Daily Health Policy Report

Monday, April 15, 2013

Last updated: Mon, Apr 15

KHN Original Reporting & Guest Opinion

Health Spending And Fiscal Battles

Health Reform

Health Care Marketplace

Health Information Technology

Administration News

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Doctor-Owned Hospitals Prosper Under Health Law

Kaiser Health News staff writer Jordan Rau reports: "Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth" (Rau, 4/12). Read the story.

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Five Ways The President's Budget Would Change Medicare

Kaiser Health News staff writer Mary Agnes Carey reports: "President Barack Obama's fiscal 2014 budget includes a variety of what he says are 'manageable' changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes and other health care providers that serve them. That assessment has drawn concern from some patient and provider groups that, although recognizing the need to address the nation's rising health care costs, say seniors shouldn't bear the brunt of efforts to reduce entitlement spending" (Carey, 4/15). Read the story.

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Capsules: Programs Help Independent Artists Access Health Care

Now on Kaiser Health News' blog, Ankita Rao reports: "Freelance artists are part of the estimated 15 million people who are currently self-employed, according to a U.S. Department of Labor 2012 estimate. … Programs like Springboard and the Freelancers' Union co-ops help a community that Hunt said is often underinsured because many artists have low incomes — between $12,500 and about $25,000 — especially when they are not yet established" (Rao, 4/15). Check out what else is on the blog.

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Political Cartoon: 'Foreshock?'

Kaiser Health News provides a fresh take on health policy developments with "Foreshock?" by Jimmy Margulies.

Meanwhile, here is today's health policy haiku:


This year's tax deadline:
The last one without any
Obamacare form.

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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Health Spending And Fiscal Battles

Obama Budget Would Up Medicare Costs For Higher-Income Seniors

The Associated Press examines how President Barack Obama's budget proposal would increase Medicare costs for some seniors while other news outlets report on reactions from the left and right.

The Associated Press: Upper-Income Seniors' Medicare Hike
President Barack Obama's plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees, the administration revealed Friday. First details of the plan emerged after Health and Human Services Secretary Kathleen Sebelius testified to Congress on the president's budget .... Currently, single beneficiaries making more than $85,000 a year and couples earning more than $170,000 pay higher premiums. Obama's plan would raise the premiums themselves and also freeze adjustments for inflation until 1 in 4 Medicare recipients were paying the higher charges. Right now, the higher monthly charges hit only about 1 in 20 Medicare recipients (Alonso-Zaldivar, 4/12).

The Associated Press: Medicare Hike Could Also Hit Some In Middle Class
Retired as a city worker, Sheila Pugach lives in a modest home on a quiet street in Albuquerque, N.M., and drives an 18-year-old Subaru. Pugach doesn't see herself as upper-income by any stretch, but President Barack Obama's budget would raise her Medicare premiums and those of other comfortably retired seniors, adding to a surcharge that already costs some 2 million beneficiaries hundreds of dollars a year each. ... Obama's budget would change Medicare's upper-income premiums in several ways ... the plan would create five new income brackets to squeeze more revenue from the top tiers of retirees (Alonso-Zaldivar, 4/12).

Kaiser Health News: Five Ways The President's Budget Would Change Medicare
President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes and other health care providers that serve them. That assessment has drawn concern from some patient and provider groups that, although recognizing the need to address the nation's rising health care costs, say seniors shouldn't bear the brunt of efforts to reduce entitlement spending (Carey, 4/15).

PBS NewsHour: Social Security Advocate: Obama's Budget Is 'Bad Policy. Bad Politics'
Max Richtman stood in the bright sunshine steps from the White House Tuesday, waiting for his turn on the bullhorn to assail a policy of a president he usually agrees with. Leaders of a half dozen liberal and progressive groups -- including Richtman's National Committee to Preserve Social Security and Medicare -- shouted to supporters that President Barack Obama's call in his budget to reduce cost-of-living adjustments to Social Security and other federal benefits amounted to economic assault on senior citizens (Holman, 4/12).

Bloomberg: Obama Programs Derided By Republicans As Pejorative Entitlements
President Barack Obama says Social Security and Medicare fulfill "the guarantee of a secure retirement," providing Americans benefits they have earned through a working lifetime of contributions. Republican House Budget Committee Chairman Paul Ryan looks at a broad array of so-called entitlement programs and sees a corrosive effect (Lynch, 4/15).

Meanwhile, the St. Louis Beacon reports on how the budget plan grants hospitals a reprieve from some Medicaid reductions -

St. Louis Beacon: Hospitals Get Reprieve From Cuts In Some Medicaid Reimbursements
Missouri hospitals are expected to avoid about $27 million in cuts in federal reimbursements. The Obama administration's next budget eliminates about $500 million nationally in what's known as disproportionate share payments, or DSH, to hospitals under Medicaid (Joiner, 4/12).

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Health Reform

Obama Discusses Health Exchanges And Premium 'Rate Shock' With Insurers

Media outlets report on a White House meeting between the president and insurance executives, the unexpected boost the overhaul has given to physician-owned hospitals and doctors' concerns that they may receive delayed pay from some patients who get coverage through the exchanges.

The New York Times: Obama Sees Insurers; Health Law Is Subject
President Obama met with insurance industry executives at the White House on Friday to coordinate the introduction this fall of the insurance marketplaces at the heart of the national health care law, and to discuss so-called rate shock if the industry sharply raises premiums. "We're all in this together," Mr. Obama told the executives, … Among attendees from the industry, which stands to get millions more customers, were Karen M. Ignagni, the head of a trade association for the insurance industry; Chet Burrell of CareFirst BlueCross BlueShield; David M. Cordani of the Cigna Corporation; Scott P. Serota of the BlueCross BlueShield Association, a federation of local Blue Cross and Blue Shield companies; and Joseph R. Swedish of WellPoint (Calmes, 4/12).

The Wall Street Journal: Q&A: Small Business Health Exchanges
The Obama administration recently revealed plans to delay part of a program designed to make health insurance more affordable for small employers. If you're a small-business owner, what does this mean for you? For starters, the initiative is called Small Business Health Options Program, or SHOP. It's an insurance marketplace, or "exchange," for businesses with 100 or fewer full-time-equivalent employees. Each state will have one starting next year. Some states will run their own exchanges, while others will be run in part or entirely by the federal government (Needleman, 4/12).

Kaiser Health News: Doctor-Owned Hospitals Prosper Under Health Law
Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth (Rau, 4/12).

Medpage Today: Docs May See Pay Delay Under ACA Exchanges
Physicians could face dramatic financial challenges for treating patients who receive health coverage through the Affordable Care Act's (ACA) exchanges starting next year. Insurance companies will not process claims on patients who haven't paid their premiums in 3 months, leaving doctors on the hook to recoup payment directly from the patients. The ACA provides a 3-month grace period to individuals who haven't paid their premiums, and the provision could prove problematic for physicians, said Elizabeth McNeil, vice president of federal government relations at the California Medical Association (CMA) in Sacramento (Pittman, 4/13).

MPR News: Until Health Law Takes Hold, Many Grapple With Insurance Limbo
For some people, big changes under the federal health care law cannot come soon enough. The law takes full effect in January, and before then many people will enter health insurance limbo as they lose coverage, including some who will age out of their parents' plans. The precise number of those losing coverage is unclear, but researchers indicate it could be in the hundreds of thousands nationwide. In Minnesota, one young woman, Laura Haynes, will soon face the expiration of her health insurance, leaving her to decide whether to buy an individual policy to carry her through until January (Stawicki, 4/15).

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Sebelius Assures Lawmakers That Insurance Marketplaces Will Open Oct. 1

In a Friday appearance before the House Ways and Means Committee, HHS Secretary Kathleen Sebelius offered assurances about the readiness of 33 federally run health insurance marketplaces and answered questions about health care "navigators."

The Hill: Sebelius: Exchanges Will Be Ready On Time, No Need For Backup Plan
The Health and Human Services Department will meet its central ObamaCare deadline and does not need a backup plan for delays, HHS Secretary Kathleen Sebelius said Friday. Sebelius told the House Ways and Means Committee that a federally run insurance exchange will be up and running by Oct. 1 (Baker, 4/12).

CQ HealthBeat: HHS Draws $304 Million From Prevention Fund To Enroll Uninsured
The Department of Health and Human Services disclosed on one of its websites Friday that it will use $304 million from the health care law's prevention fund to pay some expenses associated with enrolling people in insurance under the overhaul. Public health lobbyists recently warned that the Obama administration would begin tapping the fund to pay to stand up the federal exchange, which is expected to help provide coverage for a projected 30 million Americans (Reichard, 4/13).

The Hill: GOP Members Question Healthcare 'Navigators'
House Republicans want more information about the Obama administration's $54 million grants to help people navigate the new insurance marketplaces created by the Affordable Care Act. On Friday, six GOP members of the Energy and Commerce Committee wrote a letter asking Health and Human Services (HHS) Secretary Kathleen Sebelius seven questions about the grants, which will allow "navigators" to help consumers shop for healthcare in new insurance exchanges (Hattem, 4/12).

CQ HealthBeat: House Republicans Probe HHS Rollout Of Navigator Program
Republicans on the House Energy and Commerce Committee Friday asked the Obama administration for additional details surrounding the navigator program that will be key to helping Americans enroll in health insurance exchanges come this fall. Among their questions are how many navigators will be deployed across the country, the source of funding for the program, how navigators will be chosen, their salaries and their training (Norman, 4/12).

Kaiser Health News also tracked weekend health policy headlines, including reports about Sebelius' Friday appearance before a congressional committee (4/12).

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Nebraska, Florida Contemplate Elements Of Health Law's Medicaid Expansion

Supporters of Nebraska's effort to implement the health law's Medicaid expansion have signaled their willingness to include certain cost safeguards to advance the plan. Meanwhile, a new report finds savings for Florida taxpayers could result from a health law provision regarding federal funding for the "medically needy" and the expansion.   

The Associated Press: Medicaid Backers Will Add Safeguards To Bill
Supporters of a proposal to expand Medicaid in Nebraska said they're willing to include cost safeguards within the bill, including a mandatory review of the program if its expenses were to skyrocket and a possible requirement that the state withdraw if the federal government fails to fund it as promised. Sen. Jeremy Nordquist of Omaha told The Associated Press that he and other lawmakers plan to float the idea Tuesday when they return to the Capitol for a long-awaited debate on Medicaid expansion (4/15).

Health News Florida: New Report Finds Hidden Savings In Medicaid Expansion
State lawmakers may have overlooked more than $430 million in yearly savings for Florida taxpayers by not accepting the federal dollars promised through the Affordable Care Act. The savings, says the Medicaid director at Florida’s Agency for Health Care Administration, come from the Obama administration's recent pledge to pay the full cost of "Medically Needy" recipients annually (Gentry, 4/15).

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Providers Push For New Payment Systems

Health care providers increasingly are embracing payment systems -- based on ideas such as bundled payments, accountable care organizations and medical homes -- that reimburse based on treatment as a whole rather than the fee-for-service model.

USA Today: Health Care Providers Want Faster Changes In Payments
Health care providers are pushing the federal government to scrap the payment plan for medical services, preferring instead one payment for a patient's entire care instead of separate fees for each item. Instead of fee-for-service medicine, in which a provider receives a payment for every test, procedure and visit, providers want the government — or states or private payers — to pay for treatment as a whole. In theory, physicians would provide treatments that have been proven to work but are also cost-effective (Kennedy, 4/14).

Meanwhile, Medpage Today reports on developments regarding accountable care organizations -

Medpage Today: More Docs Joining Forces In ACOs
The number of physician-led accountable care organizations (ACOs) has recently surpassed the number led by hospitals, becoming the largest backers of the payment and delivery model, an analysis showed. Last March, hospital-led ACOs outnumbered those headed by doctors nearly two to one (91 to 45), said Neil Kirschner, PhD, ACP senior associate of regulatory and insurer affairs. But after the Centers for Medicare and Medicaid Services (CMS) approved a new batch of ACOs earlier this year, physician-led organizations outpaced their hospital counterparts (202 to 189), he reported at the American College of Physicians (ACP) annual meeting (Pittman, 4/14).

In addition, Medpage Today also reports on the challenges of coding for the ICD-10 system -

Medpage Today: Docs' Charting Falls Short Of ICD-10 Demands
Nearly 65 percent of clinical documentation doesn't contain enough information for coders to use for billing under the upcoming ICD-10 coding system, a coding expert said here at the American College of Physicians annual meeting. The switch to the new coding system will greatly increase the specificity of diagnostic codes, and most doctors don't provide enough detail for office coders to translate that to ICD-10, said Rhonda Buckholtz, vice-president of ICD-10 education and training at AAPC, a medical coding society based in Salt Lake City, Utah. Her estimate of the percentage of charts that were inadequately documented came from a survey of patient charts done by the AAPC, but further detail on the survey was not provided (Pittman, 4/12).

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Health Care Marketplace

Supreme Court To Decide Crucial Case On Patenting Human Genes

The high court will hear a challenge to Myriad Genetics' patent of breast and ovarian cancer genes in a case that will affect the future of biomedical research, the fight against diseases like breast and ovarian cancer and a multi-billion dollar biotechnology business.

The Associated Press: Supreme Court To Hear Arguments Over Whether Human Genes Can Be Patented
DNA may be the building block of life, but can something taken from it also be the building block of a multimillion-dollar medical monopoly? The Supreme Court grapples Monday with the question of whether human genes can be patented. Its ultimate answer could reshape U.S. medical research, the fight against diseases like breast and ovarian cancer and the multi-billion dollar medical and biotechnology business (Holland, 4/15).

NPR: Supreme Court Asks: Can Human Genes Be Patented? 
Myriad Genetics, a Utah biotechnology company, discovered and isolated two genes — BRCA 1 and BRCA 2 — that are highly associated with hereditary breast and ovarian cancer. Myriad patented its discovery, giving it a 20-year monopoly over use of the genes for research, diagnostics and treatment. A group of researchers, medical groups and patients sued, challenging the patent as invalid. There is no way to overstate the importance of this case to the future of science and medicine (Totenberg, 4/15).

The New York Times: Justices Consider Whether Patents On Genes Are Valid
Opponents of gene patents say no company should have rights to what is essentially part of the human body. They contend that Myriad’s monopoly has impeded medical progress and access to testing — in some cases denying patients their own genetic information. Myriad and its allies in the biotechnology industry counter that a ruling that invalidates gene patents would upend three decades of patenting practice and undermine billions of dollars of investments to develop not only genetic tests but also biotech drugs, DNA-based vaccines and genetically modified crops. (Pollack, 4/14).

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Aging Of America Means Not Enough Home-Care Workers

The Wall Street Journal: As America Ages, Shortage Of Help Hits Nursing Homes
A labor shortage is worsening in one of the nation's fastest-growing occupations—taking care of the elderly and disabled—just as baby boomers head into old age. Nursing homes and operators of agencies providing home-care services already are straining to find enough so-called direct-care workers, who help the elderly or disabled with such things as eating and bathing. They also face looming retirements in the current workforce, in which one-fifth of workers are 55 years old or older. ... The number of Americans 65 years and older is projected to reach 73 million in 2030, up from 40 million in 2010 (Hagerty, 4/14).

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Health Information Technology

Does ICU Remote Monitoring Save Lives, Money?

The New York Times: Debating The Effectiveness Of Remotely Monitoring Intensive Care Patients
High in a Manhattan skyscraper near Grand Central Terminal on a recent Tuesday, 80 critically ill patients in intensive care units scattered from Georgia to New Jersey were being monitored, remotely, by a doctor scanning a dozen computer screens. ... More than a decade ago, this kind of tele-ICU command center was trumpeted by its creators as the new standard in critical care, a way to save lives and money ... Today, with the growth of such systems stalled at about 10 percent of ICU patients nationwide, and wildly contradictory studies about the results, no one can say with authority if, or under what circumstances, tele-ICUs deliver on their promises (Bernstein, 4/14).

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Administration News

White House Mental Health Fix For Security Clearance Process Draws Critics' Questions

Politico: Critics Question White House Mental Health Fix
The Obama Administration is trying to revamp how the government approaches mental health issues in the security clearance process — but security and mental health experts say the proposed fix may open the door to new problems. Last month, the administration officially proposed rewording the standard mental-health question asked of all those applying for or renewing a clearance to handle classified information (Gerstein, 4/15).

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FDA Finds Violations At 28 Drug Compounding Pharmacies

The FDA has found safety violations at 28 of 29 compounding pharmacies that are supposed to be producing sterile drugs. In other news, a drug patent on OxyContin expires this week, but generic versions could take a while to produce.

Medpage Today: FDA Turns Up Heat On Compounders
FDA inspectors issued violation notices to 28 compounding pharmacies after surprise inspections -- that is, nearly every pharmacy they visited that was producing supposedly sterile drugs. According to the agency, FDA inspectors recently performed 29 inspections at compounding pharmacies in 18 states believed to be selling sterile drug products. All but one resulted in "Form 483" notices listing deviations from safe drug production standards (Gever, 4/14).

The Wall Street Journal: Generic OxyContin Pains The FDA
The first patent on OxyContin expires Tuesday, a milestone in the history of one of the most powerful and abused painkillers on the market. But it could be quite some time before generic versions of the drug are available (Martin, 4/14).

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State Watch

Medicaid Gamble In Ore. Could Make It National Leader, Or Cost Millions

A Medicaid experiment could make Oregon a leader in controlling costs and improving care in the program -- or it could cost the state millions in penalties. How states pay for Medicaid also makes news in North Carolina and Wisconsin.

The New York Times: Experiment in Oregon Gives Medicaid Very Local Roots
Under an agreement signed with the Obama administration last year, and just now taking shape, Oregon and the federal government have wagered $1.9 billion that -- through a hyper-local focus on Medicaid --the state can show both improved health outcomes for low-income Medicaid populations and a lower rate of spending growth than the rest of the nation. If Oregon fails on either front, the consequences are grave, potentially tens of millions of dollars in penalties a year (Johnson, 4/12).

Related, earlier KHN story: Oregon's $2 Billion Medicaid Bet (Foden-Vencil, 5/30/12)

North Carolina Health News: How 'Broken' Is NC Medicaid?
Since January, state officials have maintained that North Carolina Medicaid is 'broken.' Last month, Gov. Pat McCrory proposed an overhaul of the program, which provides health care for more than 1.8 million North Carolinians.  ... Some observers say that the problems with Medicaid have been trumped up and that McCrory’s assertions of the program’s problems were devised to provide him with the political cover not to expand Medicaid as allowed for under the Affordable Care Act (Hoban, 4/15).

Milwaukee Journal Sentinel: Wisconsin To Pay $6.3 Million More Annually For LogistiCare Replacement
State taxpayers will be shelling out an extra $6.3 million per year for medical transportation for Wisconsin Medicaid recipients once MTM Inc. takes over for LogistiCare, according to a Journal Sentinel analysis of bids. Just a few years ago, state officials estimated that having a private firm dispatch rides would save the state $4 million a year. The Journal Sentinel analysis raises questions about whether the privatization really saves state taxpayers money (Laasby, 4/14).

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Abortion-Rights Supporters Worry New Rules Could Shutter Va. Clinics

Newly passed regulations adopted Friday in Virginia will require many abortion clinics there to undergo costly renovations, a move that opponents say is aimed at forcing the clinics closed.

Politico: Virginia Adopts Stricter Rules For Abortion Clinics
The Virginia Board of Health gave final approval to a sweeping set of regulations for abortion clinics Friday. Abortion-rights supporters say the regulations -- which would require many clinics in the state to undergo costly renovations to stay in business -- have one goal: to put abortion clinics out of existence (Smith, 4/15).

Reuters: Virginia Becomes Latest State To Tighten Abortion Rules
Virginia on Friday required abortion clinics to meet stricter hospital-style standards that could force some go out of business, making it the latest state to tighten rules on the procedure. The rules, passed overwhelmingly by the Virginia Board of Health, could force abortion providers to undertake costly renovations, widening hallways and installing new ventilation system and awnings (Robertson, 4/12).

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Roundup: Long-Term Care Costs Soar In Virginia

A selection of health policy stories from Arizona, Virginia, Nevada, Massachusetts and California.

Arizona Republic: Brewer Vetoes Bill Requiring Doctors To Post Prices Online
Gov. Jan Brewer vetoed legislation Friday that would have required doctors, hospitals and other health care providers to post prices for their most common services, a move the bill's sponsor said was a blow to consumers and driven by industry pressure. In her veto letter, the governor said the measure's "ambiguous terms and definitions" could conflict with state and federal laws and expose the state to lawsuits. … Sen. Nancy Barto, R-Phoenix, dismissed the governor's explanations as "red herrings" and accused her of bowing to pressure from the hospital industry, which opposed Senate Bill 1115 (Reinhart, 4/12).

Richmond Times-Dispatch: Long-Term Care Costs Rise In Virginia
The cost to receive care at home in Virginia through a home health aide increased during the past five years, a new survey shows. The Cost of Care survey by Henrico County-based Genworth Financial found that the costs are increasing faster in Virginia than national levels in some cases. The survey, released last week, shows the hourly rate for homemaker services and home health aide services in Virginia is $17 and $18, respectively (4/14).

The Associated Press: Psychiatric Hospital Accused Of Patient Dumping
Nevada's primary state psychiatric hospital has transported more than 1,500 mentally ill patients to cities across the nation by Greyhound bus over the last five years, according to a published story. As Nevada has slashed funding for mental health services, the number of such patients being bused out of Rawson-Neal Psychiatric Hospital in Las Vegas climbed 66 percent from 2009 to 2012, The Sacramento Bee reported Sunday (4/14).

Kaiser Health News: Capsules: Programs Help Independent Artists Access Health Care
Freelance artists are part of the estimated 15 million people who are currently self-employed, according to a U.S. Department of Labor 2012 estimate. … Programs like Springboard and the Freelancers' Union co-ops help a community that Hunt said is often underinsured because many artists have low incomes -- between $12,500 and about $25,000 -- especially when they are not yet established (Rao, 4/15).

Boston Globe: Holistic Criteria Aid Medical School
Medical schools traditionally have accepted students with the highest test scores and best science grades. But in an article published online Wednesday by the New England Journal of Medicine, Dr. Robert Witzburg of Boston University School of Medicine writes about what he considers a better approach to choosing future physicians: holistic review. Medical schools that use this method give potential students points for overcoming adversity, showing resilience, and being empathetic -- as well as for academic achievement. Admissions officers consider letters of reference, interviews, and community service experience to evaluate these qualities (Conaboy, 4/15).

Boston Globe: Support Grows For Legislation Requiring Paid Sick Leave
A nearly decade-long effort to require Massachusetts employers to offer paid sick days is gaining momentum as lawmakers pass similar proposals across the country. At least five cities and one state, Connecticut, have mandated that employers provide the benefit in recent years, with New York City poised to join them after the City Council agreed to enact legislation requiring businesses with 20 or more employees to offer five paid sick days a year. Similar proposals are under consideration in Philadelphia and Vermont (Woolhouse, 4/15).

California Healthline: Step Forward For Oral Chemotherapy Bill
The Assembly Committee on Health approved a bill Tuesday that would require health insurers to provide oral chemotherapy therapy to their members with a maximum out-of-pocket $100 co-pay per prescription. Another version of AB 219 by Assembly member Henry Perea (D-Fresno) passed the Legislature last year, but was vetoed by the governor. "This bill would ensure cancer patients have affordable access to the most appropriate cancer treatment covered by insurers," Perea said. "When the governor vetoed a similar bill last year, he encouraged me to work with his administration to design a policy that will work for California. AB 219 represents a new strategy to make oral chemotherapy affordable” (Gorn, 4/12).

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Editorials and Opinions

Viewpoints: Editorial Boards Offer Advice To Supreme Court On Gene Patents

The New York Times: Are Human Genes Patentable?
On Monday, the Supreme Court is scheduled to hear argument about that decision in Association for Molecular Pathology v. Myriad Genetics. The petitioners in the case — doctors, scientific researchers and women’s health organizations — argue that the isolated genes are not materially different from genes before extraction, and that allowing Myriad a patent on them would allow the patenting of nature itself, at untold cost to scientific research, medical treatment and patients (4/14). 

The Washington Post: Patents On Human DNA Need Congress's Input
Balancing the benefits of free-flowing research against the value of mobilizing private money to detangle genetic code is a hard policy call that Congress should make. Myriad mounts a good case that refusing to offer gene patents would endanger billions invested in U.S. genetics research, plowed into the field on the assumption that companies could obtain patents. The company has reason to say that its work, though profit-motivated, has brought major progress to women’s health. That's why the rest of the industrialized world allows gene patents, too (4/15).

USA Today: Myriad Reasons To Block Gene Patents
The law here seems simple, allowing patents for "anything under the sun that is made by man," to quote a phrase from an earlier Supreme Court decision. But the question of what's man-made is much harder. Myriad Genetics says its work in isolating the BRCA genes created something man-made and patentable. Myriad's critics say — correctly, in our view — that's like patenting elements in the periodic table or claiming that a kidney could be patented once it's removed from the body for transplant. By locking up the BRCA genes and making its $3,340 test the only one doctors can use without the company's permission, Myriad stifles independent scientific inquiry and the sort of competition that might produce better or cheaper tests (4/14). 

USA Today: Myriad Genetics: Patents Save Lives, Aid Innovation
Monday, the Supreme Court will hear a challenge to patents issued to us that were essential for the creation of those tests. Our tests have been used by more than 1 million women to determine whether they are at increased risk of developing hereditary breast, colon, uterine and ovarian cancer. There are several misconceptions about this case. We did not patent the genes in anyone's body. That is not possible under U.S. patent law. Instead, we patented our own discoveries — the synthetic molecules we isolated and created in the lab to provide life-saving tests (Peter D. Meldrum, 4/14).

Roll Call: Capretta: Medicaid Overhaul Must Focus On Long-Term Care
Congressional Republicans want to convert Medicaid into a block grant — an idea the Obama administration strongly opposes. The federal government would provide fixed levels of funding to the states, and the states would be given the freedom to manage the program with fewer federal restrictions (James C. Capretta, 4/12).

The Wall Street Journal: The White House Brain Initiative Hits A Tax Hurdle
Step into any operating room where neurosurgery is being performed, and there is a good chance that the surgeon is viewing the brain through a camera. Technology today is saving lives by enabling surgeons to see what the naked eye cannot. As archeologists use advanced radar technology to examine sensitive sites before excavating, neurosurgeons use advanced imaging technology to get a clear picture of the brain before operating. The data are then loaded into microscopes that guide surgery, providing a safer path through the brain's intricate wiring, where one wrong cut risks paralyzing the patient (Gregory Sorensen, 4/14). 

Los Angeles Times: Barlow Hospital's Overreach
To finance a new facility near the site of the old one, the hospital wants to sell 19 acres of its land to a developer to create a high-density residential development of about 600 units. And to make that happen, administrators have said they will seek massive changes in the zoning and land-use designations of the property. Getting those city approvals, which will allow the hospital to sell the land at a high price, is the only thing that stands between life and death for the hospital, its chief executive, Margaret Crane, contends. If the hospital can't raise what it needs from a sale, she says, it will go out of business. As regrettable as it would be if Barlow were to close, that possibility does not justify an upheaval of the zoning and land-use plans for the Silver Lake, Echo Park and Elysian Valley area — the community plan for which was updated nine years ago (4/14).

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.