee to go down. But there is progress, too. He’s just graduated from a walker to a cane and has started driving again.

“I didn’t think I would be in this much pain, but they said it’s like having a baby and that when it’s all over you won’t remember it,” Morrow says. “I’m hanging in there and they tell me the knee looks great.”

Top White House advisor Christina Romer said that health reform would help to ease the deficit at a speech today. Reuters reports: “While some critics say Democrats’ efforts to regulate the insurance sector should wait until the deficit is under control, they should instead see it ‘as the most significant act we could take to tackle the deficit,’ Romer said in speech to the Center for American Progress, a Washington-based think-tank” (Heavey, 10/26).

The Wall Street Journal Blog reports that Romer, who heads the president’s Council of Economic Advisors, spoke about the fiscal benefits of the White House’s health care agenda and said: “‘It is fiscally irresponsible not to do health-care reform. … To bury our head in the sand for even one more year and pretend that the problem of rising government health-care expenditures will go away is simply untenable.’”

“Earlier this month, the U.S. Treasury Department reported the fiscal year 2009 deficit was $1.4 trillion, or about 10% of Gross Domestic Product. That’s the U.S.’ biggest budget deficit since World War II. Meanwhile, in August, the Obama administration estimated that a cumulative deficit over the 10-year budget window from 2010 to 2019 would reach $9 trillion. … With deficits potentially becoming a key 2010 campaign issue, the gloomy fiscal outlook could complicate Democrats’ legislative efforts, including hopes to overhaul health care. Still, Romer on Monday defended the Obama administration’s $787 billion fiscal stimulus program and the federal government’s financial-bailout program. She pinned most of the blame for the latest projected deficit on policy actions taken during the Bush administration” (Randall, 10/26).

Meanwhile, ABC News reports that Romer touted the “Cadillac Tax” as a critical part of reform: “President Obama’s chief economic forecaster went to bat on Monday for a tax on high-priced insurance plans, the so-called ‘Cadillac tax,’ calling it ‘probably the number one item that health economists across the ideological spectrum believe is likely to stem the explosion of health-care costs.’” Romer said such a tax would encourage employers and employees to be more vigilant health care consumers. “Romer’s full-throated endorsement of the ‘Cadillac tax’ keeps the Obama administration at odds on this issue with some of its closest allies. Organized labor has made killing the ‘Cadillac tax’ a top priority and more than half of House Democrats have signed a letter to Speaker Nancy Pelosi urging her not to include a ‘Cadillac tax’ in health-care legislation.”

Romer talked about how the tax should be designed, noting that “a handful of ideas were under consideration by Congress including: (1) making special provisions for high-risk occupations such as firefighters; (2) taking regional differences in health-care costs into account “for a period of time”; and (3) making special provisions for firms with older, more costly workers. … Among the multiple ideas touted as cost savers during her speech, Romer touted the capacity of a public insurance option” (Davis, 10/26).

Heard Verizon’s DroidDoes.com webpage has had over 2.5m pageviews and around 170k email opt-ins in about three days. Entire Storm launch last year is said to have been around 350k email opt-ins.

This video here came up on YouTube earlier, and what do you know, it’s Modern Warfare 2 (Xbox 360, PS3, and PC). Or so the video claims. Game info at …

The Pennsylvania home health care company Linda Bettinazzi runs is charged about $6,800 per worker for health insurance – $2,000 more than the national average for single coverage. One reason: nearly every one of her 175 employees is a woman.

Insurers say women under the age of 55 cost more to cover because they use more health services, and not just for maternal and infant care. But Bettinazzi, the president and CEO of Visiting Nurse Association of Indiana County, believes there’s something inherently wrong in charging her company more because it hires a lot of women.

“There’s a great sense of unfairness,” Bettinazzi says. “I feel angry, and maybe betrayed would be a good word.”

Gender rating is the norm today, part of a complex formula of risk factors – including health history and age — insurers say has been necessary to fairly price policies. But advocacy groups for women argue that charging more for women than men is discriminatory and should be illegal.

The battle is playing out on Capitol Hill through the debate on health overhaul legislation. If a new law results in nearly all Americans having to carry insurance, the industry has said it would agree to end rating based on gender and health status in sales of policies to individuals and small groups. But the leading industry trade group and some of its legislative allies have balked at ending such rating in the group market where larger employers purchase coverage.

The House health care overhaul bill and legislation approved by the Senate Health, Education, and Labor Committee treat the large group market much the same as the individual and small group markets, banning insurers from setting rates based on the gender and health status of applicants, and limiting how much more insurers can charge based on age.

But the Senate Finance Committee bill would allow insurers to continue to consider the gender, health status and age of workers when setting premium rates for businesses with more than 50 or 100 employees, depending on each state’s definition of a large business. Those opposed to gender rating are putting pressure on Senate leaders as they try to blend the Finance and health panel bills. The fight may not end there as senators and House members will be able to offer amendments to health overhaul legislation once the bills reach the floor in each chamber.

“Discriminatory insurance practices, such as gender rating, should be abolished across all markets – individual and group,” says Sen. Barbara Mikulski, D-Md., a senior member of the health committee. “A woman should not face discrimination based on something arbitrary like the size of the employer she works for.”

Insurers and brokers who sell policies readily defend current rating practices in the group market. “Insurance is about risk, and we can demonstrate objectively that women are a higher risk,” says Henry Stern, an insurance broker near Dayton, Ohio. “If you don’t base it on risk, you don’t have insurance. You have income redistribution,” meaning others would have to pay more.

When setting premium rates for a large employer, insurers try to assess the overall risk of the group. They gather as much data as possible about employees, including their demographics, health status, recent health costs, geographic location and whether their jobs are high risk. All of that information is evaluated to determine how much the group is likely to cost in a given year, and therefore how much the insurer should charge the employer in premiums.

Stern, who also writes the popular InsureBlog, points to “morbidity tables” that insurers use to calculate risk, which show that, until their mid-50’s, women cost significantly more than men. For example, according to the risk chart of one major insurer, the average 25- to 29-year-old woman generates nearly three times as much medical spending as men of that age.

Studies cite, among other costs, maternity and reproductive care that requires mammograms, Pap smears and regular doctor visits. Women also use more prescription drugs and may have to contend at younger ages with cervical cancer and breast cancer.

Bettinazzi says she’s heard all this from her broker: “It was sort of like, why would you even be asking the question? You’re all women, you’re having babies, you’re getting sick, you’re hurting your backs.”

By contrast, Stern says, young men are seen as “free money to the insurance company,” because they are unlikely to use many services. But starting at about age 54, men start to show greater signs of wear and tear, such as heart attacks, prostate cancer and colon cancer, and begin to cost more than their female counterparts.

If a health care overhaul bill becomes law, insurers would potentially have millions of new customers as most Americans would be required to have insurance. And America’s Health Insurance Plans (AHIP) says in that situation they would stop rating for health status and gender in the individual and small group markets. But they want to retain the ability to rate bigger employers because they fear some otherwise will self-insure, believing that would be cheaper than buying coverage from insurers. Those employers would no longer get the discount they can get now if they have a work force that uses less health care.

Another industry group that represents insurance agents, the National Association of Health Underwriters, supports eliminating gender rating for all markets, as long as there is a strong requirement that all Americans carry insurance, says Jessica Waltman, senior vice president of government affairs. Nonetheless, she says, the costs of covering higher users of medical services “aren’t going to go away. They’ll get shifted to someone else.”

The issue of rating in the large group market is being scrutinized as senators try to merge the Finance and health committee bills, aides say. Lawmakers are under pressure from all sides.

The National Women’s Law Center has been publicizing the issue with a campaign called “Being a Woman Is Not a Pre-Existing Condition.”

Women already make less money than men, says Judy Waxman, vice president for health and reproductive rights, and to force them to also pay more for health insurance is blatantly unfair. Moreover, the extra money an employer must pay to insure a group of women often gets passed along to workers in the form of higher premiums and deductibles. “It’s time to level the playing field,” she says.

Sen. Mikulski, for her part, has gotten 24 colleagues to sign on to a letter urging a ban, in all markets, on gender rating and other practices viewed as discriminatory.

Some experts say gender rating doesn’t make sense in part because of the fine line separating legislative definitions of small and large groups. Under the Finance bill, for example, a large group can be as small as 51 employees. “A large group is just one more than a small group. It’s just 51,” says Karen Pollitz, project director at Georgetown University’s Health Policy Institute.

For Bettinazzi and her organization, insurance rate relief can’t come fast enough. This year, for the first time, VNA is asking employees, who were paying nothing, to foot a small part of the premium bill. Some members of the board of directors are advocating a change to high-deductible, less expensive policies.

Premiums now account for 8 to 10 percent of annual revenue, says Bettinazzi, and that is “unsustainable.”

Sony’s PlayStation House Tour is on the move and right now, it’s in the UK hopping from one city to the next, showcasing all their best titles. And ye…

 Help wanted. That’s the cry of help from Electronic Arts’ Boom Blox team. Looks like we’re gonna see it landing on the PS3 and Xbox 360 some tim…

A rumor is making the rounds that the White House and Senator Reid are pursuing different strategies on the public option.  Those rumors are absolutely false.

In his September 9th address to Congress, President Obama made clear that he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition.  That continues to be the President’s position. 

Senator Reid and his leadership team are now working to get the most effective bill possible approved by the Senate. President Obama completely supports their efforts and has full confidence they will succeed and continue the unprecedented progress that is being made in both the House and Senate.

Dan Pfeiffer is Deputy Communications Director

Examiner: “House Speaker Nancy Pelosi (D-CA) intends to bring the legislation to the floor early this week, but Pro-life Representative Bart Stupak (D-MI) and a posse of conservative Democrats might just throw a wrench in Pelosi’s plans. Stupak recently told CNSnews.com that he and 40 Democrats are prepared to unite with Republicans in an attempt to make sure that the health reform bill doesn’t see the light of day on the House floor until consideration is given to an abortion amendment he wants to offer into the legislation” (Williams, 10/25).

The Hill: “Stupak, who is conservative on social issues, told CNS News that he has organized the voting bloc to support his amendment that would strip the abortion provisions from the legislation. House Rules Committee chairwoman Louise Slaughter (D-N.Y.), according to Stupak, said that there is ‘no way’ her panel would provide a vote for his amendment. The group of 40 would join House Republicans in voting against procedural measure that would draft rules for debating the bill on the House floor. Passage of the measure is necessary for the House to hold a floor vote. … With 177 Republicans in the House, Stupak would need at least 41 Democrats to cross the aisle and vote against the rule. Stupak’s amendment was originally defeated by the House Energy and Commerce Committee during mark-up” (Fabian, 10/24).

NPR‘s Scott Simon interviewed health policy correspondent Julie Rovner about the controversy: “Now, the main deal that’s now in both the House and Senate bills was cut in the House Energy and Commerce Committee back in July. … The idea, remember, is to write language that freezes in place current law on abortion. So, the amendment says that all funds that will pay for abortion will have to come from premiums paid by individuals, not from the federal government. That within each ‘exchange’ – these are the new marketplaces where people will go to buy their insurance, if they buy it on their own or if they’re small businesses – in each exchange, there’ll be one plan that does offer abortion as a benefit and one that doesn’t. And that, in any case, funds that will pay for abortion will have to be segregated from any federal funds” (Rovner, 10/24).

St. Petersburg Times’ Politifact put some of abortion claims through the Web site’s “Truth-o-Meter: “Republican John Boehner said that the Democrat-backed House proposal ‘will require (Americans) to subsidize abortion with their hard-earned tax dollars.’ We found that the federal government will not send tax dollars to abortion providers, so we rated his statement False. However, we found that health care plans that receive public money to help low-income people pay for insurance will be able to offer abortion coverage if those particular services are paid for with patient premiums, not the subsidies. So the National Right to Life Committee earned a True for its statement that a Senate bill ‘contains provisions that would send massive federal subsidies directly to both private insurance plans and government-chartered cooperatives that pay for elective abortion’” (Drobnic Holan, 10/25).

The inclusion of both Wi-Fi and a microphone on the DSI made it a favorite for rumors about phone functionality — and while we’ve seen voice chat in some games, there hasn’t been an official channel for that that I know of. But if new rumors, based on a support page mentioning a DSi Speak Channel, are true, then the most popular handheld in the world will be joining the most popular console in the world in having serious voice chat functionality.

The sentence that set off the rumor:

To redeem a Nintendo DSi Download Ticket number, such as for the Nintendo DSi Speak Channel, enter the number off the Nintendo DSi Download Ticket in “Settings and Features” off of the main Nintendo DSi Shop page, then select “Nintendo DSi Download Ticket.

Sounds pretty serious to me. And after all, Nintendo has been pushing that Wii Speak thing, though I don’t recall hearing about anybody using it ever. Probably because calling your friends on your Wii is just a little too weird. On the DSi, however, it could be really convenient. Say hello to DSiPhone.

Of course, Nintendo has responded saying it’s just a rumor — yeah, we knew that. But they didn’t deny it, so it’s probably true.

[via Edge and 1up]

Apollo Global Management has completed its tender offer for all of the outstanding shares of common stock Midland, Texas-based Parallel Petroleum Corp. (Nasdaq: PLLL). The total deal is valued at approximately $438 million, or $3.15 per share, including the assumption or repayment of around $351 million in debt. Apollo’s equity commitment is $283.2 million.

PRESS RELEASE

Parallel Petroleum Corporation (“Parallel”), PLLL Acquisition Co. and PLLL Holdings, LLC, entities formed for the purpose of acquiring Parallel Petroleum Corporation (NASDAQ: PLLL) and wholly owned subsidiaries of an affiliate of Apollo Global Management, LLC, today announced the completion of the tender offer for all of the outstanding shares of common stock of Parallel, including the associated preferred stock purchase rights (collectively, the “Shares”).

The initial offering period and withdrawal rights expired at 12:00 midnight, New York City time, on Thursday, October 22, 2009. Computershare Trust Company, N.A., the disbursing agent for the tender offer, has advised that a total of approximately 35,244,824 Shares were validly tendered and not withdrawn (including approximately 802,359 Shares subject to guaranteed delivery) prior to the expiration of the initial offering period, representing approximately 84.62% of the outstanding Shares. In accordance with the terms of the tender offer, PLLL Acquisition Co. accepted for payment all Shares that were validly tendered and not withdrawn prior to the expiration of the tender offer, and payment for such Shares will be made promptly in accordance with the terms of the tender offer.

PLLL Acquisition Co. and PLLL Holdings, LLC announced today that they would make available a subsequent offering period commencing immediately and expiring on Thursday, October 29, 2009 at 5:00 p.m., New York City time for all the Shares not tendered into the offer prior to the initial expiration date. During the subsequent offering period, PLLL Acquisition Co. will accept for payment and promptly pay for the Shares as they are tendered. Stockholders who tender Shares during such period will receive the same $3.15 per Share price, without interest and subject to applicable withholding taxes, that was paid in the tender offer. Procedures for tendering Shares during the subsequent offering period are the same as during the initial offering period with two exceptions: (1) Shares cannot be delivered by the guaranteed delivery procedure and (2) pursuant to Rule 14d-7(a)(2) under the Securities Exchange Act of 1934, as amended, Shares tendered during the subsequent offer period may not be withdrawn.

During the subsequent offer period, Parallel may issue Shares to PLLL Holdings, LLC at a price of $3.15 per Share in accordance with the terms of the merger agreement by and among PLLL Acquisition Co., PLLL Holdings, LLC and Parallel, dated as of September 15, 2009 (as amended, the “Merger Agreement”). These Shares, when added to the number of Shares owned by PLLL Acquisition Co. as a result of the initial offer period and the subsequent offer period, may result in PLLL Acquisition Co. owning more than 90% of the number of shares of Parallel common stock then outstanding. In such case, PLLL Holdings, LLC and Parallel would effect the merger in accordance with the short-form merger provisions of the Delaware General Corporate Law, without prior notice to, or any action by, any Parallel stockholder.

PLLL Acquisition Co. and PLLL Holdings, LLC reserve the right to extend the subsequent offering period in accordance with applicable law and the terms of the Merger Agreement. After expiration of the subsequent offering period, PLLL Acquisition Co. will acquire all of the remaining outstanding Shares by means of a merger under Delaware law. As a result of the purchase of Shares in the tender offer, PLLL Holdings, LLC has sufficient voting power to approve the merger without the affirmative vote of any other Parallel stockholder. In the merger, each Share not previously purchased in the tender offer will be converted, subject to appraisal rights, into the right to receive the same $3.15 per Share price, without interest and subject to applicable withholding taxes, that was paid in the tender offer. After the merger, Parallel will be a wholly owned subsidiary of PLLL Holdings, LLC and Parallel’s common stock will cease to be traded on the NASDAQ Global Select Market.

About Apollo

Apollo is a leading global alternative asset manager with offices in New York, Los Angeles, London, Singapore, Frankfurt and Mumbai. Apollo had assets under management of over $38 billion as of June 30, 2009 in private equity and credit-oriented capital markets funds invested across a core group of industries where Apollo has considerable knowledge and resources.

About Parallel Petroleum Corporation

Parallel Petroleum Corporation is an independent energy company headquartered in Midland, Texas, engaged in the exploitation, development, acquisition and production of oil and gas using 3-D seismic technology and advanced drilling, completion and recovery techniques. Parallel’s primary areas of operation are the Permian Basin of West Texas and New Mexico, North Texas Barnett Shale, Onshore Gulf Coast of South Texas, East Texas and Utah/Colorado. Additional information on Parallel is available via the internet at www.plll.com.

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Superior Global Solutions, a Dallas-based provider of medical documentation, has raised $6 million of preferred stock and subordinated debt from Petra Capital Partners.

PRESS RELEASE

Petra Capital Partners, a private equity firm based in Nashville, Tennessee, today announced a $6 million investment in Superior Global Solutions (“SGS”). The capital is a combination of subordinated debt and preferred stock. SGS marks Petra’s fourth investment in 2009 and sixth investment from its newest fund, Petra Growth Fund II, L.P. Based in Dallas, TX, SGS is a leading provider of medical documentation, coding and technology enabled services to many of the largest hospitals and health systems in the country. SGS used a portion of the proceeds to buyout a minority shareholder and to make a strategic technology acquisition. Petra Managing Partner, Mike Blackburn, and Petra Venture Partner, David Fitzgerald, will join SGS’s Board of Directors.

“We’re excited about Petra Capital Partners’ deep experience working with healthcare services and technology companies and the opportunity to work with their talented team of professionals,” said Greg Hackney, Chief Executive Officer of SGS. “Petra has an outstanding track record of partnering with founding management teams to create valuable businesses. We view Petra as an ideal partner for SGS as we continue our focus on providing our hospital clients with technology and services that help them operate more efficiently.”

David Fitzgerald commented, “Hospitals and health systems are searching for technology enabled solutions that lower costs, improve workflows and accelerate the revenue cycle. SGS addresses these issues by providing its clients with a bundled solution, comprised of professional services and innovative technology. We are pleased to have the opportunity to partner with such an outstanding management team and look forward to helping SGS achieve its growth plans.”

About Superior Global Solutions

Based in Dallas, TX, Superior Global is a nationwide supplier of technology and outsourced services for the medical documentation and coding industries. Our sophisticated technology streamlines the transcription and coding processes and identifies clinically relevant information from medical records, allowing our clients to reduce costs and better manage their revenue cycles. Superior Global’s people and technology work closely together to deliver the highest-quality healthcare documentation, coding and document analysis solutions possible

About Petra Capital Partners

Petra Capital Partners, LLC is a private equity firm based in Nashville, Tennessee. The firm is actively investing its second SBIC fund, Petra Growth Fund II, which has $160 million of available capital to invest. Its previous funds under management total $130 million. Petra provides non-control subordinated debt and/or preferred stock to high growth companies for expansion, acquisition, buyout, refinancing or recapitalization in partnership with the founding management team. Petra seeks to invest up to $15 million in growth companies that possess a minimum of $10 million in revenue and positive EBITDA at the time of investment. The fund targets business, healthcare and information technology services companies. For more information, please visit Petra’s website at www.petracapital.com or call (615) 313-5999.

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Frank Tannura has joined LaSalle Capital Group as a senior operating advisor. He previously was CEO of Packaging Dynamics Corporation.

PRESS RELEASE

LaSalle Capital Group, L.P. (“LaSalle”) is pleased to  announce that Frank Tannura has joined the firm as a Senior Operating Advisor effective October 1, 2009.  Mr. Tannura is an accomplished executive with over twenty-five years of leadership experience in the packaging industry.

Prior to joining LaSalle, Mr. Tannura served as Chief Executive Officer of Packaging Dynamics Corporation where he was instrumental in growing the company from a specialty bag producer with $125
million revenue to a vertically integrated flexible packaging leader with $800 million in revenue, 2,500 employees and 12 production plants.  Prior to Packaging Dynamics, Mr. Tannura spent 18 years
with Ivex Packaging Corporation, working his way from Corporate Controller to Executive Vice President and Chief Financial Officer.

During Mr. Tannura’s career with Ivex, the company grew from $100 million to $1 billion in revenue with 3,600 employees working in 29 production plants.  Prior to Ivex, Mr. Tannura began his career as a Senior Auditor at Price Waterhouse.  He has a BBA from Loyola University Chicago and an MBA from the University of Texas at Austin.

Jeff Walters and Rocco Martino, Co-Founders of LaSalle, noted: “We are excited to have Frank join our team as our fourth Senior Operating Advisor.  Frank’s extensive leadership and operating expertise will provide a valuable contribution to our current and future portfolio companies.”

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It’s no fire sale, but Canon has some significant savings on many of their flagship lenses. If you or someone you know needs some sweet glass for Christmas (hint hint to people getting me presents), you can save a couple bills now, though there really isn’t any hurry. The rebates last until January, which makes this probably the longest sale of all time.

It’s really only like an 8-10% savings, but hey, would you rather have 10% off or 0% off? Click the pic to make it bigger, and then head to your favorite lens e-tailer to get buyin’.

[via Canon Rumors]

CQ Politics: “Support for a government-run health care option is gaining ground in the Senate and could be included in overhaul legislation, top Senate Democrats said Sunday. … ‘The American people are for some alternative that will create some competition for the abuses of the insurance industry,’ said Sen. Russ Feingold , D-Wis., on CBS’s ‘Face the Nation.’ … Sen. Ben Nelson , D-Neb., objects to a national government-run insurance program, but said he would be interested in a proposal that allows states to participate only if they ask to join. ‘I think if you go with a state-based public option, you can get bipartisan support,” Nelson said on CNN’s ‘State of the Union.’ (Silvassy, 10/25).

Politico kept a running list of the chatter:

“Missouri Sen. Claire McCaskill, a key Democratic moderate, acknowledged on Sunday there was concern about losing the support of moderate Republican Sen. Olympia Snowe of Maine” (Isenstadt, 10/25).

“Appearing on CNN’s State of the Union with John King, Utah Republican Sen. Orrin Hatch said that he believes Democrats will implement a public option of some kind if they get enough votes to break cloture in an upcoming Senate floor vote. … Hatch is adamantly opposed to the idea, arguing that Medicare and Medicaid are badly run” (Javers, 10/25).

“Appearing on CNN’s State of the Union with John King, Ohio Sen. Sherrod Brown (D) said he wouldn’t rule out voting for a health care bill that didn’t have a public option. ‘I don’t draw lines in the sand,’ Brown said” (Javers 10/25).

Reuters: “Senate Democratic leaders are close to securing enough votes to advance a sweeping healthcare reform backed by President Barack Obama, a top Senate Democrat said on Sunday, adding that it likely would include a national health plan that would allow states the option of dropping out. Senator Charles Schumer, a member of the Senate Democratic leadership team, said he is pushing a compromise that would create a new national health insurance plan and allow states to opt out. The proposed public plan would compete on a level playing field with other insurers, he said.”

(Sen. Schumer spoke on NBC’s ‘Meet the Press’)

“Senate Majority Leader Harry Reid is expected to produce a bill on Monday that will be sent to the Congressional Budget Office for an official cost estimate, an aide said” (Smith, 10/25).

The Buffalo News:  “The ‘public option’ appeared to be the rotting corpse of health care reform only two months ago, but it now looks as if Sen. Charles E. Schumer has helped to bring the proposal back to life. Working behind the scenes over the past four weeks, the New York senator has rekindled interest among some of his moderate Democratic colleagues in establishing a government-run health care plan to compete with private insurers. Now Democratic congressional aides say Senate Majority Leader Harry Reid is likely to include a public option in the compromise reform bill that’s expected to hit the Senate floor in November. And it’s likely to be built around Schumer’s proposal that states be allowed to opt out of the public option” (Zremski, 10/25).

The Washington Post caught the weekend sensation: “in a video clip starting to circulate online, we have “Public Option Annie” — the singing protest at the America’s Health Insurance Plans state issues conference in Washington on Friday morning” (Franke-Ruta, 10/24).

McClatchy Newspapers: “A handful of moderate Senate Democrats will determine the fate of this year’s health care overhaul, and they’re sending strong signals that while they’re willing to compromise, they’re wary of a strong public option. … The informal centrist roster includes senators who have broken with the party the most this year — Indiana’s Evan Bayh and Nebraska’s Ben Nelson — as well as Tom Carper of Delaware, Joseph Lieberman of Connecticut (an independent who caucuses with the Democrats), Mark Pryor of Arkansas, Mark Warner and Jim Webb of Virginia, Jon Tester of Montana and Kent Conrad and Byron Dorgan of North Dakota.”

“Their chief messages: Constituents are confused and wary of changes to the nation’s health care system, and if a plan is perceived as too expensive and complex, there could be political consequences. … In states where voters are more conservative, health care change is emblematic of something bigger, something analysts say could hurt those states’ Democrats in next year’s mid-term congressional elections. Thirty-eight Senate seats are up next year; each party now holds 19 of those” (Lightman, 10/23).

The Los Angeles Times had a Q & A which included this Q:  “Would a public option make it possible for everyone to be covered?”

“A public option could make affordable insurance more accessible to those whose incomes are above the subsidy limit, but it is not likely that everyone would be covered. The House bill, which does contain a public option, is estimated to cover about 3% more people than the Senate Finance Committee bill, which does not include a public option and would cover 94% of the population. It is also possible that a public option would include a ‘firewall’ that would prevent some people from enrolling, specifically those who work at a company that already offers coverage, even if that policy is not affordable for the employee” (Oliphant and Geiger, 10/25).

Oh, it is a strange world we live in. Our phones are computers, our computers are supercomputers, and our bikes are rocket bikes. So why should it seem strange when our email provider translates incoming voicemails?

This one in particular shows how far technology has come. If only the caller had something more interesting to say.

[via Reddit]

By Lauryn Abbott

Love and marriage, and . . . sex. In her new book Kiss Me Again, (Multnomah Books/ Sep 2009) Barbara Wilson explores intimacy and sex in marriage and how emotions, sexual abuse and past sexual impurity can sabotage the sacred union between a husband and a wife. In society today, premarital sex is more the rule than the exception (sadly, even in Christian circles), and this creates unhealthy and invisible bonds to any persons with shared sexual history. And these bonds cause pain, scars, and hang-ups that are damaging to marriage. But forgiveness, healing and freedom are available. This great book includes a 10-week study guide at the end. It can be read and worked-through individually, as a couple, or even within a safe women’s small group setting.

Many married women genuinely want to feel more desire toward their husbands. But while sex before marriage was hard to resist, now resisting seems like all they do. In her new book, Barbara Wilson shows how couples can suffer for years from the “invisible bonds” of previous relationships without even knowing it. Hidden emotions of distrust, shame, and resentment can sabotage even the most loving marriage.

In Kiss Me Again, Wilson:

~ Shares her own story of healing and renewed desire
~ Helps women forgive themselves and their husbands for past choices
~ Shows readers how to break free from “invisible bonds”
~ Explains God’s plan for helping a husband and wife to re-bond
~ Includes conversation helps for both wives and their husbands
~ Helps couples reignite the passion that they thought was lost

With assessment tools, write-in exercises, and gentle guidance, Kiss Me Again offers a biblical plan for rekindling the closeness and passion women long for in marriage. Because no past is beyond the reach of God’s healing touch.

Barbara Wilson is the author of The Invisible Bond and former director of sexual health education for the Alternatives Pregnancy Resource Center in Sacramento. She speaks nationwide to youth and adults with her message of sexual healing, and she teaches frequently in the women’s ministry at the multi-campus Bayside Church in Northern California. Barbara and her husband, Eric, have been married for 28 years.  You’ll find the author online at www.barbarawilson.org

Sexually Satisfied Women Have Better General Well-Being and More Vitality

Copyright © 2006-2010, Basil & Spice. All rights reserved.

Inhibitex Inc. (Nasdaq: INHX), an Alpharetta, Ga.-based, has agreed to sell approximately $23 million
in common stock and warrants. QVT is leading the PIPE, and is being joined by existing shareholders like OrbiMed Advisors, New Enterprise Associates and Great Point Partners.

PRESS RELEASE
Inhibitex, Inc. (Nasdaq: INHX) today announced that it has entered into definitive purchase agreements with institutional investors for the sale of approximately $23 million of its common stock, and warrants to purchase common stock, in a private placement. The private placement was led by QVT funds, and co-investors include OrbiMed Advisors, New Enterprise Associates (NEA) and Great Point Partners, as well as several other existing investors. Each unit, consisting of one share of common stock and a warrant to purchase 0.45 of a share of common stock, will be sold at a purchase price of $1.28, which is equal to the consolidated closing bid price of the Company’s common stock as reported on the Nasdaq Capital Market on October 22, 2009, plus $0.06. Accordingly, the Company anticipates issuing approximately 18 million shares of common stock and warrants to purchase approximately 8.1 million shares of common stock pursuant to the private placement.

The warrants will have a four-year term and an exercise price equal to $1.46 per share. The Company intends to use the proceeds for research and development, working capital and general corporate purposes. MTS Securities, LLC, an affiliate of MTS Health Partners, served as the placement agent in the private placement.

The Company expects that the private placement will close on October 28, 2009, subject to customary closing conditions. The Company anticipates filing a Registration Statement on Form S-3 with the Securities Exchange Commission (”SEC”) for the resale of the shares offered in the private placement, and the shares issuable upon the exercise of the related warrants, within thirty days of closing.

The shares and warrants offered in the private placement, and the shares issuable upon the exercise of the related warrants, have not been registered under the Securities Act of 1933, as amended, or state securities laws, and may not be offered or sold in the United States without being registered with the SEC or through an applicable exemption from SEC registration requirements. The shares and warrants were offered only to accredited investors. This news release shall not constitute an offer to sell or the solicitation of an offer to buy, nor shall there be any sale of any of the securities referred to in this news release in any state in which such offer, solicitation or sale would be unlawful prior to the registration or qualification under the securities laws of any such state. Any offering of the Company’s shares under the resale registration statements referred to in this news release will be made only by means of a prospectus.

About Inhibitex

Inhibitex, Inc., headquartered in Alpharetta, Georgia, is a biopharmaceutical company focused on developing products to treat serious infectious diseases. The Company’s pipeline includes FV-100, its clinical-stage nucleoside analogue in Phase II development for the treatment of herpes zoster (shingles), as well as INX-189, an HCV nucleotide polymerase inhibitor in preclinical development. The Company has also licensed the use of its proprietary MSCRAMM(®) protein technology to Wyeth for the development of staphylococcal vaccines.

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 Another action-packed week has come and gone, and although the QuickPeek has not been so quick on its feet the past couple of weeks, rest assure…