Daily Health Policy Report

Wednesday, May 9, 2012

Last updated: Wed, May 9

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Reform

Health Care Marketplace

Campaign 2012

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Capsules: These Health Law Bets Aren't A Figure Of Speech

Now on Kaiser Health News's blog, Jay Hancock reports: "The stakes are high in the Supreme Court's consideration of the 2010 health law, as countless commentators have observed. In some circles, however, the gambling metaphor has been pushed to its logical conclusion" (Hancock, 5/8). Check out what else is on the blog.

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Political Cartoon: 'Lazy Boy?'

Kaiser Health News provides a fresh take on health policy developments with "Lazy Boy?" by Jeff Parker.

Meanwhile, here's today's health policy haiku:

LATEST LINE

Step off NBA 
New focus of wagering
Supremes v. reform
-Anonymous

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

Senate Embroiled In Partisan Struggle Over Student Loan Rates

At issue is how to pay for an extension of the current interest rate. Democrats propose increasing the Social Security and Medicare payroll taxes on high-earning stockholders of some privately owned corporations. Republicans would like to take funds from the health law's prevention fund.

The New York Times: Republicans In Senate Block Bill On Student Loan Rates
Senators said quiet negotiations had begun to resolve the impasse, but Democrats sought to raise the political pressure. … [T]he Republicans would not accept the Senate Democrats' proposal to pay for a one-year extension by changing a law that allows some wealthy taxpayers to avoid paying Social Security and Medicare taxes by classifying their pay as dividends, not cash income. ... But the Democratic line of attack has been complicated by the House's actions. Shrugging off a veto threat, the House passed an extension of the subsidized rate last month, paid for with the preventive health care fund (Weisman, 5/8).

Los Angeles Times: Senate Republicans Block Proposal To Keep Student Loan Rates Low
Republicans also want to avoid raising the rate on college loans, but would pay for it by eliminating a public health fund in Obama's new healthcare law. The stalemate comes as both parties turn routine legislative votes into campaign debates (Mascaro, 5/8).

The Associated Press: GOP Blocks Senate Debate On Dem Student Loan Bill
Senate Republicans derailed a Democratic bill on Tuesday that would keep interest rates on federal college loans from doubling July 1 in an election-year battle aimed at the hearts — and votes — of millions of students and their parents. Republicans said they favor preventing the interest rate increase but blocked the Senate from debating the $6 billion measure because they oppose how Democrats would pay for it: Boosting Social Security and Medicare payroll taxes on high-earning stockholders of some privately owned corporations (Fram, 5/8).

Roll Call: Political Upside To Stalled Student Loan Bill
Seeing a political opportunity, Senate Democrats will continue to criticize Senate Republicans on the floor this week for voting against their student loan bill before moving to the next item of business, which could be the Democrats' small-business tax cut package. … Republicans and business groups have said the Democrats' offset would make businesses less likely to hire because it would increase their tax burden. Senate Republicans prefer the House-passed bill, which is offset by eliminating a fund in the 2010 health care overhaul that covers prevention and public health (Sanchez, 5/9).

Meanwhile, in other Capitol Hill news -

The Associated Press/Washington Post: Republican-Led House Panel Considers Higher 2013 Defense Spending Plan
The House bill challenges the administration's proposal on several important fronts, including a provision that would block planned increases in health care fees for certain military retirees. The administration argues that such increases are overdue and that the savings are needed to preserve spending in other areas (5/9).

Modern Healthcare: Budget Bill Riles Public Health Advocates
Public health advocates this week decried healthcare reductions in a bill from the House Budget Committee that aims to replace across-the-board cuts in federal programs scheduled for next January. In a 21-9 vote, the committee approved the Sequester Replacement Reconciliation Act of 2012, a 187-page GOP proposal to replace the so-called sequester, which would cut $109 billion in defense and nondefense government spending on Jan. 2, 2013 (Zigmond, 5/8).

And, in a rare report of legislative progress -

Politico: House Measure On FDA User Fees Set For Markup Thursday
The "must-pass" Food and Drug Administration user fee bill was sent to the full House Energy and Commerce Committee on Tuesday morning on a raft of blown kisses from Democrats and Republicans on the Health Subcommittee. After more than a year of work, at least 10 hearings related to user fees and "intense negotiations as recently as last weekend," Joe Pitts (R-Pa.), chairman of the subcommittee said its members praised their staffs and one another and passed the bill by unanimous voice vote (Norman, 5/8).

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Health Reform

HHS Awards 26 Innovation Grants

The grants, which were created by the 2010 health law, were made to support projects that aim to improve coordination of care and reduce health care costs. News outlets also offer a look at some of the programs that will receive a funding boost.

Modern Healthcare: HHS Sees Health Care Innovation Awards Leading To Savings
A program to hire critical-care professionals to work in underserved areas in Georgia, a project to improve services for Rhode Island mothers who give birth to pre-term babies, and a plan to train paramedics and telehealth technicians to provide care for cardiovascular patients in Colorado are among the recipients of the first round of Health Care Innovation Awards that HHS announced Tuesday. The CMS Innovation Center will administer the awards, which were created by the Patient Protection and Affordable Care Act and will provide up to $1 billion in grants to applicants who present the best ideas on how to deliver better care and lower costs for people enrolled in the Medicare, Medicaid and Children's Health Insurance Programs (Zigmond, 5/8).

CQ HealthBeat: HHS Gives The Green Light To 26 Projects Stressing Health Care Innovation
A plan to improve dental care for American Indian mothers, children and diabetics living on reservations in South Dakota is among 26 innovation projects that the Department of Health and Human Services announced Tuesday it will fund. Delta Dental Plan will receive $3.4 million to train two dozen dental hygienists and community health workers to provide preventive care to patients on the reservations and coordinate their care, according to the HHS grant announcement (Norman, 5/8).

The Philadelphia Inquirer: Three Health Care Projects In Region Awarded Almost $10M
The Center for Medicare and Medicaid Innovation, part of the U.S Department of Health and Human Services, has awarded $122.6 million for 26 projects nationwide -- including $9.7 million for three in the Philadelphia region -- designed to improve care and reduce health-care costs in urban and rural areas. Among those receiving money in the first batch of such awards under the Affordable Care Act was Cooper University Hospital in Camden, [N.J.,] to expand the work of the Camden Coalition of Healthcare Providers (Brubaker, 5/9).

Chicago Sun-Times: Michelle's Old Program Gets $5.9M Grant
A University of Chicago Medicine’s health program -- once headed by First Lady Michelle Obama when it was created, now run by Dr. Eric Whitaker, close friend of the First Couple -- was awarded a $5.9 million grant by the Department of Health and Human Services. The grant was announced on Tuesday; the U. of C.'s Urban Health Initiative was one of 26 programs winning federal Health Care Innovation grants -- funded through President Barack Obama's Affordable Care Act (Sweet, 5/8).

Boston Globe: $11.6M Grants Go To Boston Programs Serving Elders, Homeless
Three Boston organizations will receive $11.6 million from the federal government to expand programs focused on keeping sick seniors out of the hospital, improving the health of children with asthma, and connecting people who are homeless with better medical care. The grants announced Tuesday by the Centers for Medicare & Medicaid Services are among $123 million awarded under the Affordable Care Act to programs aimed at improving health care quality and lowering costs (Conaboy, 5/8).

New Orleans Times-Picayune: Ochsner Clinic Foundation receives Health Care Innovation Award
Utilizing the Innovation Award, Ochsner will focus on better serving almost 1000 acute stroke patients in Jefferson and St. Tammany parishes by employing two telemedicine enabled concepts called "Stroke Central" and "Stroke Mobile." These systems will enable care providers to monitor patients, evaluate outcomes, and check on medication and treatment adherence on a real-time basis both in the hospital and in the home (Barkoff, 5/8). 

North Carolina Health News: Three NC Health Care Orgs Get Federal Innovation Grants
Diabetes patients in Southeastern NC counties, people with chronic pain in 16 Western NC counties, and homeless patients statewide will be getting a little more health care, thanks to grants announced today. ... One project will be administered through Duke University, where doctors, nurses and patient educators will identify patients with diabetes in Durham and Cabarrus Counties, and work with them to have better clinical outcomes (Hoban, 5/8). 

Politico Pro: Innovation Awards Fail As Job Creators
Just how many jobs will be created as a result of the Health Care Innovation Awards, announced Tuesday as a part of President Barack Obama's "We Can't Wait" initiative? Well, dozens. About $2 million in funding awarded to a project at George Washington University is expected to result in just three new jobs, according to the project profiles listed on the website of the Center for Medicare and Medicaid Innovation. Another $2.5 million to an awardee in Tennessee — Vanderbilt University Medical Center — will create a total of 4.6 new jobs (Smith, 5/9).

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How Much Muscle Is Behind HHS' Power To 'Scrutinize' Rate Increases?

Politico examines HHS's ability to protect consumers from"unreasonable" premium increases. Meanwhile, The Hill reports on a study analyzing how many insurance plans should be allowed in state-based health exchanges.   

Politico: Jawboning By HHS Doesn't Scare Insurers
The health reform law gave HHS the power to scrutinize "unreasonable" rate hikes in states that didn't have robust review programs. But "scrutiny" doesn't give the department power to actually block the rates from going into effect. HHS can use its bully pulpit to publicly shame insurers whose rates don't pass its sniff test – and HHS has done just that, holding four media calls since November to scold insurers each time it's made a new "unreasonable" determination. Faced with the choice of dealing with some negative press on the national stage or upending their business plan, the four insurers that have been dinged by HHS have all chosen to stick with the business plan (Millman, 5/8).

The Hill: Study: States Should Limit Number Of Plans In Exchanges
States should use their new insurance exchanges to narrow down the number of plans consumers can choose from, according to an analysis published in the journal Health Affairs. The article says states should follow Massachusetts's example as they create their exchanges. A hands-on exchange with the power to set standards on top of the federal healthcare law will help prevent consumers from being "overwhelmed" by the process of buying insurance, the authors wrote (Baker, 5/8).

Also in the news, what are the odds on the Supreme Court's health law decision -

Kaiser Health News: Capsules: These Health Law Bets Aren't A Figure Of Speech
The stakes are high in the Supreme Court's consideration of the 2010 health law, as countless commentators have observed. In some circles, however, the gambling metaphor has been pushed to its logical conclusion (Hancock, 5/8).

Georgia Health News: Analyzing The Future Of Health Reform Law
Fifty-fifty. Those are the odds given by a prominent Atlanta attorney that the Supreme Court will uphold the 2010 health reform law. He gives the same odds that the justices will strike down the Affordable Care Act (ACA) in its entirety or just its controversial mandate for most individuals to purchase health insurance (Miller, 5/9). 

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Health Care Marketplace

How Much Will A Retired Couple Spend On Health Care? $240,000

This estimate, released by Fidelity Investments, reflects a 4 percent increase over medical bill projections for a couple that retired a year earlier. The amount doesn't include long-term care costs or over-the-counter drug expenses, among other things.

The Associated Press: Retired Couples May Need $240,000 For Health Care
Couples retiring this year can expect their medical bills throughout retirement to cost 4 percent more than those who retired a year ago, according to an annual projection released Wednesday by Fidelity Investments. The estimated $240,000 that a newly retired couple will need to cover health care expenses reflects the typical pattern of projected annual increases. The Boston-based company cut the estimate for the first time last year, citing President Barack Obama's health care overhaul. Medicare changes resulting from that plan are expected to gradually reduce many seniors' out-of-pocket expenses for prescription drugs (Jewell, 5/9).

Market Watch: Your Retirement Health-Care Tab Will Run $240,000
Retirement health-care costs are enough to cause a severe anxiety attack. Even with Medicare benefits, a 65-year-old couple retiring in 2012 will spend at least $240,000 in retirement, according to the latest estimate from Fidelity Investments. That doesn't include long-term-care costs, over-the-counter medications and most dental costs (Coombes, 5/9).

Bloomberg: Health Law Repeal To Cost Seniors $20,000, Fidelity Says
Retirees may pay about $20,000 more for medical care if the U.S. Supreme Court overturns the 2010 health care overhaul, Fidelity Investments said. A 65-year-old couple retiring this year will spend $240,000 out-of-pocket for care before their deaths, after accounting for Medicare coverage, Fidelity said in an annual estimate released today. That's an increase of $10,000 from last year and includes premiums and co-payments under Medicare and supplementary coverage called Medigap, the Boston-based mutual-fund manager said (Wayne, 5/9).

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Chicago Mayor To Minnesota Attorney General: Step Back From Accretive Probe

In response to a letter from Chicago Mayor Rahm Emanuel, Minn. Attorney General Lori Swanson vowed to press on in her investigation of Accretive Health, Inc. Meanwhile, Sen. Al Franken, D-Minn., scolded the company.

Market Watch: Emanuel Steps In To Aid Accretive In Dispute
Chicago Mayor Rahm Emanuel has stepped in on behalf of an ailing health-care consultant in its current dispute with Minnesota authorities. Emanuel, former chief of staff to President Barack Obama, has written a letter to Minnesota Attorney General Lori Swanson asking that she try to negotiate directly with Accretive Health Inc., which is based in Chicago (Britt, 5/8).

(St. Paul) Pioneer Press: Despite Chicago Mayor's Intervention, Minnesota AG Says She Won't Back Off Accretive Probe 
In April, Swanson released the results of her investigation of Accretive Health's relationship with the Fairview health system, saying the parties had engaged in overly aggressive billing tactics that included pressuring patients for payment in emergency rooms and maternity wards (Snowbeck, 5/8).

Minneapolis Star Tribune: Rahm Emanuel: Back Off Accretive Health Probe
Emanuel’s letter did not directly address any of the concerns Swanson’s report raised, but said Accretive Health “does important work for hospitals and good things for our City, particularly for our neediest citizens" (Mitchell, 5/8).

The Hill: Franken Chides Embattled Medical Debt Collector For Dragging Feet On Questions
Sen. Al Franken (D-Minn.) scolded one of the largest U.S. medical debt collectors for twice missing deadlines to defend its practices, which allegedly include pressuring patients to pay for emergency medical care before they receive it. "I am disappointed that Accretive [Health] still has not responded to my letter," Franken wrote CEO Mary Tolan on Tuesday (Viebeck, 5/8).

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Trends: Nonprofit Hospital Challenges, Rules At Hospitals With Religious Affiliations

Nonprofit hospitals face a range of challenges related to increasing costs and diminishing resources, while hospitals with religious affiliations play by rules that can affect the care they deliver.

Reuters: Nonprofit U.S. Hospitals To Do More With Less -- Moody's
Nonprofit hospitals in the United States face a future of rising costs and dwindling funds as the healthcare reform is implemented and the Congress battles over the budget, according to a Moody's Investors Services report released on Wednesday. To survive what the rating agency is calling a "transition period," the hospitals, which frequently provide free or discounted care for lower-income patients, will have to drastically cut spending (5/9).

NPR: When Religious Rules And Women's Health Collide
When you go to the hospital these days, chances are good that it will be affiliated with a religious organization. And while that may might just mean the chaplain will be of a specific denomination or some foods will be off limits, there may also be rules about the kind of care allowed (Rovner, 5/8).

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Campaign 2012

Health Law Leaving Mark On Campaigns

Health care votes and positions continue to leave their mark on races for office around the country as well as in the battle for the presidency where both Mitt Romney and President Obama are courting Latino voters.

The Washington Post: Virginia Poll: Kaine, Allen Still Tied In Much-Watched Senate Contest
Yet the new poll includes some negative trends for Kaine: Registered voters are now equally divided in their impression of him, with 41 percent apiece viewing the Democrat favorably and unfavorably. A year ago, Kaine's rating was 2 to 1 positive, at 57 to 28 percent. Kaine's decline could be the partial result of negative ads that have aired against him in the state and efforts by Republicans to link him to health care reform, the stimulus package and other controversial Obama administration policies (Pershing and Craighill, 5/8).

The Associated Press: Chamber To Run Congressional Ads
The U.S. Chamber of Commerce is launching ads in Florida, Missouri, Hawaii and Ohio as Democrats struggle to hold Senate seats and their slim majority. The Republican-friendly lobbying group is also targeting 17 House races from New York to Minnesota. The ads, hitting Democratic incumbents over votes for President Barack Obama's health care overhaul and backing his energy policies, will begin airing Wednesday and Thursday and run for 10 days to two weeks, part of a multimillion-dollar buy six months before the election (Cassata, 5/8).

The Associated Press: Obama And Romney Campaigns Target Hispanic Voters
President Barack Obama's re-election campaign is launching a series of Spanish-language television ads in three battleground states. ... The Obama campaign ads promote the president's federal health care overhaul, and are running in Florida, Nevada and Colorado. Polling shows that Obama has a wide lead over Romney among Hispanics (Fouhy, 5/8).

Denver Post: Obama Campaign Launches Second Round Of Spanish-Language Ads
President Obama's re-election campaign is releasing a new series of Spanish-language ads in Colorado, Nevada and Florida today. The ads focus on how the Affordable Care Act, the president's health care legislation currently before the U.S. Supreme Court, affects Hispanics. They follow ads that went up last month about how Obama's education policies -- particularly Pell Grants and HeadStart -- impacted the Hispanic community (Burnett, 5/8).

Politico: Obama Up With Second Spanish-Language Ad Campaign
President Obama's re-election campaign is going on the air with a second series of Spanish-language ads. According to the campaign, the ads will air in Colorado, Nevada and Florida. The ads tout Obama's health care reform effort -- a reform effort that the campaign says has made affordable health care available for up to 9 million Hispanics. It's the second Spanish-language ad buy from the campaign -- with the Obama campaign hoping to max out their support among Hispanics wary of Republican rhetoric on immigration (Tau, 5/8).

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Public Health & Education

Obesity Report Proposes Sweeping Changes In Schools, Communities, Workplaces

The Institute of Medicine panel recommended five critical areas to focus on to lower obesity: physical activity, food and beverage, marketing, work and schools.

Boston Globe: Do We Finally Have A Solution To The Obesity Epidemic?
In order to reverse the American obesity epidemic that has left 1 out of 3 children and 2 out of 3 adults overweight, the nation needs to pool its resources to implement a number of sweeping initiatives (Kotz, 5/8).

The Wall Street Journal: The ABCs Of Beating Obesity
Obesity is so entrenched in the U.S. that it would take an intense push by schools, employers, doctors and others to reverse an epidemic that accounts for billions of dollars in annual health-care costs, concluded a report released Tuesday (McKay, 5/8).

The Associated Press: Report: Schools Key To Fighting America's Obesity
[S]chools should be a national focus because that's where children spend most of their day, eat a lot of their daily calories -- and should be better taught how to eat healthy and stay fit, the influential Institute of Medicine said Tuesday (Neergaard, 5/8).

The New York Times: Bans On School Junk Food Pay Off In California
Five years after California started cracking down on junk food in school cafeterias, a new report shows that high school students there consume fewer calories and less fat and sugar at school than students in other states. The findings suggest that state policies can be successful to some extent in influencing the eating habits of teenagers (O'Connor, 5/8).

Reuters: Obesity Fight Must Shift From Personal Blame -- U.S. Panel
In an ambitious 478-page report, the IOM refutes the idea that obesity is largely the result of a lack of willpower on the part of individuals. Instead, it embraces policy proposals that have met with stiff resistance from the food industry and lawmakers, arguing that multiple strategies will be needed to make the U.S. environment less "obesogenic" (Begley, 5/8).

Los Angeles Times: Obesity Vs. 'Nanny State'? Recommendations Lead To Backlash
These recommendations -- made Tuesday at a government-led conference on the nation's health -- were greeted with applause by health care advocates alarmed at the nation's obesity problem. But in other corners, the recommendations were seen as a shift away from personal responsibility (Lynch, 5/8).

MedPage Today: IOM: Society Must Rally to Fight Obesity
But the Center for Consumer Freedom, a nonprofit group supported by restaurants and food vendors, called the report's endorsement of policies such as soda taxes and restaurant zoning laws "misguided." It cited a lone study showing that food prices and restaurant locations play a "miniscule" role in the obesity epidemic, and noted recent CDC data that show obesity rates are leveling off (Fiore, 5/8). 

National Journal: Recess, New Menus Key To US Obesity Crisis, Report Finds
[The report says] Children need to get at least an hour of exercise a day at school -- a difficult goal at a time when recess is often limited to 10 or 15 minutes a day -- and Americans need help in making exercise a regular part of their daily lives (Fox, 5/8).

Medscape: Obesity Prevention Addressed in New IOM Report
The IOM formed the Committee on Accelerating Progress in Obesity Prevention to address the health care challenges presented by obesity. ... The new report identifies 5 critical areas, or "environments," from which to attack the problem: physical activity, food and beverage, message (or marketing), health care and work, and schools (MacReady, 5/8). 

ABC: Why U.S.'s Big Fat Problem Is Your Problem, Too
Dr. Shiriki Kumanyika, an IOM committee member and professor of epidemiology at the University of Pennsylvania School of Medicine, said that what this report does is "qualitatively different." "It’s not a laundry list. It’s a specific kind of road map and recipe for change," she said. "We packaged those 'ingredients' so we can counter a recipe for what, specifically we should do, where should we put our energy, which things will work together" (Marshall, 5/8).

NewsHour: Obesity In America: By The Numbers
Collectively, the numbers spell out a familiar story. American adults are expanding by the year, along with their children and health care costs. Depressing? Yes. ... [C]lick the map below to watch a tidal wave of weight gain sweep across the nation between 1995 and 2010 (Chou and Kane, 5/8).

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State Watch

Mass. Senate To Release Plan To Revamp Health Payments

The proposal, which will be formally unveiled today, follows suggested blueprints from the governor and the House on cutting the growth rate of health care costs.

Politico Pro: Mass. Payment Reform Bill Set For Release
The battle lines are being drawn in Massachusetts for an effort to remake the state's health care delivery system and slow surging health care costs. Lawmakers in the state Senate are preparing to release a bill Wednesday that would require publicly funded insurance plans — including the state's Medicaid program — to take steps to curb fee-for-service payments by July 2014. The plans would be required to adopt new payment methodologies that offer doctors financial incentives to keep patients healthy (Cheney, 5/9).

Boston Globe: 2 Mass. Plans Vie For Savings On Health Care
Massachusetts Senate leaders' plan to tame medical costs will call for less-aggressive spending limits on the health care industry than the House proposed last week, and fewer controls on high-priced hospitals and doctors, according to a summary provided to the Globe. The Senate legislation is to be unveiled Wednesday, and in interviews Tuesday, both House and Senate leaders stressed the similarities in their approaches (Kowalczyk, 5/9).

WBUR: Senate Health Cost Bill: 'Darn Similar' To House Plan, With A Few Differences
The Massachusetts Senate today released its version of a sweeping plan to control health care costs. And guess what? It's pretty close to the sweeping plan the House released last week. Both emphasize preventive care and wellness. Both place a specific cap on the growth of health spending linked to the growth of the state economy. And both envision shifting more care into systems that put doctors on a budget instead of paying per procedure. In the details, the Senate plan may be slightly more business-friendly (Zimmerman and Goldberg, 5/9). 

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DOJ Probes Fraud At Parkland Hospital; Texas Group Calls Medicaid 'Indispensable'

In other Medicaid news, Florida officials are trying to change the "Medically Needy" program, and the Connecticut House passes a budget that would cut $50 million from Medicaid programs.

The Dallas Morning News: Parkland Hit With New Medicare-Medicaid Fraud Allegations
The U.S. Justice Department has been investigating new allegations that Parkland Memorial Hospital and UT Southwestern Medical Center doctors defrauded the federal government's health insurance programs for the poor and elderly. The investigation came to light Tuesday after a federal judge unsealed a whistle-blower lawsuit filed by Dr. Lien Kyri .. [who] alleges that "hundreds of thousands" of Medicare or Medicaid billing claims were falsely submitted for rehabilitation consultations (Moffeit and Egerton, 5/8).

The Dallas Morning News: New Group Touts Medicaid As 'Indispensable'—And Not Fiscal Villain
A new coalition began sounding a contrarian note about Medicaid at the Texas Capitol on Tuesday. My Medicaid Matters said that ... contrary to conventional wisdom around the Legislature, Medicaid's costs actually have grown more slowly over the past decade than the costs of either the Medicare program for seniors or employer-provided health plans in the private sector (Garrett, 5/8).

News Service of Florida: State Seeks Changes To Medically Needy Program
Florida Medicaid officials have asked the federal government to approve major changes in a program that serves tens of thousands of people with costly medical conditions, seeking to install a type of managed care and require monthly premium payments. ... The Medically Needy program, which the agency says will cost about $1 billion this fiscal year, serves people who have often-debilitating conditions but don't qualify for the regular Medicaid program because of their income levels (5/8). 

The Connecticut Mirror: House Passes Budget That Closes $200 Million Deficit
The House of Representatives voted early Tuesday to approve a revised $20.5 billion budget for the next fiscal year. ... The new plan forecasts saving $50 million by tightening eligibility and limiting nursing home coverage in a Medicaid program that serves poor adults who don't have minor children. The changes include limiting enrollment to people with assets below $10,000  (Phaneuf, 5/8).

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States Grapple With Inadequacies In Mental Health Services

Advocates hope the fatal beating of a California homeless man by police, captured by a security camera, may spur changes. In the meantime, a D.C. report says thousands of children who need mental health services aren't getting them, and New York state fines insurers over mental health notices.

Los Angeles Times: Kelly Thomas Video A Turning Point For Mental Health Care?
This week, after the tape was played for the first time in court, it exploded in the public consciousness -- one YouTube version had been viewed 91 times each minute -- and became an instant touchstone for those who advocate for a more robust and effective mental health system. Advocates for the mentally ill said they viewed the recording, the centerpiece of the prosecution's case against two officers accused in Thomas' death, as something akin to their Rodney King video (Gold, Winton and Sewell, 5/8).

The Washington Post: Report: D.C. Children Who Need Mental Health Services Not Getting Help They Need
Thousands of District children who need mental health services are not getting them, and the city’s complex system relies too heavily on institutionalizing and medicating those who do receive care, according to a report issued this week by a leading advocacy group (Moyer, 5/8).

The Associated Press/Wall Street Journal: NY Fines 15 Insurers Over Mental Health Notices
New York regulators have fined 15 insurers $2.7 million for failing to notify small businesses they were eligible to buy special coverage for mental illnesses and children with serious emotional disturbances (5/8). 

In North Carolina, changes have set the public and private interests at odds --

North Carolina Health News: Public Money and Private Rights At Odds in NC's Mental Health System 
Last summer, North Carolina legislators set the state’s mental health system on a new course, they set state and local officials, mental health providers, and program administrators scrambling to get changes in place, and set a grueling schedule to get it all done. All the while, basic questions remain unanswered: Who ultimately decides how much care consumers get? What privacy rights do publicly funded agencies have? Who's left holding the bag if it all fails? Questions about governance of the state's new mental health agencies remain unanswered, even as some of those agencies are already open for business (Wilson, 5/9). 

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State Roundup: Ga. Personal Care Homes In Peril; Texas Vets' Wait For VA Disability

A selection of health policy stories from around the United States.

The Atlanta Journal-Constitution: Perils In Personal Care Homes
Georgia hasn't done enough to rein in an "epidemic" of mistreatment of vulnerable people by personal care home operators, an Atlanta Journal-Constitution investigation has found. Growing demand, combined with a convoluted, overstretched system of oversight, leaves the door open for abuses of elderly, mentally ill or developmentally disabled residents, many experts say. There are about 100 licensed homes for every state inspector, and for years unlicensed homes have operated with impunity (Simmons and Schneider, 5/9). 

Houston Chronicle: Texas Veterans Face Long Waits For VA To Process Disability Claims
Despite more funding and staff at the U.S. Department of Veterans Affairs, the backlog of disability claims in Houston has more than doubled since this time three years ago. More than 37,100 claims are pending at the Houston VA Regional Office, up from 17,537 in 2009. Veterans wait an average of 263 days for the office to process their claims, according to data obtained by the Houston Chronicle (Wise, 5/8).

Boston Globe: Mass. Health Law Did Not Expand Inpatient Care For Addictions, Study Says
The number of people who received inpatient treatment for drug and alcohol abuse at state-contracted facilities in Massachusetts has remained nearly unchanged since 2006, despite the expansion of insurance coverage under the state law passed that year. Authors of a study published Monday in the journal Health Affairs said their results show that increasing coverage, while helpful, is not enough to get people with addictions the care they need. Changing how care is paid for and increasing capacity for treating people with addictions is necessary, too, they said (Conaboy, 5/8).

Baltimore Sun: Maryland Health Insurance Plan Makes Cost Benefit Changes
The federal program that offers health insurance to Marylanders with pre-existing conditions has made changes recently that will make some costs go up and others go down. The program was created under the federal health reform law and was intended as a bridge for those who could not buy commercial insurance until 2014 when new exchanges are slated to launch. The program could be terminated if the health care law is overturned by the Supreme Court. But for now, officials say the program operates at market rates and they must adjust premiums and benefits each year as other insurers do with their plans (Cohn, 5/8).

The Kansas City Star: Plan To Provide More Dental Help In Kansas Gets Pulled
Kansas lawmakers have wrestled with the issue this year, but they rejected a plan that social service advocates believe would do the most good but that dentists say would put patients at risk. At the urging of the dental industry, lawmakers killed a bill that would have created a midlevel provider -- a registered dental therapist -- who could perform some of the duties now handled by dentists, including filling cavities and pulling teeth. Other states have considered similar bills, but only Alaska and Minnesota have comparable laws (Cooper, 5/9). 

Des Moines Register: Iowa House Speaker: Legislative Session Could End Today
Iowa’s 2012 legislative session could wrap up as early as today, House Speaker Kraig Paulsen said this morning. ... Still unresolved are the session’s three major reform proposals -- affecting K-12 education, the state's mental health care delivery system and property taxes. Paulsen suggested all three could be finished within hours (Noble, 5/8).

Des Moines Register: New Bill To Ban Synthetic Drugs Passes House, Heads To Governor
A bill aimed at cracking down on synthetic drugs passed the Iowa House on Tuesday, and is now headed to Gov. Terry Branstad to be signed into law. ... Proponents say the bill’s changes to the state's banned-substance list will make it much more difficult for synthetic drug manufacturers to continue selling potentially harmful drugs by making subtle tweaks to their chemical makeup (Noble, 5/8).

The Kansas City Star: Kansas House Considers Study Of Selling KU Hospital
As debate on the Kansas budget approached midnight, a Kansas House member proposed the idea of studying the sale of the University of Kansas Hospital. Rep. Gene Suellentrop, a Wichita Republican, proposed studying the sale of the facility during a nearly nine-hour debate on the budget. The study would be done by the budget division of the Department of Administration. Suellentrop introduced the amendment just before 11 p.m., but withdrew it about 30 minutes later after it was roundly criticized by several legislators, including House Speaker Mike O'Neal, a Hutchinson Republican (Cooper, 5/9).

Modern Healthcare: Layoffs Planned At Fla. Medical School
The University of Miami's Miller School of Medicine intends to lay off up to 800 employees at the end of the July. The positions are concentrated in unfunded research and administration, including support staff, information technology, human resources and marketing. Dr. Pascal Goldschmidt, CEO of the University of Miami Health System, cited declining reimbursement as well as a reduction in funding from the National Institutes of Health as prompting the action (Kutscher, 5/8).

California Healthline: Disability Rights Withdraws Contempt Filing -- For Now 
A contempt-of-court motion filed against the Department of Health Care Services was recently withdrawn by Disability Rights California, though adult day health care advocates said they might re-file later. ... The two sides agreed on the group of ADHC beneficiaries who should be presumed eligible for Community-Based Adult Services, the new program created as part of a settlement of a lawsuit in December. The contempt filing claimed that the DHCS violated terms of that settlement (Gorn, 5/9).

California Watch: In N.Y. And Calif., Different Approaches To Patient Abuse Reform
Wherever the developmentally disabled live, abuse is their neighbor. It comes as deliberate assault by caregivers and sometimes relatives. It comes as acts of frustration, when people exhausted from the relentless difficulties of caring for patients with intellectual disabilities shove and hit the vulnerable. ... New York lawmakers plan to add a new independent overseer focused solely on the disabled. ... California Gov. Jerry Brown’s administration is working to upgrade an existing in-house police force that has long struggled to investigate crimes at the state's institutions for residents with cerebral palsy and other intellectual disabilities (Gabrielson, 5/9). 

The Texas Tribune: Interactive: Mapping Access to Health Care in Texas 
Doctors, pharmacists and family planning clinics say state budget tightening may force many health care providers out of business or prevent them from providing adequate patient care. ... The Tribune created this data interactive to illustrate just how lacking access is in some regions of the state. The majority of rural Texas lacks primary care physicians, pediatricians, obstetricians and gynecologists and other specialists, while more populated areas have a sufficient number of providers (Aaronson, 5/8).

HealthyCal: Brown's Proposal On Child Health Meets Strong Opposition
Gov. Jerry Brown's proposal to shift nearly 1 million children from subsidized private insurance into the state Medi-Cal program is running into a wall of opposition from children's advocates, health care providers and faith-based groups. Brown included the proposal to eliminate the state's Healthy Families program in his January budget and is expected to stick with it when he releases his revised budget next week (Weintraub, 5/8).

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Editorials and Opinions

Viewpoints: Can't Americans Be 'Fat And Happy'? Trying To Intimidate WellPoint; Generous Coverage Helps GOP Sen. Kirk Recuperate

Los Angeles Times: Fat And Happy? You Must Be American
If we’re going to be fat, can’t we also be happy? That way, when you read this -- "a new report estimated that the cost of treating those additional obese people for diabetes, heart disease and other medical conditions would add up to nearly $550 billion over the next two decades" -- you won't despair. Instead, you'll channel your inner Warren Buffett -- and buy stock in health insurance companies and hospitals and medical supply firms (Paul Whitefield, 5/8).

The Washington Post: The Sweet Tooth That Spawned An Epidemic
Close your eyes and picture 110 million obese people waddling around America's sidewalks. You'll probably want to keep your eyes closed. Such is the scenario suggested by a new study projecting that 42 percent of American adults will be obese by 2030. That's 32 million more than today's 78 million. Of course, they probably won't be waddling. They'll be in their cars in the fast-food lane, as they are now. Recall that independent filmmaker Morgan Spurlock ("Super Size Me") gained 24.5 pounds after one month of eating exclusively at McDonald's (Kathleen Parker, 5/8).

Boston Globe: Obesity, A New Kind Of Smoke
The war on smoking can help guide the nation's fight against obesity. Trash food can be the cigarette. Obesity can be lung cancer. This week, at the Centers for Disease Control and Prevention's Weight of the Nation conference in Washington, researchers projected that 42 percent of Americans will be obese by 2030. That is more than triple the rates a half-century ago. The health care costs of obesity have, by most accounts, surpassed the medical costs of smoking (Derrick Z. Jackson, 5/9).

The Wall Street Journal: Intimidation By Proxy 
The campaign to intimidate companies from exercising their free-speech rights is in high gear as shareholder proxy season arrives, and the most prominent early target is health-insurer WellPoint. ... insurers still make inviting political targets because they are unpopular and have no choice but to raise premiums due to ObamaCare's new coverage mandates. The White House wants to blame insurers for these increases, and it doesn't want the insurers to be able to fight back. In addition to attacking WellPoint, Change to Win has already begun a shareholder campaign targeting Cigna for contributing to the insurance trade association (5/8).

Chicago Sun-Times: Kirk Talks About Tax Cuts Due To Quality Health Care
U.S. Sen. Mark Kirk (R-Ill.) on Tuesday released a brief videotape of his recovery process from a severe stroke he suffered Jan. 21. … As a U.S. senator, Kirk is covered by excellent health insurance. He also can raise money through influential friends and political party members to whom most Americans do not have access if he needs it to pay other medical costs. … I want Kirk to release an itemized list of his health care bills since the stroke. I want to see if any 401(k)-type self-insurance plan, supported by Republicans, could have financed the Kirk Care Plan (Phil Kadner, 5/8).

Politico Pro: Patients Facing Unnecessary Barriers On Imaging Services
As the founder of Patient Advocate Foundation, an organization dedicated to helping patients with cancer and other serious conditions access the care they need, I believe that recent changes to public policies that reduce reimbursement for imaging services, restrict utilization and encumber patients’ ability to have more than one diagnostic procedure per day are counterintuitive (Nancy Davenport-Ennis, 5/9).

The Philadelphia Inquirer: What Does Pa. Have Against Mom?
Consider this: The proposed Pennsylvania state budget would slash funds paid to hospitals for the delivery of babies. Einstein Healthcare Network is one of only six medical centers in Philadelphia that still delivers babies. Over the past 15 years, 18 local hospitals closed their obstetrics departments primarily because of the financial burden of rising malpractice costs combined with inadequate reimbursements. To make matters worse, the state proposes to reduce Medicaid payments to hospitals for deliveries, and slash a special fund to compensate hospitals that have kept their obstetrics departments open for their increased patient load (Barry Freedman, 5/9).

The Lund Report (an Oregon news service): Economist Challenges Governor Kitzhaber to Make Evidence-Based Practice The Standard Of Care
Regence's recently announced decision to drop contracts with certain provider networks used by individual policyholders in the Portland area is an ominous and dangerous development. Not only does it challenge the single thing most healthcare consumers think is best about the current payment system -- wide choice and dependable coverage of one's personal caregivers -- it is inexplicable as a first line of response to the problem of costs (Larry Kirsch, 5/8).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Lisa Gillespie
Marissa Evans

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.