Daily Health Policy Report

Wednesday, June 20, 2012

Last updated: Wed, Jun 20

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Campaign 2012

Health Care Marketplace

Health Care Fraud & Abuse

Coverage & Access

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Catholic Hospital Leader Defends Split With Obama Administration On Contraceptives

Late last Friday, the Catholic Health Association dealt the Obama administration a blow when it announced that it would not support a compromise plan on contraception coverage. In an effort to work with religious organizations' concerns about providing free contraception in employees' health plans, the administration had proposed that insurers be the ones to contact workers and pay for the coverage. Kaiser Health News' Mary Agnes Carey talked with CHA chief Sister Carol Keehan, a key ally of President Barack Obama during the run up to passage of the health care law (Carey, 6/19). Read the interview.

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What's At Stake For Women If SCOTUS Overturns The Health Law

Kaiser Health News staff writer Julie Appleby reports: "A provision in the 2010 health care law requiring contraceptive coverage for women without copays has gotten most of the press. But much more is at stake for women if the Supreme Court overturns the health care law. Starting in 2014, the law bars insurance practices such as charging women higher premiums than men, or denying coverage for pre-existing conditions that could include pregnancy, a Caesarean-section birth or a sexual or a domestic violence assault" (Appleby, 6/19). Read the story.

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What's At Stake For Medicare Beneficiaries In Supreme Court Decision

Kaiser Health News staff writer Marilyn Werber Serafini reports: "On average, seniors and disabled people covered by Medicare saved $604 in 2011 on prescription drugs, and more than 26 million saw their doctors for wellness visits or got preventive services. If the court strikes down only the law's individual mandate, which requires most people to buy insurance, nearly all of the health law's Medicare changes will remain intact" (Werber Serafini, 6/19). Read the story.

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Some Health System Changes Will Stay, No Matter How SCOTUS Rules

Kaiser Health News staff writer Jay Hancock reports: "Now the Affordable Care Act is in jeopardy, but many of the reforms it encouraged aren't, Wilson says. Soaring costs, tight budgets, better technology and industry consolidation ensure health care won't go back to 2009 no matter what the court or Congress do, say analysts and industry officials" (Hancock, 6/19). Read the story.

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Capsules: Obama Administration Finds 3.1 Million Young Adults Gained Coverage Under Law; LGBT Community Still Has Hurdles In Health Care Equality

Now on Kaiser Health News' blog, Christian Torres reports on the latest numbers regarding young adults’ health insurance coverage: "More than 3 million young adults have gained insurance coverage under the health law, according to the latest government estimate. Obama administration officials touted the benefit Tuesday as an example of how the law is making a difference" (Torres, 6/19).

Also on the blog, Shefali S. Kulkarni reports that this year’s Human Rights Campaign's Healthcare Equality Index "shows which hospitals and health care facilities score best on measures relating to lesbian, gay, bisexual and transgender patients, visitors and employees, is flashing some big numbers" (Kulkarni, 6/19). Check out what else is on Capsules.

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Political Cartoon: 'Uncle Sam, R.I.P?'

Kaiser Health News provides a fresh take on health policy developments with "Uncle Sam, R.I.P?" by David Fitzsimmons.

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

WILL THURSDAY BE DECISION DAY?

Ten in the morning.
Washington stops and listens.
Supreme Court ruling? 
-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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Health Reform

Poll: Majority Want New Effort If Court Overturns Health Law

A new Associated Press-GfK poll found that Americans want Congress and the president to work on new legislation to overhaul the health care system if the high court rules that the 2010 health law is unconstitutional. Meanwhile, the lead attorney for the states challenging the law said it's difficult to predict what the court will do.

The Associated Press: Poll: Vast Support For New Health Care Effort
Americans overwhelmingly want the president and Congress to get to work on a new bill to change the health care system if the Supreme Court strikes down President Barack Obama's 2010 overhaul as unconstitutional, a new poll finds. A new health care bill doesn't seem to be in either party's plans on the verge of the high court's verdict on the law aimed at extending health insurance to more than 30 million Americans who now lack coverage (Sherman, 6/20).

Politico: Fix Health Care After Supreme Court Ruling, Poll Says
If the Supreme Court strikes down President Barack Obama's signature health care reform law, 77 percent of Americans want the president and Congress to work on new legislation overhauling the system, according to a new AP-GfK poll on Wednesday. Only 19 percent of Americans want lawmakers to leave health care the way it is (Robillard, 6/20).

Politico Pro: Clement: SCOTUS Ruling Tough To Predict
Paul Clement, the lead attorney for the states challenging the health care law, said he doesn't like to draw conclusions about how the Supreme Court will rule in the highly anticipated Supreme Court health care case, particularly given the unusual length and format of the oral arguments. "In the Supreme Court, the way that it was structured doesn't allow you to draw conclusions the way that you might have been able to draw conclusions if it had been sort of a four hour free-for-all," he said at a Supreme Court panel discussion hosted by the American Constitution Society for Law and Policy on Tuesday (Smith, 6/19).

Politico: Health Care Ruling: What To Expect
No matter what the Supreme Court finally rules on the health law, tens of millions of Americans are not going to like it. And judging from the wildly contradictory polls and expectations of the past few years — in which people often declare how much they detest the health law and at the same time say how much they like what's in it — many won't understand the ruling, either (Kenen, 6/19).

Also in the news, the White House and GOP congressional leaders hint at their preparations for the outcome -

The Wall Street Journal: Band-Aids For The Health Law
White House officials say they are confident the Supreme Court will uphold the health-care law, but they also are preparing for a range of outcomes, including pressing ahead with what remains of the law if the court strikes down only part of it (Meckler and Radnofsky, 6/19).

The Associated Press: McConnell: Time To 'Start Over' On Health Care
The top-ranking Republican in the Senate calls the Obama health care law the first step in "Europeanizing America" and says Congress should "start over" if the system is ruled invalid by the Supreme Court. Kentucky's Sen. Mitch McConnell says Republicans believe Americans want to "repeal the whole thing" (6/19).

Bloomberg: Boehner Says House to Seek Repeal of Health-Care Law
House Speaker John Boehner said the Republican-led chamber will move to repeal President Barack Obama's health-care overhaul law if the U.S. Supreme Court doesn't strike it down….Boehner didn't say when the House would act. He said it would take a "step-by-step" approach to rewrite the health-care law to reduce costs and ensure that the American people go to the doctor of their choice (Tiron, 6/19).

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What's At Stake In The Much-Anticipated High Court Health Law Decision?

News outlets report on how the ruling will impact seniors, women and states, among other stakeholders. Reports also examine what might happen if the individual mandate is overturned but other elements of the law are left intact.

Reuters/Chicago Tribune: Health Benefits Americans Could Lose In Court Ruling
The U.S. Supreme Court is expected to issue a ruling by the end of this month on the fate of President Barack Obama's healthcare law. Following are some of the provisions already in effect under the law that Americans would lose immediately if it were to be overturned. Other provisions not listed below would come into force in 2014 if the court were to leave the law in effect (6/19).

Los Angeles Times: California To Lose Big If Supreme Court Scraps U.S. Healthcare Law
If the Supreme Court scraps the Affordable Care Act in the coming days, California will lose out on as much as $15 billion annually in new federal money slated to come its way, dealing what state officials say would be a critical blow to efforts to expand coverage to the poor and uninsured. The state is one of the biggest beneficiaries of the federal healthcare law because of its large number of uninsured residents — about 7 million people, or nearly 20% of California's population (Terhune, Gorman and Loury, 6/20).

HealthyCal.org:  Millions Will Remain Uninsured After Health Care Reform
Up to 10 percent of California’s 40 million residents will not have health insurance after national health care reform begins in 2014, according to new numbers released from University of California, Berkeley last week.  Those numbers, health officials say, run contrary to the popular belief that nearly everyone will be covered by insurance in two years. That’s when the Affordable Care Act, passed into federal law in 2010, takes full effect. As a result, doctors and clinics that traditionally provide care to the uninsured are working to make sure the money to treat those patients does not disappear (Bookwalter, 6/20).

Baltimore Sun: Supreme Court Decision On Health Care Reform Law May Mean Changes In Maryland
Initial projections show about 180,000 people in Maryland would gain insurance through the exchange and 84,000 through Medicaid's expansion in the first year, according to the Governor's Office of Health Reform. The exchange and Medicaid expansion could move ahead without the subsidies but other funding would be needed, [Lt. Gov. Anthony] Brown said. More than $400 million in federal subsidies was expected just for those on the exchange, according to the Hilltop Institute at the University of Maryland, Baltimore County, a nonpartisan health research organization. It's "probable" Maryland's exchange would operate without the law, Brown said, but there would be a lot of review and debate. Requiring the public to buy insurance in Maryland might be a tougher sell but "would be part of the conversation," he said (Cohn and Walker, 6/19).

Kaiser Health News: What's At Stake For Women If SCOTUS Overturns The Health Law
A provision in the 2010 health care law requiring contraceptive coverage for women without copays has gotten most of the press. But much more is at stake for women if the Supreme Court overturns the health care law. Starting in 2014, the law bars insurance practices such as charging women higher premiums than men, or denying coverage for pre-existing conditions that could include pregnancy, a Caesarean-section birth or a sexual or a domestic violence assault (Appleby, 6/19).

Kaiser Health News: What's At Stake For Medicare Beneficiaries In Supreme Court Decision
On average, seniors and disabled people covered by Medicare saved $604 in 2011 on prescription drugs, and more than 26 million saw their doctors for wellness visits or got preventive services. If the court strikes down only the law's individual mandate, which requires most people to buy insurance, nearly all of the health law's Medicare changes will remain intact (Werber Serafini, 6/19). 

Kaiser Health News: Some Health System Changes Will Stay, No Matter How SCOTUS Rules
Now the Affordable Care Act is in jeopardy, but many of the reforms it encouraged aren't, Wilson says. Soaring costs, tight budgets, better technology and industry consolidation ensure health care won't go back to 2009 no matter what the court or Congress do, say analysts and industry officials (Hancock, 6/19). 

The Hill: House Dem: Ruling Striking Mandate Won't Be A 'Show-Stopper' For Health Law
A leading House Democrat said Tuesday that if the Supreme Court strikes down the individual mandate, it will not be "a show-stopper" for the healthcare law. Rep. Jan Schakowsky (Ill.), the chief deputy whip for House Democrats, predicted during an interview on The Bill Press Show that the entire law would be upheld but said her party "would absolutely move forward" with the remaining reforms even if the mandate is defeated. "There are other ways to skin the cat — to make sure that people do join and get insurance," she added. "So I don't think [a ruling against the mandate] would be a complete show-stopper" (Viebeck, 6/19).

The New York Times' Economic Scene: Self-Interest Meets Mandate
Odds that the justices will reject this measure, the so-called individual mandate, are approaching 80 percent on Intrade, a market where investors can bet on the outcome of pretty much everything. What's harder to figure out is what will then happen to health insurance. Advocates of health care reform argue that eliminating the mandate could gut the president's plan. Most health economists would probably agree. But this consensus is based on a fairly optimistic view that the individual mandate and accompanying fines for failing to comply will be highly effective at persuading Americans to buy health insurance that they would otherwise forgo (Porter, 6/19).

CQ HealthBeat: End Of Mandate Wouldn't Mean Certain 'Death Spiral,' Analysts Say
It's not true that premiums inevitably would zoom out of sight in the individual insurance market if the Supreme Court strikes down the individual mandate in the health care law. So say two Kaiser Family Foundation analysts, contradicting widespread predictions that such a "death spiral" would occur. "It is by no means inevitable that the individual insurance market will enter a spiral of death," Larry Levitt and Gary Claxton said in a blog post Tuesday. "In fact, there are some good reasons to believe that may not happen" (Reichard, 6/19).

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Winners And Losers In The Health Care Messaging War

The Pew Research Center's Project for Excellence in Journalism says that opponents of the health law prevailed at least in part because their positions were sharper and easier to understand. 

NPR's Shots Blog: How Opponents Won The Health Care Messaging War
OK, so it's not exactly news that the Obama administration hasn't done the best job in the world selling the Affordable Care Act to the American public. But now the Pew Research Center's Project for Excellence in Journalism has some statistics to demonstrate just how sorry that job has been. And it suggests that the media gets at least some of the blame (Rovner, 6/19).

The Associated Press: Study Shows Health Care Opponents Won In Media
Opponents of President Barack Obama's health care plan decisively beat supporters in getting their message across through the media, according to a study released Tuesday. The Pew Research Center's Project for Excellence in Journalism said opponents won, in part, because their positions were sharper and easier to understand. Critics also more frequently drove the coverage, particularly when Tea Party demonstrations came to the fore (Bauder, 6/19).

Meanwhile, members of the Senate Judiciary Committee added their voices to requests that the Supreme Court's health decision be televised -

The Associated Press/Washington Post: Senate Judiciary Committee Leaders Request Live TV For Supreme Court Health Care Decision
Leaders of the Senate Judiciary Committee are asking the Supreme Court to allow live television coverage when it delivers its ruling on President Barack Obama's health care overhaul. Chairman Patrick Leahy and ranking Republican Charles Grassley said the issues in the case are as important and consequential as any in recent court history (6/19).

The Wall Street Journal's Washington Wire: Senators Want TV Cameras At Supreme Court
It’s hard to predict how the Supreme Court will rule on the Obama health law, but we can safely forecast the court’s action in one aspect of the case: It will strike down a request by the leaders of the Senate Judiciary Committee to televise the ruling (Landers, 6/19).

CQ HealthBeat: Grassley And Leahy Urge Live TV Coverage Of Health Care Decision
Two senior senators who have pushed for televised coverage of Supreme Court proceedings are urging Chief Justice John G. Roberts Jr. to open up the court to cameras when a decision on the constitutionality of the health care law is announced. Judiciary Committee Chairman Patrick J. Leahy and ranking Republican Charles E. Grassley wrote Roberts on Monday saying that "the issues in the case are as important and consequential as any in recent court history" and Americans should be able to view the delivery of the court’s opinion live (Norman, 6/19).

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HHS Reports 3.1 Million Young Adults Gained Coverage Under Health Law

The law's provision requiring that insurers allow many adults under the age of 26 to stay on their parents' plans is popular.

The Associated Press: Officials: 3.1M Young Adults In US Gain Coverage
U.S. health officials say the number of young adults with medical coverage grew by more than 3 million since the new health care overhaul took effect. The Affordable Care Act mandates that insurers allow young adults to remain on their parents' plans until they turn 26, even if they move away from home or graduate from school. About 64 percent of adults ages 19 to 25 had insurance when the policy took effect in 2010 (Stobbe, 6/20).

Kaiser Health News: Obama Administration Finds 3.1 Million Young Adults Gained Coverage Under Law
More than 3 million young adults have gained insurance coverage under the health law, according to the latest government estimate. Obama administration officials touted the benefit Tuesday as an example of how the law is making a difference (Torres, 6/19).

Boston Globe: Affordable Care Act Leads To 3.1 Million Young Adults Gaining Health Coverage
The law requires insurers to allow young adults to remain on their parents’ family plans until they turn 26, even after moving away from home or graduating from college. As a result, the proportion of insured adults ages 19 through 25 rose to nearly 75 percent, up from 64 percent prior to the provision taking effect in September 2010 (Jan, 6/19).

Politico Pro: HHS Discounts Insurers' Coverage Promises
The report comes about a week after three major insurers promised to keep some ACA provisions --including dependent coverage -- no matter what the Supreme Court does to the law. But an HHS official offered a subtle reminder that the insurers' promise is nothing more than that. And not all insurers have promised to follow that policy. "The additional 3.1 million young adults with coverage now have valuable protection for their finances and health, and only a law can guarantee those protections," said Richard Kronick, HHS deputy assistant secretary for health policy, on a media conference call (Millman, 6/19).

The Hill: HHS: 3 Million Young Adults Gained Coverage Under Health Care Law
HHS touted that popular benefit Tuesday amid deep uncertainty about the fate of the health law and questions about which parts Republicans would try to preserve. The Supreme Court is expected to issue a ruling by the end of next week that could strike down all or part of the law. Republicans have vowed to repeal the entire law if the court only strikes down part of it, but they're divided over which parts to replace. ... Adding more young people to the insurance pool is popular in part because it helps lower premiums for everyone. Young people often go without insurance because they're healthy and don't think they will need it (Baker, 6/19).

Other data show that many Americans still are without coverage --

HealthDay News/Philadelphia Inquirer: More Than 46 Million Americans Uninsured In 2011: Report
A new government report finds that 46.3 million Americans went without health insurance in 2011, and more than 34 million of them had already been uninsured for more than a year. The report, released Tuesday by the National Center for Health Statistics (NCHS), draws on data from more than 100,000 people questioned as part of the annual National Health Interview Survey. Overall, nearly one in five Americans (19.2 percent) went without health care coverage during at least part of 2011, the NCHS reports (Mundell, 6/19).

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Birth Control Mandate Remains Divisive Health Coverage Issue

The head of the Catholic Hospital Association explains her group's split with the Obama administration on the question of contraception coverage. Meanwhile, another Catholic organization is launching a nationwide ad campaign against this policy.  

Kaiser Health News: Catholic Hospital Leader Defends Split With Obama Administration On Contraceptives
Late last Friday, the Catholic Health Association dealt the Obama administration a blow when it announced that it would not support a compromise plan on contraception coverage. In an effort to work with religious organizations' concerns about providing free contraception in employees' health plans, the administration had proposed that insurers be the ones to contact workers and pay for the coverage. Kaiser Health News' Mary Agnes Carey talked with CHA chief Sister Carol Keehan, a key ally of President Barack Obama during the run up to passage of the health care law (Carey, 6/19).

The Hill: Catholic Group To Launch Ad Against Birth Control Mandate
An association of lay Catholics will air a nationwide ad against the Obama administration's birth control coverage mandate on Fox News Thursday. The move serves to highlight a two-week effort by U.S. Catholic bishops to build momentum against the mandate, which some have argued violates religious freedom. The debate puts the church in a tough spot because polls show that the vast majority of Catholic women use and support birth control (Viebeck, 6/19).

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Capitol Hill Watch

Congress Considers Medicare, FDA Proposals

The Senate Finance Committee is once again talking deficit reduction and Medicare as both houses are "poised" to pass an FDA bill.

Modern Healthcare: Baucus Questions Need For Medicare Overhaul
Slowing healthcare inflation may have removed the need to overhaul either Medicare or Medicaid as part of a grand-deficit reduction deal, according to the senior Senate Democrat overseeing federal entitlement programs. Sen. Max Baucus (D-Mont.), chairman of the Finance Committee, challenged the long-held assumption on Capitol Hill that any agreement to rein in the $16 trillion historic federal debt must include the two federal healthcare programs because they comprise more than 25% of all federal spending (Daly, 6/19).

CQ HealthBeat: Bipartisan Medicare Proposal Draws Skepticism
The authors of a bipartisan deficit reduction plan insisted that the country’s fiscal problems cannot be solved without significant changes to Medicare, but some senators expressed skepticism about their proposal. At a Senate Finance hearing Tuesday, former Sen. Pete V. Domenici, R-N.M., and Alice Rivlin, director of the Congressional Budget Office in the Clinton administration, urged lawmakers to set aside partisanship and act to avoid running into "a fiscal wall" (Ethridge, 6/19).

The Associated Press/Seattle Times: Congress Poised To Pass Safety-Focused FDA Bill
A bill designed to beef up the safety of the nation's prescription drug supply is poised to pass Congress, but without a tracking system that public health advocates say is critical to weeding out counterfeit pharmaceuticals. House and Senate lawmakers agreed late Monday on compromise legislation that helps supplement the Food and Drug Administration's budget. The two chambers previously passed separate versions of the bill, which also increases safety inspections and penalties against drug counterfeiters (Perrone, 6/19).

CQ HealthBeat: User Fees Compromise Would Reduce Deficit, Get Generics To Market Faster
A final agreement on the five-year reauthorization of the Food and Drug Administration’s user fee programs would reduce the deficit by $311 million over 10 years, according to the Congressional Budget Office. That is less savings than the estimates for the House-passed and Senate-passed measures on which it is based, but still favorable enough to encourage leaders who hope to clear the bill before the end of month (Ethridge, 6/19).

MedPage Today: House Report Blames FDA For Drug Shortages
The recent nationwide shortages of critical drugs, including oncology agents, are largely the FDA's fault, according to a congressional committee report. Since Margaret Hamburg, MD, became FDA Commissioner in 2010, "the FDA has failed to ensure that enforcement and compliance activities are conducted in a manner that does not create unnecessary shortages of critical drugs," reads the report issued by the House Committee on Oversight and Government Reform (Frieden, 6/19).

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Campaign 2012

Parsing The Facts From Romney, Obama Statements; Romney Advisers Meet With GOP Members Of Congress

The New York Times looks at the hyperbole in each candidate's statements. Meanwhile, Romney advisers held talks on Capitol Hill ahead of the Supreme Court decision.

The New York Times: In Romney And Obama Speeches, Selective Truths
Despite Mr. Romney's claim, the new health care law will not drive government spending up to half of the economy, unless all health care spending in the country is reclassified as government spending. Given that the new law still relies heavily on private insurance provided by employers, it is a stretch to treat all of that as if it were government expenditures (Baker and Cooper, 6/19).

The Washington Post's Two Chambers: Mitt Romney Adviser Mike Leavitt Meets With Conservative GOP Lawmakers About Health Care
A campaign adviser to Mitt Romney who supports elements of the 2010 health-care reform law huddled Monday with conservative Republican lawmakers to discuss health care just days before the U.S. Supreme Court is expected to rule on the constitutionality of the reforms (O'Keefe, 6/19).

Politico Pro: Romney Health Advisers, House GOP Meet
Two of Gov. Mitt Romney's top health care policy advisers met with House Republicans on Tuesday to discuss the Supreme Court's upcoming ruling on President Barack Obama's health care reform law. Romney campaign advisers Tevi Troy and Matt Hoffmann met with at least two groups of House Republicans on Tuesday, according to people who attended the meetings. Troy is a former deputy secretary at HHS and Hoffmann previously worked for House Budget Committee Chairman Paul Ryan. The advisers released few details about how the campaign will respond to the ruling. In particular, they did not discuss many details of the response if the court strikes the ban on insurance companies denying customers coverage because of pre-existing conditions, according to people in the meetings (Haberkorn and DoBias, 6/19).

The Wall Street Journal’s Washington Wire: SEIU To Focus On 8 Battleground States
The union's goal is to inform the public where candidates stand on issues such as job creation, taxation, immigration overhaul, Social Security and Medicare. It plans to convey that President Obama is the candidate who's prepared to help working people (Trottman, 6/19).

The Hill: Giant Pack Of Birth Control To Follow Romney On Campaign Trail
Planned Parenthood's political arm is sending a special surrogate out on the campaign trail to highlight the group's disagreements with Mitt Romney: a gigantic package of birth control. Dubbed "Pillamina" by the group, the costumed figure will follow the presumptive Republican nominee to draw attention to his objection to President Obama's birth-control coverage mandate. The move highlights the breadth of Planned Parenthood's political action this election cycle, as women's health issues remain in the headlines and Democrats seek to solidify their lead among female voters (Viebeck, 6/19).

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Health Care Marketplace

Minn. AG Seeks To Expand Complaint Against Hospital Collection Company

In court papers, Minn. Attorney General Lori Swanson alleges a dozen new instances in which patients were "hustled with bedside collection visits" and led to believe "they had to pay before receiving care."

Chicago Tribune: Minnesota Seeks To Expand Suit Against Accretive Health
The Minnesota attorney general's office moved Tuesday to expand its lawsuit against Chicago-based Accretive Health Inc., after more patients have come forward with complaints of aggressive collection of current and past-due bills (Sachdev, 6/19).

Bloomberg: Minnesota Seeks Wider Complaint Against Accretive Health
Accretive Health Inc. (AH) maintains "an aggressive boiler room-type culture within hospitals," Minnesota's attorney general said in court papers seeking to add to her lawsuit complaint against the health-care billings management company. Attorney General Lori Swanson, who sued the Chicago-based company in January over alleged violations of privacy law, raised new claims today in a bid for permission to revise her complaint against Accretive for the second time. On April 30, the company asked U.S. District Judge Richard H. Kyle in St. Paul, Minnesota to throw out the case, arguing it is "factually baseless and legally indefensible" (Harris, 6/19).

Modern Healthcare: Minn. Attorney General Seeks To Widen Complaint Against Accretive
Accretive Health would face new claims the company violated debt-collection and consumer-protection laws under a proposed amended complaint by Minnesota's attorney general. Lori Swanson, Minnesota's attorney general, has asked a federal judge to allow new claims against Accretive Health in the state's lawsuit against the billing and collection company (Evans, 6/19).

(St. Paul) Pioneer Press: New Accretive Allegations: Debt Collector Told New Mom To Pay Or Baby Would Stay
Swanson's revised complaint, filed Tuesday, June 19, in U.S. District Court in St. Paul, cites a dozen instances where "emergency room patients (were) hustled with bedside collection visits" that led them to believe they had to pay before receiving care. ... In addition, the amended complaint alleges the company committed consumer fraud by trying to collect from patients before knowing what services they needed or what the costs would be, often overcharging them (Snowbeck, 6/19).

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Health Care Fraud & Abuse

Was Castro Government Part Of Multimillion Dollar Medicare Money-Laundering Scam?

McClatchy Newspapers: U.S. Prosecutors Probe Whether Castro Government Was Involved In Medicare Scam
Just two days after alleging that a South Florida man ran a "vast cash-to-Cuba operation," federal prosecutors said they have no proof that the Castro regime is behind a multimillion-dollar Medicare money-laundering scam. But if the crux of a case filed in U.S. District Court is true - that a network of fraudsters funneled tens of millions of Medicare dollars to Havana - experts say there's no way that much cash could wind up in bank accounts in Cuba without the government there knowing it. So does check-cashing agent Oscar L. Sanchez's indictment on a conspiracy to commit money laundering charge offer the first shred of substantiation to the long-held theory that the Castro brothers pull the strings behind elaborate plots to defraud Medicare (Robles, 6/19)?

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Coverage & Access

Report: Sexual Orientation Still Affecting Access To Health Care

The Human Rights Campaign issued its annual evaluation of how hospitals and other health care facilities score on  care for lesbian, gay, bisexual and transgender patients.

Kaiser Health News Capsules blog: LGBT Community Still Has Hurdles In Health Care Equality
This year the Healthcare Equality Index, a report produced by the Human Rights Campaign that shows which hospitals and health care facilities score best on measures relating to lesbian, gay, bisexual and transgender patients, visitors and employees, is flashing some big numbers (Kulkarni, 6/19).

Medscape:  LGBT Patients See Gains But Not Equality In Healthcare Index
The HEI 2012 survey consisted of 24 questions assessing healthcare assess and quality in 4 core areas: nonpatient discrimination, visitation, nonemployee discrimination, and training. The 2012 survey consisted of 407 institutions, a 40% increase over the participation in the 2011 survey. In particular, 71 institutions, encompassing 234 facilities, achieved the status of "Leader in LGBT Healthcare Equality" in the 2012 survey, a 162% increase over the number who achieved this status in the 2011 survey (Barber, 6/19).

Modern Healthcare: 40% More Facilities Take LGBT Equality Survey
In January 2011, the CMS released regulations that required hospitals to allow patients to choose their visitors and prohibited discrimination in patient visits based on gender identity and sexual orientation. The Joint Commission subsequently aligned its standards to meet those requirements (Zigmond, 6/19).

CQ HealthBeat: Sebelius Touts HHS Efforts To Improve Care To LGBT Community
This year,[CDC] will identify cases of intimate violence and stalking by sexual orientation. The Ryan White HIV/AIDS program will support HIV prevention and treatment programs for transgender minority women. And the [NIH] will support biomedical research on health issues affecting lesbian, gay, bisexual and transgender people. All of these initiatives were outlined in a report released Tuesday ... The Obama administration has sought to demonstrate its attention to issues affecting people who are lesbian, gay, bisexual or transgender (LGBT), which is a core constituency of Democrats' base voters (Adams, 6/19).

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State Watch

Mass. Calls For Bids To Manage 111,000-Person 'Dual Eligibles' Program

Massachusetts is seeking a new manager to run the commonwealth's health care program for people who qualify for both Medicare and Medicaid.

Boston Globe: State Calls For Applications For Groups To Manage Health Care For 'Dual Eligibles'
The Patrick administration on Tuesday put out a call for bids from organizations interested in managing the health care of about 111,000 low-income people in the state who have complex and costly medical needs. The group includes people age 21 to 64 who are disabled and have been covered by both the government Medicaid and Medicare programs, in an arrangement that can be confusing for patients, strain communication among providers, and lead to fractured care (Conaboy, 6/19). 

WBUR: For The Most Expensive Patients: Better Care, More Savings (Hopefully)
Massachusetts is rolling out a pilot project that aims to provide better care and save money for some of the state’s most expensive patients. About 111,000 young and middle aged adults with serious medical problems are on both Medicare and Medicaid. Figuring out which services the different programs cover can be a nightmare. There are a few programs that pool Medicare and Medicaid money for older Americans (65 and up). Now, for the first time, Massachusetts will merge Medicare and Medicaid resources for younger adults so that they have one package of coordinated medical and support services (Beibinger, 6/19).

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Medicaid: Minn. Program Prepares For Influx Of Boomers; Other News

Changes to Medicaid programs make news in Minnesota, where officials are preparing for an influx of baby boomers into the system. In Kansas, Medicaid changes there are attracting public comment, and in Oregon a group asks for more time to institute a collaborative care program.

Minnesota Public Radio: State Proposes Medicaid Adjustment As Boomers Enter System
The Minnesota Department of Human Services unveiled a proposal this week to adjust the state's Medicaid program to prepare for the expected influx of aging Baby Boomers. The agency plans to hold at least two public meetings in the next week to gather input on the plan, which includes proposals for more consumer engagement and the streamlining of the state's purchasing systems. DHS Commissioner Lucinda Jesson said the biggest change in the plan is an increased emphasis on home and community services that allow people to stay longer in their homes. "We're not trying to take anything away from people who need the intensive high-end services. If they need that, and they qualify for Medicaid, they should have those services," Jesson said (Collins, 6/19).

Kansas Health Policy Institute: Witchita KanCare Forum Draws More Than 200
Gov. Sam Brownback's plan to remake the state Medicaid program got a chilly reception Monday at the first of two scheduled public forums on KanCare. There were nearly two hours of comments and questions from a crowd of more than 200 people gathered at a Wichita State University auditorium. Most of the 40 comments were negative. Those who spoke were officially capped at three minutes each, though many went much longer (Cauthon, 6/19).

The Oregonian: Changes To Oregon Health Reforms Cause Delay By Portland-Area Medicaid Group
As reforms to the Oregon Health Plan kick in, a consortium that hopes to provide more efficient care to low-income people in Clackamas, Multnomah and Washington counties has asked the state for more time. The Tri-County Medicaid Collaborative had applied to be in the first wave of coordinated care organizations approved by the state under a law passed in February. The organizations will integrate care and focus on prevention to cut Medicaid spending. However, the Portland-area group has now decided to pull out of the first round of CCO approvals-- which aim to be up and running by August -- to instead target the second round of approval, meaning a start-up in September (Budnick, 6/19).

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Health Providers Already Raking In Millions In HIT Incentive Funds

News outlets are detailing the incentive payments health care providers in Arizona and Kansas have received from the Centers for Medicare & Medicaid Services for instituting standardized electronic health records.

Arizona Republic: Incentives Net Ariz. Health Care Providers $114M
Arizona health care providers have received $114.3 million in payments from the Centers for Medicare and Medicaid electronic health record incentive programs. CMS and the Office of the National Coordinator for Health Information Technology said Tuesday that 1,704 health-care providers in Arizona received payments. The federal program has paid more than $5.7 billion to more than 110,000 health-care professional and more than 2,400 hospitals nationwide (Alltucker, 6/19).

Kansas Health Policy Institute: Kansas HIT Incentives Total $71.7 Million
More than $71.7 million in combined Medicaid and Medicare incentives has been awarded to 769 Kansas doctors and 54 hospitals for implementing electronic health record systems since the program began in 2011 through May 2012, U.S. Department of Health and Human Services officials announced today. The incentive payments were made available by the federal economic stimulus law passed in 2009 for health care providers whose electronic health record systems meet certain federal standards. Hospitals may apply for both the Medicaid and the Medicare incentives. Physicians must choose which program to apply for and then may only switch programs once (6/19).

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State Roundup: Exchange Details; N.Y. Same-Sex Lawsuit

A selection of health policy stories from New York, California, Arizona and Florida, among others.

The Associated Press/ABC News: Budget Turnarounds: Some States Socking Cash Away
States starting to turn the corner on their Great Recession budget woes are taking the cautious approach, socking away millions of dollars in rainy day funds rather than restoring spending for education, health care and social services. At least 21 states, including Arizona, Michigan and Ohio, are putting parts of their surpluses into reserves. ... They also cite still-tepid economic growth, potential costs that could flow to the states under the federal health care overhaul's Medicaid expansion and the possibility that federal deficit-reduction efforts will force states to shoulder more costs (Davenport, 6/19).

California Healthline: Details Of Exchange Begin To Emerge
California Health Benefit Exchange Board members yesterday heard presentations on a number of topics including stakeholder opinions on qualified health plans, potential exchange users' opinions on what they need from the exchange and possibilities for creating call centers.  All of those discussions seemed to lead to the same two things: cost and service (Gorn, 6/20).

Related, earlier KHN story: California Bullish On Health Exchange—No Matter What (Bartolone, 6/15)

The Associated Press: NY Marriage Act Lawsuit Seeks Health Care Benefits
A New York hospital worker and her spouse have filed a lawsuit saying spousal health benefits were denied to the same-sex couple (6/20).

The New York Times: Employee Sues For Benefits To Cover Same-Sex Spouse
Since same-sex marriage became legal in New York last July, most companies in the state have extended spousal health benefits to same-sex couples. But self-insured employers, which include St. Joseph’s [hospital] and other large institutions, are primarily governed by federal, not state regulations. As a result, they may deny health coverage to same-sex couples under the federal Defense of Marriage Act (Otterman, 6/19).

Arizona Republic: Arizona Midwives Want Regulations Overhauled
Arizona midwives, their clients and officials want to overhaul regulations and update best practices for the state's licensed midwives. Right now, Arizona women who have had a Caesarean section or are expecting twins can't give birth at home with a midwife. And women hoping to become licensed midwives must first plod through a years-long state process of training and testing (Rau, 6/19).

Modern Healthcare: Calif. Hospital Awarded Nearly $21 Million In Dispute With Sutter
An arbitrator has awarded the publicly owned Marin General Hospital in Greenbrae, Calif., a net award of $20.9 million after sorting through a blizzard of post-breakup litigation with the hospital's former parent system, Sutter Health (Carlson, 6/19).

Health News Florida: UM Wins $4M Innovation Award
University of Miami and six collaborators have won a $4.1-million, three-year Health Care Innovation Award to improve care to children with chronic illnesses, the Department of Health and Human Services announced. UM and other winning projects aim to do three difficult things simultaneously: improve the quality of care, cut costs and train a new cadre of health-care workers (6/19).

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Editorials and Opinions

Viewpoints: Health Law Can Be Intensely Personal; Insurers' Promises Miss The Mark

Los Angeles Times: When Healthcare Reform Is Personal
Whenever I read or hear objections to "Obamacare," I think about my friend's son. The son had cancer when he was a teenager. Thankfully, his dad had health insurance -- through his job. A job that he lost. He has a new job now, but like so many new jobs, it doesn’t pay as much -- and it doesn't come with benefits. Fortunately, his son seems to have beaten the cancer. And the family now has health insurance from the mom's job. So the son, thanks to "Obamacare," can be insured through his parents (Paul Whitefield, 6/19).

Denver Post: Health Care Reforms Must Treat Costs
With a Supreme Court decision on federal health reform expected any day, you might expect us to cheer news that several of the largest health care providers will keep popular provisions of the Affordable Care Act, or "Obamacare," in place. And while we're pleased to see the insurers finally come around on some issues, the fact remains that none is willing or able to address the costliest of the health reforms (6/19).

Detroit Free Press: An Investment In Health At The Community Level
Today, I'm scheduled to visit the Covenant Community Care health center here in Detroit to announce nearly $129 million in additional grants that will bring primary care to underserved communities across America. These grants, made possible by the 2010 health reform law, are part of one of the underreported success stories of the last few years -- a historic investment that is bolstering health services for our most vulnerable populations around the country. We know that people who have doctors, nurses, dentists and mental health professionals nearby are much more likely to get the care they need. Yet we've seen a growing shortage of health care providers in many communities, especially in inner-city neighborhoods (HHS Secretary Kathleen Sebelius, 6/20).

Archives of Otolaryngology--Head & Neck Surgery: Why Are More Costly And More Dangerous Surgical Procedures Being Developed? 
Yet during this time of dramatic cost-containment initiatives for health care in the United States and around the world, (two journal studies) are seemingly advocating modifications to standard approaches that currently have low morbidity to procedures that are more expensive and more dangerous. Why is this occurring? ... It would seem that now is the time for our journal leaders to consider mandating some type of discussion of cost-effectiveness in every publication proposing a new diagnostic, therapeutic, or preventive innovation so that the readership can consider a component of professional responsibility that is now becoming increasingly important (Dr. David E. Schuller, 6/19).

The Wall Street Journal: Foreign Medicare Fraud
The $31 million Medicare-fraud case reported from Miami yesterday may not be the largest in American history but certainly is one of the more innovative. According to the Miami Herald, it is "the first such case that directly traces money fleeced from the beleaguered program into the Cuban banking system." The Herald described the heist as "an intricate system" that funneled money "from fraudulent HIV treatment and medical equipment billings, first through banks in Canada and Trinidad and eventually [to] Cuba" (Mary Anastasia O'Grady, 6/19).

Boston Globe: Put Away The Red Tape
As sure as if Medicare had given every doctor in the nation a stroke, your physician has become paralyzed. A surreal series of demands from insurance companies and Medicare for increasing amounts of documentation on every patient has produced large inefficiencies in modern medicine. Intended to trim costs and improve care, these rules have instead burdened doctors with needless, time-consuming paperwork. As the state and federal governments look for ways to cut health care costs, adding more paperwork requirements can’t be part of the solution (Drs. Allan H. Ropper, Anthony A. Amato and Martin A. Samuels, 6/19).

Philadelphia Inquirer: Pharma Strategies For 2020 Take A Hit
Even people with good health insurance that includes a prescription drug benefit should not remain blasé about these escalating costs because more policies are changing to shared risk coverage. Under that sort of system, out-of-pocket costs are not limited to standard deductibles and co-payments. They also include a percentage of a drug's total cost (Daniel Hoffman, 6/19).

JAMA: Designing Health Care For The Most Common Chronic Condition—Multimorbidity
Despite the predominance of multiple chronic conditions, however, reimbursement remains linked to discrete International Classification of Diseases diagnostic codes, none of which are for multimorbidity or multiple chronic conditions. Specialists are responsible for a single disease among the patient's many. Quality measurement largely ignores the unintended consequences of applying the multiple interventions necessary to adhere to every applicable measure (Drs. Mary E. Tinetti, Terri R. Fried and Cynthia M. Boyd, 6/20).

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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.