Daily Health Policy Report

Wednesday, February 15, 2012

Last updated: Wed, Feb 15

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Coverage & Access

Campaign 2012

Health Care Marketplace

Administration News

Medicare

Health Care Fraud & Abuse

Health Reform

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Candidates Court Seniors On Medicare

Kaiser Health News reporter Marilyn Werber Serafini writes: "Medicare is likely to play a key role in the 2012 elections — from the presidential race to contests for Congress. While young and middle-age voters are more focused on the economy, 'seniors are single-issue voters when it comes to Social Security and Medicare,' said Democratic pollster Anna Greenberg, senior vice president of Greenberg Quinlan Rosner. 'They are such an important constituency in elections because they are very reliable voters'" (Werber Serafini, 2/14). Read the story.

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Capsules: Unraveling Some Of The Geographic Disparities In Health Costs; End-Of-Life Wishes Often Unspoken

Now on Kaiser Health News' blog, Jordan Rau reports: "Why does health care cost more in some areas of the country than others? It’s a question researchers have struggled with for decades. ... Now a new study from the Center for Studying Health System Change takes a novel approach by comparing claims among 218,000 autoworkers in 19 metropolitan areas" (Rau, 2/15).

Also, Sarah Barr reports: "Most Californians say it is important to plan for end-of-life care but far fewer have done so, a gap that means they may not spend their dying days the way they wish" (Barr, 2/14).  See what else is on the blog.

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Alaska Takes Biggest Step Yet Toward Health Insurance Exchange

Alaska Public Radio Network's Annie Feidt, working in partnership with Kaiser Health News, NPR and APRN, reports: "Alaska has opposed the federal health law so adamantly that it is the only state that chose not to even apply for a $1 million grant the federal government was passing out to states to plan a health insurance exchange. But that doesn't necessarily mean there won't be an online marketplace to buy insurance in Alaska" (Feidt, 2/14). Read the story.


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Political Cartoon: "Wipe Out?" By Eric Allie

Kaiser Health News provides a fresh perspective on health policy developments with "Wipe Out?" by Eric Allie.

Meanwhile, here's today's haiku:

A SMARTER SMARTPHONE
What is the best use
for a smartphone? Angry Birds?
Give me KHN.
-- Karl Eisenhower

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Capitol Hill Watch

Tentative Deal Reached To Prevent Physician Pay Cuts, Preserve Payroll Tax Cut

But congressional aides warned that negotiators still had to sign off on the agreement and that obstacles could surface.

Los Angeles Times: Deal Would Extend Jobless Benefits, Prevent Medicare Cut
One day after House Republican leaders made a major concession on the payroll tax cut, congressional negotiators struck a tentative deal that also would extend long-term unemployment benefits and prevent drastic reductions in doctors' Medicare payments (Mascaro, 2/15).

The New York Times: Tentative Deal Reached To Preserve Cut In Payroll Tax
A vote on the measure would most likely happen by Friday, when Congress is set to recess for a week. ... The piece of the deal that would protect doctors from a huge cut in Medicare reimbursement fees would do so through cuts in the new prevention and public health fund established in the health care law, combined with reducing help for hospitals with bad debt and other health-care-related spending trims (Steinhauer, 2/14).

The Washington Post: Congressional Negotiators Reach Tentative Deal On Payroll Tax, Unemployment Benefits
A deal also would mean that doctors would not see a drop in rates paid by Medicare, according to senior aides in both parties. Lawmakers and aides stressed that final details are still being ironed out — including which cuts would be used to finance the unemployment and Medicare provision — but they were optimistic that a broad deal would be announced Wednesday and approved by Friday (Kane and Nakamura, 2/14).

The Wall Street Journal: Deal Reached On Payroll Tax
The agreement showed the reluctance of both sides, but especially Republicans, to re-engage in the sort of brinksmanship that has caused congressional approval to plummet. ... The agreement would also provide that Medicare would continue to pay physicians at current rates, avoiding a 27.4% cut in fees that would have kicked in March 1. That fee adjustment, expected to cost about $30 billion, would be funded by cuts in payments to Medicare providers, as well as a cut to the wellness and prevention fund in Mr. Obama's health-care law (Bendavid and Peterson, 2/15).

Reuters: US Lawmakers Get Tentative Deal On Payroll Tax, Jobless Benefits
Some of the costs of maintaining doctor fees and continuing long-term jobless benefits will be covered by increased government auctions of Internet and broadcast airwaves, according to lawmakers and aides (Ferraro and Smith, 2/14).

Politico Pro: House GOP Hates SGR Deal
House Republicans emerged from a nearly 90-minute conference meeting late Tuesday disgruntled and disappointed over an emerging payroll tax and Sustainable Growth Rate deal — but they predicted it would likely win enough support to pass by week’s end. "I don’t like it," Rep. Phil Gingrey (R-Ga.), a member of the House GOP Doctors' Caucus, told POLITICO. "I want to see the details, but what I heard, I don’t like." Other members expressed a similar sentiment. Rep. Phil Roe (R-Tenn.), who like Gingrey is also a physician and a member of the caucus, said he is "unhappy" (DoBias and Haberkorn, 2/14).

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Reid Will Allow Repeal Vote On Contraception Mandate

Senate Majority Leader Harry Reid will allow a vote on a Republican amendment to allow employers to opt out of health coverage mandates — including one requiring free coverage of birth control for women - that they find immoral.

The Hill: Reid Will Allow Vote On Repeal Of Administration's Birth Control Mandate
Republicans are picking a new fight over contraception — and at least some Democrats are happy to let them have it. Senate Majority Leader Harry Reid (D-Nev.) said Tuesday that he'll let the Senate vote on a proposal to reverse the White House's controversial birth-control mandate. The amendment, sponsored by Sen. Roy Blunt (R-Mo.), would let employers opt out of any coverage mandates they find immoral (Baker, 2/14).

Roll Call: Harry Reid Will Allow Vote On GOP Birth Control Proposal
Senate Majority Leader Harry Reid (D-Nev.) said he would allow a vote on a Republican proposal to let companies and insurance providers opt out of mandated birth control coverage. "I have agreed to a vote on contraception," Reid said today. He did not specify what vehicle he had in mind, but the next opportunity would be on the transportation bill the Senate is considering (Sanchez, 2/14).

Earlier Tuesday, other Democrats criticized the GOP effort.

The Hill: Dems Rebuke GOP For Trying To Attach Birth-Control Exemption To Highway Bill
Senate Democrats on Tuesday sharply criticized Republicans for trying to attach a contraception measure to a transportation bill. Sen. Barbara Boxer (Calif.) and other Democrats blasted the proposal from Sen. Roy Blunt (R-Mo.), which would broaden the exemption to the requirement that employers cover contraception in their health care plans (Baker, 2/14).

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Coverage & Access

Bishops Plan United Front Campaign Against Contraception Rule

While most of the public favors the Obama administration's contraception compromise, the Catholic bishops will launch TV and radio ads against the mandate.

The New York Times: Obama Shift On Providing Contraception Splits Critics
The near-unified front led by the nation's Roman Catholic bishops to oppose a mandate for employers to cover birth control has now crumbled amid the compromise plan that the Obama administration offered last week to accommodate religious institutions. The leaders of several large Catholic organizations that work directly on poverty, health care and education have welcomed the president’s plan as a workable compromise that has the potential to protect religious freedom while allowing employees who request it to have contraceptives covered by their insurance plans (Goodstein, 2/14).

Reuters: Bishops Plan Aggressive Expansion Of Birth-Control Battle
The U.S. Conference of Catholic Bishops plans to work with other religious groups, including evangelical Christians, on an election-year public relations campaign that may include TV and radio ads, social media marketing and a push for pastors and priests to raise the subject from the pulpit (Simon, 2/14).

The New York Times: Support Is Found For Birth Control Coverage And Gay Unions
Despite the deep divide between some religious leaders and government officials over contraceptives, the latest New York Times/CBS News poll found most voters support the new federal directive ... 65 percent of voters in the poll said they supported the Obama administration’s requirement that health insurance plans cover the cost of birth control, and 59 percent, said the health insurance plans of religiously affiliated employers should cover the cost of birth control (Connelly, 2/14).

Bloomberg: Obama Allies Seek To Reframe Birth-Control Debate For Voters
The debate ... is likely to persist, with the two sides struggling to frame the issue as either one over access to birth control or of religious freedom. …Whoever is more successful at defining the dispute is likely to prevail with the electorate on the policy, pollsters and political strategists say. ... [Terry Madonna, a political science professor and director of the Franklin & Marshall College poll said that] access to contraception and equal treatment of women in workplace-benefit plans both resonate with college-educated women (Talev and Dorning, 2/14).

The Associated Press: U.S. Bishops Fight Birth Control Deal
Cardinal-designate Timothy Dolan, who heads the U.S. Conference of Catholic Bishops, said in an interview with The Associated Press that he trusted Obama wasn't anti-religious and intended to make good on his pledge to work with religious groups to fine-tune the mandate. ... Separately, he said, the bishops will back court challenges to the mandate being undertaken by others. He said he didn't think the USCCB itself, however, would sue the government over the issue (Winfield, 2/14).

Denver Post: Denver Catholics Reject Obama Contraception Compromise
Denver Catholic Charities said today it is united with Archdiocese of Denver Bishop James Conley and the U.S. Conference of Catholic Bishops in opposing the Obama administration's compromise on universal coverage of contraception (Draper, 2/14).

CBS: Axelrod: Obama Birth Control Fight Was Unwanted
A top campaign adviser to President Obama said Wednesday the recent announcement and subsequent backtracking on forcing religiously-affiliated institutions to provide birth control to employees for free was not designed to pick a fight with social conservatives. "We were not looking to create divisions. We were looking to advance the cause of women's health and I think we have done that and we have done it in the appropriate way," David Axelrod said in an interview with "CBS This Morning" (2/15).

Denver Post: A Q&A With Diana DeGette About Obama's Contraception Controversy
Rep. Diana DeGette, D-Colo., and co-chair of the pro choice caucus has been outspoken in support of the measure. The Denver Post chatted with her for a few minutes about what she thinks of Obama's decision, which some are billing as a "scale back" (Sherry, 2/14).

NPR: Does Contraception Really Pay For Itself?
The Obama administration claims health insurance companies won't have a problem providing free contraceptive coverage for women who work at religious groups. Officials say that's because it is much cheaper for the industry when pregnancies are planned (Zarroli, 2/15).

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Campaign 2012

Debate Over Medicare, Health Law Already Playing Out In 2012 Races

Nearly all the candidates for president are weighing in on how to make Medicare fiscally sustainable, while Virginia Attorney General Ken Cuccinelli says the health law will factor into which candidate he endorses.

Kaiser Health News: Candidates Court Seniors On Medicare
Kaiser Health News reporter Marilyn Werber Serafini writes: "Medicare is likely to play a key role in the 2012 elections—from the presidential race to contests for Congress. While young and middle-age voters are more focused on the economy, 'seniors are single-issue voters when it comes to Social Security and Medicare,' said Democratic pollster Anna Greenberg, senior vice president of Greenberg Quinlan Rosner. 'They are such an important constituency in elections because they are very reliable voters'" (Werber Serafini, 2/14).

The Wall Street Journal: Sen. Graham To AARP: Wealthy Seniors Shouldn’t Get Free Health Care
Sen. Lindsey Graham (R., S.C.) is known as an independent thinker who doesn’t mind speaking his mind, even if it creates waves around the Capitol. Tuesday morning at a meeting of the Senate Budget Committee he did so again, questioning the underlying principle behind Medicare that all seniors should receive free health care. Mr. Graham turned to the camera and said that if anyone from the powerful seniors lobby group AARP was watching the hearing, he wanted to make it clear:  He doesn’t think that wealthy seniors should enjoy free health care. Of course, Medicare, the health care program for the elderly, isn’t free. Seniors pay premiums along with copays and deductibles, and those with greater income pay more (Boles, 2/14).

Politico Pro: Who Will Win The Cuccinelli Primary?
Virginia Attorney General Ken Cuccinelli says he may endorse a Republican presidential candidate — but Mitt Romney and Newt Gingrich already have a strike against them because of their support for an individual mandate. “It’s not disqualifying, but it’s certainly a strike against” both of them, said Cuccinelli, who filed a lawsuit against health reform the day President Barack Obama signed it into law. “Whenever you have a government takeover of things, you’re not headed in a good direction” (Haberkorn, 2/14).


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Health Care Marketplace

Report Looks At Autoworker Health Care For Spending Variation Clues

A new report looks at autoworker health care claims to find clues as to why spending varies by region and finds that hospital price variation made up one-third of the difference.

Kaiser Health News: Autoworkers' Health Claims Offer Clues To Regional Spending Variations
Why does health care cost more in some areas of the country than others? It’s a question researchers have struggled with for decades, because the potential answers — unnecessary surgeries, generally bad health of patients or high prices charged by providers — each carry different prescriptions for how to hold down medical costs. Now a new study from the Center for Studying Health System Change takes a novel approach by comparing claims among 218,000 autoworkers in 19 metropolitan areas (Rau, 2/15).

Modern Healthcare: Report Notes Impact Of Hospital Price Variation
Hospital price variation accounted for one-third of the difference in health spending in 19 communities, even after accounting for geographic differences in wages and rent, according to a report. ... Spending per person ranged from $4,500 to $9,000 with price accounting for 33 percent of the difference, according to the report by Chapin White, a senior researcher for the center (Evans, 2/15).

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Administration News

Drilling Down Into Obama's Budget

The Wall Street Journal reports the plan would scale back money for public health and prevention programs; The Associated Press covers the debate about the proposed defense budget, which would scale back retirees' health coverage.

The Wall Street Journal: What Obama’s Budget Proposal Means For Disease Prevention
Obama’s fiscal 2013 budget would scale back the Prevention and Public Health Fund, established as part of the health law, by over $4 billion by fiscal 2022 — leaving that much less money for public-health prevention programs meant to thwart outbreaks or cut down on rates of diabetes, heart disease, and other chronic conditions that account for 75% of U.S. health-care costs. ... the prevention fund has been used heavily to compensate for cuts to the regular budget of the Centers for Disease Control and Prevention rather than for its originally intended use — new disease prevention-related programs (McKay, 2/14).

The Associated Press: Panetta, Dempsey Defend Military Budget Plan
While military personnel still would get a 1.7 percent pay raise, retirees would get hit with a series of increases in health care fees, co-pays and deductibles. The impact would be greater on those who are under 65 and are likely to have another job, as well as on those who make more money (Baldor, 2/14).



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Medicare

CMS Signals It May Delay Deadline On New Codes To Be Used By Doctors, Hospitals

Acting Director Marilyn Tavenner says the agency will re-examine the October 2013 deadline for the coding system, known as ICD-10. It expands the number of codes used for billing medical services.

The Wall Street Journal: Pace of New Medical Coding Implementation To Be 'Re-Examined'
Today the acting head of the Medicare agency, Marilyn Tavenner, said the Centers for Medicare and Medicaid Services will "re-examine" the pace of ICD-10 implementation. … A CMS spokesman confirmed the remarks. … ICD-10, which stands for International Classification of Diseases, 10th Revision, is a new set of codes that will be used by doctors and hospitals to describe medical services in bills they send to insurers. It will expand the number of codes in use from around 18,000 in the current ICD-9 code set to about 140,000 (Wilde Mathews, 2/14).

CQ HealthBeat: Tavenner Rethinking Bill Coding Deadline
The AMA has been urging federal officials to delay the Oct. 1, 2013 deadline for physicians to adopt the new system. Tavenner said she will convene a task force on the issue and then launch rulemaking, to change the deadline (Reichard, 2/14).

Modern Healthcare: CMS Will Re-Examine ICD-10 Timeline, Tavenner Says
Tavenner told reporters that the CMS will "re-examine the timeframe" through a rulemaking process. She did not say when that rulemaking process will begin but said the CMS would send details about the process in the coming days (Zigmond, 2/14).

Modern Healthcare: Concern And Cautious Optimism From IT Leaders On Possible ICD-10 Delay
Members of the physician informatics community expressed surprise, elation and concern in reaction to the CMS' announcement that it will reconsider the Oct. 1, 2013 implementation deadline for the International Classification of Diseases 10th Revision family of diagnostic and procedural codes (Conn, 2/14).

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Despite Fewer Amputations, Medicare's Bill For Artificial Feet Rises 60%

The Associated Press examines the complicated issue of health costs by looking at foot amputations from diabetes.

The Associated Press: Medicare Puzzle: Big Rise In Artificial Feet Costs
What's wrong with this picture? Medicare's bill for artificial feet rose nearly 60 percent in recent years, although foot and leg amputations due to diabetes continued a dramatic decline. Medicare paid $94 million for artificial feet in 2010, according to research conducted for The Associated Press. That was nearly $35 million more than in 2005, even though in 2010, Medicare covered about 1,900 fewer such prostheses (Alonso-Zaldivar, 2/15).

Meanwhile, a new report finds many seniors aren't getting all their benefits.

Reuters: U.S. Seniors Missing Out On $20 Billion Of Benefits
Millions of seniors in the United States are missing out on more than $20 billion in aid that could help pay for food, medicine and heating, simply because they don't know it's there, according to a report released on Tuesday by organizations that advocate for seniors. In response, the National Council on Aging (NCOA) and the National Association of Area Agencies on Aging (n4a) have launched a campaign, "You Gave, Now Save," to help bridge the gap between the available funding and those who need it the most (Baum, 2/14).

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Hospitals Would Have To Voluntarily Return Overpayments Under New Proposal

Even as officials announced record recoveries of fraudulent Medicare claims, they proposed new rules to force providers to voluntarily return overpayments within 60 days of discovering them. The proposal is intended to cut down on the need for criminal or civil investigations.

Modern Healthcare: New Overpayment Rules Proposed
The same day that federal officials unveiled record-breaking statistics on healthcare fraud enforcement, regulators announced the publication of new proposed rules designed to force doctors, hospitals and suppliers to voluntarily return overpayments within 60 days of discovering them. … HHS Secretary Kathleen Sebelius noted that the rules were intended to cut down on improper payments without the need for criminal or civil investigations (Carlson, 2/14).

Boston Globe: Federal Authorities Report Record Fraud Judgments, Settlements In 2011
Two cases highlighted in the report were linked to Massachusetts. In one case, Beth Israel Deaconess Medical Center paid $233,932 to resolve a case alleging that it overbilled Medicare for injections of a drug used to treat prostate cancer, using a billing code under which the hospital would be paid nearly twice what it should have been for the drug, called Lupron (Conaboy, 2/14).

CQ HealthBeat: Administration’s Health Care Fraud Victories In Fiscal 2011 Similar To Previous Year
During the past fiscal year, federal officials won or negotiated about $2.4 billion in health care fraud judgments and settlements, according to an annual report released Tuesday. That total is slightly less than the $2.5 billion total for fiscal 2010. The federal report found that the amount of money deposited into federal accounts in fiscal 2011 because of anti-fraud efforts was the highest ever at $4.1 billion, as work from the past few years paid off in accumulated collections (Adams, 2/14).

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Health Care Fraud & Abuse

DEA Tries To Stem Prescription Drug Abuse By Suspending Pharmacies

The Wall Street Journal: Pharmacies Swept Into Drug Wars
Federal drug agents and one of the nation's biggest drug distributors are heading for a legal showdown that will test the government's strategy of going after larger corporations to fight rampant prescription drug abuse. The Drug Enforcement Administration moved earlier this month to suspend four pharmacies in Sanford, Fla., from selling controlled substances. ... At the same time, the DEA also moved to punish the supplier of the pharmacies — Cardinal Health Inc. — by seeking to block the distribution of controlled substances from Cardinal's facility in Lakeland, Fla. (Barrett and Martin, 2/15).

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Health Reform

Conservatives' Mixed Message On Health Care Mandate

The New York Times explores the history of the individual mandate. In other health law articles, a Gallup poll finds small business owners worried about the costs they will incur and some doctors in favor of a single payer health system file a brief with the Supreme Court opposing the federal law.

The New York Times: Conservatives Sowed Idea Of Health Care Mandate, Only To Spurn It Later
It can be difficult to remember now, given the ferocity with which many Republicans assail it as an attack on freedom, but the provision in President Obama’s health care law requiring all Americans to buy health insurance has its roots in conservative thinking. ... The individual mandate, as it is known, was seen then as a conservative alternative to some of the health care approaches favored by liberals — like creating a national health service or requiring employers to provide health coverage (Cooper, 2/14).

Politico: Poll: Health Care Costs Just One Factor In Slow Hiring
For small business owners in the U.S. who are not hiring new employees, almost half say worries about the potential cost of health care and new government regulations are the reasons they are not hiring, according to a new Gallup poll Wednesday. An overwhelming majority of small business owners surveyed, 85 percent, indicated that they are currently not looking for new workers. Asked to describe the reason, 48 percent of those not hiring said it was due to concerns about possible rising healthcare costs, while 46 percent said they were worried about new government regulations (Lee, 2/15).

CQ HealthBeat: Single-Payer Advocates Argue Health Care Law Should Be Struck Down
Opponents of the health care law gained some allies when doctors who advocate a single-payer health care system announced Tuesday that they have filed a brief with the U.S. Supreme Court arguing that Americans shouldn’t be required to get insurance. Numerous other groups and Republican members of Congress also filed by a Monday court deadline in support of the case against the overhaul brought by 26 state governors and attorney generals, the National Federation of Independent Business and four individuals  (Norman, 2/14).

 

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Public Health & Education

Drugmaker Warns That Fake Cancer Drug Is On The Market

The Wall Street Journal reports that the manufacturer of Avastin says it has found counterfeit vials of the drug in the United States.

The Wall Street Journal: Fake Cancer Drug Found in U.S.
The maker of the widely used Avastin cancer drug said Tuesday that it is warning doctors, hospitals and patient groups that a counterfeit version of the medicine has been found in the U.S. Tests of counterfeit vials of Avastin showed that they didn't contain the active ingredient in Roche Holding AG's intravenous drug, according to the Swiss company's Genentech unit. ... An FDA spokeswoman said it hasn't received any reports of patient side effects that appear to be linked to the counterfeit product (Rockoff and Weaver, 2/15).

Meanwhile, the FDA says that reports of a cancer drug shortage are being addressed.

USA Today: FDA: Shortage Of Kids' Cancer Drug Can Be Averted
The Food and Drug Administration has managed to avert a "crisis" for children with cancer by preventing a looming shortage of a lifesaving drug, officials announced Tuesday. The shortage of methotrexate — a mainstay of treatment for kids with acute lymphoblastic leukemia(ALL) — is the latest in a series of serious shortages of cancer medications and other drugs that have frustrated doctors and patients over the past year and a half (Szabo, 2/14).

WBUR's CommonHealth blog: Cancer Drug Shortage All Too Real For Some
Betsy Neisner of Northampton has survived a decade with ovarian cancer – half her daughter’s life and long enough that her 17-year-old son doesn’t remember her before she became a patient. ... Neisner is now faced with the shortage of the drug that has kept her cancer in check since last April. Doxil, which has worked well for her with minimal side effects, is being severely rationed after the single plant that manufactures it shut down late last year (Weintraub, 2/14).

The New York Times also reports on concerns about marketing of an artificial hip.

The New York Times: Hip Implants U.S. Rejected Sold Overseas
The health care products giant Johnson & Johnson continued to market an artificial hip in Europe and elsewhere overseas after the Food and Drug Administration rejected its sale in the United States based on a review of company safety studies. During that period, the company also continued to sell in this country a related model, which earlier went on the market using a regulatory loophole that did not require a similar safety review (Meier, 2/14).

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State Watch

Kansas House Approves 'Compact' Bill Opposing Health Law; Conn., Alaska Moving Ahead With Exchanges; Mass. Reform Very Popular

States are in various stages of implementing, or opposing, aspects of the health care law.

The Connecticut Mirror: Legislature To Consider Expanding Exchange Board
The proposed change has the support of Gov. Dannel P. Malloy and Lt. Gov. Nancy Wyman, who chairs the exchange board. The bill would add two voting members to the board. One would be a small employer and ... [the other] would be "a consumer of specialized health care services for a disability, a chronic illness or special needs, or of health care services" (Levin Becker, 2/14).

Kaiser Health News: Alaska Takes Biggest Step Yet Toward Health Insurance Exchange
Last month, the administration of Gov. Sean Parnell, a Republican, hired Public Consulting Group to study the state's options for setting up an exchange. The state is spending $200,000 on the contract with the Boston-based firm. ... Josh Applebee, Alaska's deputy director for health care policy, described the reasoning for hiring the consultant. "The biggest problem, I think, is we don't have enough information to decide," Applebee said. "Are we going to do a state exchange?" (Feidt, 2/14).

Kansas Health Institute News: Health Care Compact Bill Approved By House Committee
Members of a House committee today voted to support Kansas joining a multistate compact formed to challenge the federal government’s authority to set health policy. ... Once 20 or more states have joined the compact, proponents of the bill have said the member states will demand that Congress ratify an agreement to return tax dollars used to fund Medicare, Medicaid and the Children’s Health Insurance Program to the states (Cauthon, 2/14). 

Related, earlier KHN story: Some States Seeking Health Care Compact (Gugliotta, 9/18)

Milwaukee Journal Sentinel: Health Centers Growing More Slowly Than Planned
Outreach Community Health Centers, which saw almost 2,000 additional patients last year, recently expanded its main clinic. …That was the plan under federal health care reform. Community health centers, located in low-income urban neighborhoods and rural areas, were expected to double in size in five years. That target now seems unlikely. ... Federal budget cuts in the face of massive government deficits have reduced money available for expansion by $3 billion over five years (Boulton, 2/14).

Meanwhile --

WBUR: Poll: Most Mass. Residents Support State Health Care Law
In the latest WBUR poll, 62 percent support the law and 33 percent oppose it. “Even with all the attention the Massachusetts law has gotten nationally, it really hasn’t driven down support among voters here in Massachusetts,” said Steve Koczela, president of the MassINC polling group, which conducted the poll. The difference between national and local opinions about the law is part politics, part misinformation, and partly a difference of experience, said Robert Blendon (Bebinger, 2/15).

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State Roundup: Legislatures Tackling Abortion Restrictions, Medicaid Cuts/Revamps, Rx Drug Abuse

The Associated Press: Va. House GOP Muscles Through Abortion Curbs
A Republican supermajority has muscled two of the most restrictive anti-abortion bills in years through the Virginia House, including one that would all but outlaw the procedure in the state by declaring that the rights of persons apply from the moment sperm and egg unite. The bills passed over bitter yet futile objections from Democrats. And one GOP delegate caused the House to ripple when he said most abortions come as "matters of lifestyle convenience." ... The bills now go to the Senate (Lewis, 2/14).

Georgia Health News: State Health Budgets Bring Relief
Usually at the midpoint of a Georgia General Assembly session, health care industry groups are scrambling to prevent deep cuts in the budgets of Medicaid and other government programs. Not so this year. Hospitals, doctors and other medical providers ... see no major reductions in the Medicaid or PeachCare programs, either in services, benefits or payments (Miller, 2/14).

The Associated Press/Bangor Daily News: Budget-Cutting Plan Gets First House OK, LePage Says It Doesn't Go Far Enough
The Maine House yesterday gave initial approval to Medicaid cuts that are intended to help close a $120 million state budget shortfall, but the governor says they do not go far enough ... in reducing costs of MaineCare, the state’s Medicaid program for the poor and disabled, which cost more than $552 million in state funds in fiscal 2011 (Adams, 2/15).

Milwaukee Journal Sentinel: Senate Votes Unanimously To Lift Cap On Family Care Program
The enrollment cap on a state long-term care program for the elderly and disabled would be lifted, under a measure approved unanimously by the Senate on Tuesday. Gov. Scott Walker announced the $72 million plan to expand Family Care in December following an order from President Barack Obama's administration. Walker and Republican lawmakers had capped the program on July 1 as part of the state budget to hold down rising costs, but now say they've come up with other ways to control them (Stein, 2/14).

The Lund Report (Oregon): Transformation Bill Passes Senate in Party Line Vote
After lengthy, impassioned discussion and procedural votes from Senate Republicans in a last ditch attempt to amend Senate Bill 1580 and send it back to committee, the Senate passed the bill allowing for the complete overhaul of the Oregon Health Plan’s delivery system ... [The bill] allows the Oregon Health Plan to move forward with implementing the creation of coordinated care organizations (CCOs) throughout the state (Waldroupe, 2/14).

Minneapolis Star Tribune: Feds Look Into Minnesota’s Premium Rates For Poor
The federal government has launched an investigation into whether Minnesota has set premium rates too high on health insurance coverage for low-income people, officials said Tuesday. The probe came to light at a state House committee hearing, at which one critic of the state's nonprofit plans said they earn more on the state plans for Medical Assistance than they have on commercial plans, even as doctors and hospitals collect less reimbursement (Crosby, 2/14).

(St. Paul) Pioneer Press: Feds Investigating State Over Medical Assistance Program
This year, the state and federal government are spending $3.3 billion to provide care for low-income and disabled residents on Medical Assistance; next year, they are budgeted to spend $3.6 billion. For more than a year, [former lobbyist David] Feinwachs has been raising questions at the Capitol about whether state dollars have wrongly inflated the profits of four HMOs that have contracts with the state to manage care for many Medical Assistance recipients (Snowbeck, 2/14).

KQED/The California Report: Prescription Drug Monitoring Program Facing Cuts
This is a story about what can happen when no one is looking. ... More Californians die from overdosing on prescription drugs than from illegal street drugs. To root out pill-shopping patients and unscrupulous doctors, dozens of states, including California, electronically track the prescriptions for powerful narcotics like Vicodin and OxyContin. Now, California's unrelenting budget cuts are threatening to close the system down (Varney, 2/13). 

Stateline: States Struggle With Prescription Drug Abuse
Governors and lawmakers in a handful of states are taking steps to tackle a growing scourge — prescription drug abuse. All but two states and the District of Columbia have enacted some kind of prescription drug monitoring program, but many state officials argue that this is not enough (Clark, 2/15).

San Francisco Chronicle: Despite Pleas, Burlingame Care Center Closing
Anna Tupou, 76, has lived at the Burlingame Long-Term Care center for the past four years, a resident of one of only five county-run facilities in the state like it. On Tuesday, she was put on notice that she would soon have to find somewhere else to live….Burlingame Long-Term Care is a victim of state and local budget constraints, including a proposed 23 percent reduction in Medi-Cal reimbursement rates (Colliver, 2/15).

Kaiser Health News: Despite Best Intentions, Californians Don’t Talk About End-Of-Life Wishes 
Sixty percent of Californians said it is “extremely important” that their family not be burdened by tough decisions about their care, but 56 percent have not communicated their end-of-life wishes to the loved one they would want to make decisions on their behalf (Barr, 2/14).   

California Watch: Researchers To Examine Revamp Of Public Health
As California continues to forge ahead implementing health reform, state Medi-Cal leaders and UC Davis researchers announced an agreement to examine public health system transformation efforts that may serve as models for the nation. The researchers will evaluate public hospital systems as they revamp daily operations in ways meant to simultaneously reduce health costs and improve patient health (Jewett, 2/15).

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Hospital News: Colorado Hospital Settles Suit With Indian Tribe; In Dallas, 'Problems Persist' At Parkland

Denver Post: Cortez Hospital Inks Landmark Civil Rights Settlement With Indian Tribe
Two years ago, a Cortez hospital turned away a Ute Mountain Ute woman who was seeking treatment because she allegedly had been raped. ... The settlement inked this week between the Colorado Civil Rights Commission and Southwest Health Systems Inc., the company which operates Southwest Memorial Hospital, establishes new policies to ensure tribal members who come off reservations for medical treatment aren't discriminated against. ... According to those familiar with the story, a physician told her to go back to the reservation because Indian Health Services too often fails to reimburse the hospital for the care of indigent Native Americans (Lofholm, 2/14).

The Dallas Morning News: Hospital To Pay Plano $1 Million In Corporate Sponsorship Deal
A Plano hospital has agreed to pay the city $1 million over five years in a sponsorship deal that will give the hospital limited advertising rights at more than a dozen public facilities. Texas Health Presbyterian Hospital Plano will receive signs, track decals and other mentions at four of the city’s recreation centers (Kim, 2/15).

The Dallas Morning News: Parkland Safety Report Says Problems Persist
Life-threatening problems persist at Parkland Memorial Hospital and are more widespread than previously known, enabled by a "business as usual" culture that has kept it from fixing serious breakdowns, according to a report obtained by The Dallas Morning News. The report by the Alvarez & Marsal Healthcare Industry Group details hundreds of problems in "nearly every aspect of the system." The monitors were installed last November as a condition of continued federal funding (Moffeit, Egerton, Dunklin and Jacobson, 2/14).

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Editorials and Opinions

Viewpoints: Health Law In 'Red And Blue' States; OpEds Slam Obama Compromise On Birth Control; Illinois' Medicaid Disaster

Politico: The Health Care Law In Red And Blue
[M]ore than one in six Americans younger than 65 could have access to help with their health insurance costs as a result of the [health] law. Red and blue congressional districts look remarkably similar here. Republican districts have, on average, an estimated 18 percent of the nonelderly people eligible for help with health insurance costs under the reform law. Democratic districts have about the same, 17 percent (Larry Levitt, Drew Altman and Gary Claxton, 2/14).

The Wall Street Journal: Birth-Control Mandate: Unconstitutional And Illegal
In an effort to rally its base in the upcoming November election, the Obama administration seems more interested in punishing religiously based opposition to contraception and abortion than in marginally increasing access to contraception services. ... the birth-control mandate violates both statutory law and the Constitution. The fact that the administration promulgated it so flippantly, without seriously engaging on these issues, underscores how little it cares about either  (David B. Rivkin Jr. and Edward Whelan, 2/14).

Boston Globe: On Birth Control, Obama Imperiously Overreaches
On the same day the White House announced its "full accommodation," it formally adopted — without change — the very regulation that had triggered the backlash. The compromise turned out to be merely a promise to modify the new rule before it goes into effect next year (Jeff Jacoby, 2/15).

The Fiscal Times: How Obamacare Reignited the Culture Wars
The mainstream press keeps telling us that the struggle of Catholics v. Obamacare  is about birth control. ... [But] it’s also about the “morning after” pill and sterilization, and down the road it will be about suicide pills, genetic engineering, abortion and mandatory abortion training, transgender operations, and a whole new series of morally problematic procedures about to come over the horizon (John Leo, 2/14).

Chicago Tribune: Free Health Care? That's Rich
The "accommodation" -- the White House rightly refuses to call it a compromise -- is a farce. If you're paying for health insurance -- or if you self-insure, as many institutions do -- shifting responsibilities to the insurance companies doesn't shift the costs, just the paperwork. A Catholic hospital would still pay for the services; there just wouldn't be a line item for it in the monthly insurance bill. That's not accommodation; that's laundering (Jonah Goldberg, 2/15).

Denver Post: Obama's Contraception Compromise Rings Hollow
Most media coverage of the rule requiring religious institutions to offer contraception coverage has focused exclusively on objections of the Catholic Church. To some extent this is natural, given the church's size. ... Yet this selective focus overlooks the fact that the administration's rule also offends religious outfits that have no problem with contraception per se (Vincent Carroll, 2/15).

Arizona Republic: Are Bishops Being Hypocrites?
A hospital is not a church. Particularly a hospital that treats patients of all different faiths, employs people of different faiths and accepts taxpayer money. A hospital like that is a business, and should be required to follow the same requirements of any other business that so happily accepts government funds (E.J. Montini, 2/14).

The Wall Street Journal: Bone-Headed On Bone Marrow 
Recently, the Justice Department asked the full circuit to overturn the unanimous and enlightened decision of a three-judge panel allowing bone marrow donors to be compensated for their donations. ... The pilot program is a sensible effort to adapt an outdated law and encourage donations that can save thousands of lives (2/15).

The Dallas Morning News: Parkland Consultants' Report Is A Scathing Indictment
If Parkland Memorial Hospital weren’t so essential to the health and well being of so many, it might matter less that it’s falling so far short of a minimum standard of safe, quality care. … The only possible cure lies in a radical, top-to-bottom rededication to quality and safety from every person who forms this vital institution (2/14).

Chicago Tribune: Illinois To Feds: Enough!
Illinois officials have been pleading with the Obama administration for almost a year to let the state protect itself from Medicaid fraud. Amazingly, the administration has turned its back on the state. ... Federal health care changes envision a lot more people coming on to Medicaid in the years ahead. If the administration doesn't care if the people on Medicaid qualify for it, this is a recipe for disaster (2/15).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Ankita Rao
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2012 Kaiser Health News. All rights reserved.