Daily Health Policy Report

Wednesday, June 4, 2014

Last updated: Wed, Jun 4

KHN Original Reporting & Guest Opinion

Health Reform

Administration News

Capitol Hill Watch

Medicare

Health Information Technology

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

A Hot Sauce Accident Leads To Health Insurance

Houston Public Media’s Carrie Feibel, working in partnership with Kaiser Health News and NPR, reports: “When we first met Tammy Boudreaux, a freelance social worker in Houston, last December, she was still weighing her health insurance options. She told us she was overwhelmed and confused by the choices she was finding on healthcare.gov; plus, the high deductibles of the Obamacare plans didn't seem like such a great deal. But when we checked back in with Boudreaux this month, we learned that complications from a chance encounter with a bottle of hot sauce ultimately changed her mind” (Feibel, 6/3). Read the story.

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Hospital Prices Vary Wildly For Common Treatments

The Seattle Times' Carol M. Ostrom, working in partnership with Kaiser Health News, reports: "Some heart surgeries have become so common — the angioplasty, for example, to open clogged arteries — you might think the charge for it wouldn’t vary much from hospital to hospital. You might assume the same about hip or knee replacements, which now hold the top spot in this country as the reason for overnight hospital stays by Medicare patients. You would be so wrong" (Ostrom, 6/3). Read the story.

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Political Cartoon: '(Mis) Managed Care?'

Kaiser Health News provides a fresh take on health policy developments with "(Mis) Managed Care?" by Pat Bagley.

Meanwhile, here's today's haiku:

SOMETHING NEW? OR A REPRISE?

A private option?
Some say that's the way to meet
health care needs of vets.
-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

States Scramble To Pay Hefty Tab For Health Exchange Fixes

According to The Wall Street Journal, five states -- Maryland, Massachusetts, Minnesota, Nevada and Oregon -- will look to their own funds, remaining federal grants and new federal funding requests to pay these costs. In addition, a new study examines the impact of cost-sharing subsidies. News outlets also report on health exchange developments in Missouri and Minnesota.  

The Wall Street Journal: Five States' Health-Care Exchanges See Costly Fixes
Five states that launched health exchanges under the Affordable Care Act expect to spend as much as $240 million to fix their sites or switch to the federal marketplace, a Wall Street Journal analysis shows. Maryland, Massachusetts, Minnesota, Nevada and Oregon estimate the money will be needed to fix problems with troubled marketplaces or to join the federal exchange before the next enrollment period in November, according to an analysis of data provided by the state exchanges. Funds may come from the states, remaining federal grants and new federal requests (Armour, 6/3).

CQ Healthbeat:  Insurers Don’t Lower Costs for All Care Through Cost-Sharing Subsidies, Study Says
Low-income people who get federal assistance to help pay insurance co-pays and deductibles should check to see whether insurers are lowering costs for all kinds of care, according to an analysis by Avalere Health that was released Tuesday. The health care law provides financial help to people who buy insurance in the new health law marketplaces if their income is less than 250 percent of the federal poverty line. The extra help with cost-sharing is available for a single person with income between $11,670 and $29,175 in 2014. But the Avalere analysis shows that many health insurance plans do not lower cost-sharing for treatments such as specialty drugs (Adams, 6/3).

The Oregonian: Moda Health Mulls Raising Premiums For Individual Market As Competitors Drop Rates
After a tumultuous first-ever open enrollment period under federal health reforms, Oregon health insurers are bracing for round two. Rate filings by carriers this week show that barely a month after seizing a commanding share of Oregon's individual health insurance market in this year's enrollment period, Moda Health is asking for an average 12.5 rate increase in 2015. Meanwhile, many competitors are seeking to drop their premiums next year to get closer to Moda's 2014 premiums (Budnick, 6/3).

Minnesota Public Radio: Minn. Legislative Auditor To Review MNsure, Despite Federal Directive
Minnesota's legislative auditor will continue reviewing a main part of MNsure's operations -- despite a federal directive not to. The Centers for Medicare and Medicaid say state auditors should not review how well their states are determining who is eligible for public health insurance programs such as Medical Assistance. The directive applies to last Oct. 1, the day online health insurance marketplaces such as MNsure began determining such eligibility (Stawicki, 6/3).

St. Louis Post-Dispatch: Wentzville Obamacare Center In Showdown With Congress
A showdown has begun between Congress and the Center for Medicare & Medicaid Services over allegations that employees were doing little work at a center near St. Louis that processes applications under the new federal health care law. Rep. Blaine Luetkemeyer, R-St. Elizabeth, wrote CMS Director Marilyn Tavenner Tuesday complaining that the federal agency had not complied with his May 30 deadline request for answers to questions about a facility, near Wentzville, run by the contractor Serco. Whistleblowers have alleged that employees there and in other Serco health-care application facilities in other states did little or no work. A CMS spokesman responded with a written statement that his agency will respond to the letter from the Missouri congressional delegation, but that statement had no timeline as to when that will be (Raasch, 6/3).

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Democrats Tout Medicaid Expansion In Campaigns

But House Republicans are divided over their promise to vote on a health law alternative this year as millions of Americans are now enrolled in expanded Medicaid and subsidized private coverage. Meanwhile, a proposed tightening of work requirements for Utahans getting food stamps could complicate the state's push to expand Medicaid, and hospitals in states that expanded Medicaid are treating fewer charity cases.

Politico: Democrats Embrace Medicaid Expansion On Trail
Democrats have found a big piece of Obamacare that nearly all factions of their party can back -- and they say it’ll be a winning issue on the campaign trail this fall. Even some of the Democrats running for reelection in red states are embracing the Affordable Care Act’s optional Medicaid expansion and, along with their compatriots, pressuring Republican governors and legislatures to do the same (Haberkorn, 6/4).

Associated Press:  House GOP Conflicted On Health Law Alternative
House Republicans are united as ever in their election-year opposition to "Obamacare," but they're increasingly divided over their promise to vote this year on an alternative to it. The disagreement comes amid a shifting political calculus around President Barack Obama's health care law. Millions are enrolled for medical insurance through the law's exchanges, and an all-out repeal has become less practical and popular. Some Democrats have begun promoting the measure in campaign commercials, and some Republicans are treading more carefully in belittling the program. At a recent closed-door House Republican caucus meeting, several conservatives pressed GOP leaders over the pledge Majority Leader Eric Cantor made in January that House Republicans would rally around an alternative to "Obamacare" and pass it this year (Werner, 6/4).

Denver Post: Medicaid Expansion Reducing Hospital Losses From Uninsured, Study Says
Hospitals in Colorado and 25 states that opted to expand Medicaid under the Affordable Care Act treated fewer charity cases and other uninsured patients in the first quarter of 2014, according to a study released this week. Researchers concluded that the previously uninsured represented the lion's share of new Medicaid enrollees. The Colorado Hospital Association study, released Monday, gathered data from 465 hospitals in 30 states. It showed more people are finding coverage who didn't have it before, rather than people with private insurance switching to public insurance under Medicaid's eased eligibility requirements (Draper, 6/3).

Salt Lake City Tribune: Utah’s Medicaid Work Requirement: Details Revealed
A proposed tightening of the work requirements for Utahns who receive food stamps could complicate the state’s push for federal flexibility with its Medicaid expansion. Able-bodied adults must spend at least 20 hours a week working or in job training in order to receive food stamps, after an initial three-month grace period. A loophole gives recipients the option of volunteering at certified "work sites," such as food pantries, instead of working in a paid job. The state is considering closing that loophole — and possibly applying the same work requirements to Utahns covered under a Medicaid expansion (Stewart, 6/3).

In other Medicaid news -

CQ Healthbeat: Pharmacy Coalition Wins Extra Time On Medicaid Payment Changes
Pharmacists expressed relief Tuesday after federal Medicaid officials said they will postpone the finalization of a new drug payment policy that would change drugstores’ reimbursements. The Centers for Medicare and Medicaid Services did not say when they would complete the policy, which was called for in the 2010 health care law. The agency said it will stick to its plans to issue further details on implementing the policy through a future guidance memo, and that the upcoming memo will include a new effective date. “We remain committed to ensuring that this guidance is provided to states with sufficient time to implement” the policy, said CMS in the notice (Adams, 6/3).

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Administration News

Cleveland Clinic Chief Considered For VA Post

Delos "Toby" Cosgrove, the top executive of one of the nation's most prestigious hospital systems and also a decorated Vietnam veteran, is being considered by the White House, reports The Wall Street Journal. In addition, lawmakers and veterans' groups demand changes, starting with addressing the waiting-list problem.

The Wall Street Journal: White House Considering Cleveland Clinic Head For VA Secretary Post
The White House is considering nominating the chief executive of the Cleveland Clinic to be the next secretary of the Department of Veterans Affairs, people familiar with the matter said. Delos "Toby" Cosgrove has led one of the nation's most prestigious hospital systems and is a decorated Vietnam veteran. Three people familiar with the matter said the White House has approached Dr. Cosgrove about the position, and two of them said Dr. Cosgrove is seriously considering pursuing the position (Paletta, Weaver and Adamy, 6/3).

Politico: Many Ideas, But Few Names For VA Pick
Veterans’ advocates and lawmakers won’t name their picks for the next Veterans Affairs secretary — but that’s about the only thing they won’t say about the department’s future. Veterans service organizations have long lists of ways they think the VA must reform and the kinds of skills needed to run it. Their positions are as different as the veterans they represent, but they all agree on one thing. “Urgency,” said retired Vice Adm. Norb Ryan, president of the Military Officers Association of America (Ewing and Herb, 6/3).

McClatchy: Acting VA Secretary Pledges Quick Solution For Scheduling Problems
Sloan Gibson, the acting secretary of the Veterans Affairs Department, on Tuesday acknowledged that “not all veterans are getting access to the healthcare that they have earned” and pledged to make addressing the problems quickly the VA’s top priority. Gibson took over last week when Eric Shinseki, a retired four-star general, resigned following reports of treatment delays and other problems at VA hospitals across the country. Gibson said in his first statement as acting secretary that “systemic problems in scheduling processes have been exacerbated by leadership failures and ethical lapses” (Schoof, 6/3).

Meanwhile, a new poll shows the VA scandal impacting the president's approval ratings -

The Washington Post: Poll: American Back Afghan Pullout, Deeply Concerned By VA Scandal
[A] scandal at the Department of Veterans Affairs has united the country in its alarm about the problems, according to a new Washington Post-ABC News poll. … The VA scandal, in contrast, shows no partisan differences and reflects public outrage over reports of long delays for treatment and falsification of records at some veterans’ facilities. The new poll finds a near-unanimous verdict, with 97 percent of Americans describing the problems as serious and 82 percent calling them “very serious” (Balz and Clement, 6/3).

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Capitol Hill Watch

Congress Wrestles With Best Way To Solve VA Problems

Lawmakers ponder whether to expand the system or just give veterans more opportunities to opt into private health care at federal expense. Some analysts say, though, that any fixes could be held up in the Senate by election year bickering.

Los Angeles Times: VA Healthcare Crisis Sparks Competing Solutions In Congress
Whether to expand the massive — and troubled — VA healthcare system or simply give veterans greater ability to seek private care promises to ignite Congress' customary partisan wrangling and complicate passage of reform legislation. Republican senators, led by John McCain of Arizona, on Tuesday rolled out the Veterans Choice Act , which would allow veterans facing weeks-long waits at VA facilities to seek care from private doctors, at the VA's expense. A more sweeping measure sponsored by Senate Veterans' Affairs Committee Chairman Bernie Sanders (I-Vt.) would give veterans who can't get timely appointments with VA doctors the option of going to community health centers, military hospitals or private doctors at the VA's expense (Simon, 6/3).

Politico: VA Reform Could Face Senate Deadlock
The Senate's fix to veterans health care problems might be headed down a familiar path: Right into the chamber's procedural chokehold. There are already signs that Veterans Affairs Department reform could become the next victim of the Senate's election-year legislative war over amendments votes. Those votes have killed popular tax break and energy efficiency bills in recent weeks and translated to a paucity of legislative votes since last summer (Everett and Herb, 6/4).

NPR: Can Civilian Health Care Help Fix The VA? Congress Weighs In
Veterans across the country are still waiting too long for medical care, a situation that drove the resignation of Veterans Affairs Secretary Eric Shinseki last week. Now Republicans and Democrats in Congress are competing to pass laws they think will fix the problem of medical wait times and other problems at the VA. The discussion over how to reform veterans' health care is starting to sound familiar. … Another private sector solution on the table is a sort of voucher system, which Sen. John McCain has been pushing since his presidential campaign in 2008 (Lawrence, 6/3).

The Wall Street Journal: Top Lawmakers Call For Disclosure Of VA Hospital Data
Two top lawmakers leading Congress's probe of the Department of Veterans Affairs called on Tuesday for the agency to disclose internal analyses that measure treatment outcomes at VA hospitals. … The finding was based on internal VA data called Strategic Analytics for Improvement and Learning, or SAIL. The data, which the VA doesn't make public, rank and score more than 100 VA hospitals according to a variety of metrics, including infection and mortality rates (Paletta and Burton, 6/3).

McClatchy: GOP Senators Say Management, Not Money, Is The Problem At VA
North Carolina Sen. Richard Burr and three Republican colleagues on Tuesday announced support for legislation they say would tackle the root causes of treatment delays at veterans medical facilities by giving former service members the option of choosing private health care. Their measure would allow veterans unable to get an appointment in a timely way or who live more than 40 miles from a Department of Veterans Affairs facility to receive care from any doctor in Medicare or the military’s TRICARE health program. The legislation, which the Republican lawmakers unveiled at a press conference at the Capitol, also would establish penalties for VA workers who falsified data and would give the VA secretary the power to fire senior officials who performed their jobs poorly (Schoof, 6/3).

The Oregonian: VA Secretary Is Gone, But Portland Veterans Still Wait For Care
Dwight Hintz couldn't believe what he was hearing from the staffer at his regular Portland VA Medical Center clinic. He called Monday to say a hernia diagnosed by a civilian doctor was bulging and painful. He asked if he could get in to see his primary VA doctor. "The doctor asks if you can hold it in until your regular appointment in July," Hintz said the nurse told him. "Are you kidding me?" asked Hintz, 70, of Gresham, a retired Navy Seabee. So this week, Hintz is moving gingerly, a belt strapped around his lower belly, with a wallet stuffed over the hernia. He has become another unwilling symbol of the Department of Veterans Affairs' difficulty keeping up with the demand for its services from U.S. military veterans (Francis, 6/3).

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Medicare

Medicare Overpays Advantage Plans Billions Because Of Billing Errors: Report

An investigation by the Center for Public Integrity examines how use of a "risk score" that is supposed to help protect the private plans if they have an excess of sicker beneficiaries may have been mishandled. 

Center for Public Integrity: Why Medicare Advantage Costs Taxpayers Billions More Than It Should
[Medicare Advantage] plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found. Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year. ... billions of tax dollars are misspent every year through billing errors linked to a payment tool called a "risk score," which is supposed to pay Medicare Advantage plans higher rates for sicker patients and less for those in good health. Government officials have struggled for years to halt health plans from running up patient risk scores and, in many cases, wresting higher Medicare payments than they deserve, records show (Schulte, Donald and Durkin, 6/4).

The Hill: Feds Overpaid $70B To Medicare Advantage
The federal government wrongfully paid Medicare Advantage programs almost $70 billion, mostly through overbilling between 2008 and 2013, according to a new report. The Center for Public Integrity released the first of its four part investigative series Wednesday on Medicare Advantage payments that examines the use of risk scores used by providers to charge the government more for sicker patients. CPI found between 2007 and 2011, scores for Medicare Advantage patients grew twice as fast when compared to ordinary Medicare patients in more than 500 counties. The report cites government audits of six Medicare Advantage plans in 2007 alone with nearly $650 million in overpayments (Al-Faruque, 6/4).

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Health Information Technology

Transforming Health Care With Data Proves Daunting

Speakers at Health Datapalooza, the annual convention for data geeks, doctors, researchers and patients, offered numerous examples of how people are trying to use data to make medical care safer, swifter and less expensive. But most of those projects are still works in progress. 

NPR: The Health Data Revolution Enters An Awkward Adolescence
The crowd in a hotel ballroom in Washington, D.C., was rocking on Monday, the 2,000 people shrieking with excitement over federal health-care databases. That could only happen at Health Datapalooza, the annual summit for data geeks, doctors, researchers and patients who want to use data to transform health care — or at least make a buck. Both of those goals are proving to demand a lot more than just coming up with a nifty API and getting the venture capitalists to buy in (Shute, 6/3).

Marketplace: Sharing Our Personal Health Data – For Good
Health privacy can, at times, be at odds with a major cultural shift happening in healthcare: a demand for greater transparency. The Health Data Exploration project is another example where sharing trumps privacy. The Robert Wood Johnson Foundation – in collaboration with several California schools – aims to convince consumers to share the personal health data that’s being generated from an avalanche of apps and wearable devices like Fitbit. The question behind the Health Data Exploration project is how to harness that data, and do something other than make money off of it (Gorenstein, 6/4).

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State Watch

Federal Appeals Court Blocks Ariz. Abortion Pill Restrictions

The court said the state didn't present evidence that the regulations furthered women's health. Elsewhere, a bill to stop employers from denying birth control coverage in their plans is considered in New York.

The Wall Street Journal: Arizona's Limits On 'Abortion Pills' Struck Down By Court
A federal appeals court Tuesday struck down an Arizona regulation requiring that so-called abortion pills be administered under a protocol that abortion-rights activists say is outdated and overly restrictive. Ruling in favor of Planned Parenthood Federation of America and the Center for Reproductive Rights, the 9th U.S. Circuit Court of Appeals found that lawyers for the Arizona Department of Health Services "presented no evidence whatsoever that the law furthers any interest in women's health" (Phillips, 6/3).

The Associated Press: Arizona Abortion Restrictions To Remain Blocked
The nation's strictest rules on the use of abortion drugs are likely to be struck down and will continue to be blocked while a lawsuit against them plays out, a federal appeals court ruled Tuesday. A unanimous three-judge panel of the 9th U.S. Circuit Court of Appeals ruled the Arizona regulations appear to be an unconstitutional "undue burden on a woman's right to abortion" and kept in place its injunction on them. The decision reverses a lower court ruling that found the rules legal (Christie and Elias, 6/3).

The Associated Press: Senate Advances Bill On Birth Control Insurance
A bill that would prevent employers from denying their workers reproductive health coverage under their insurance plans is slowly making its way through the [New York] Senate toward a vote. On Tuesday, the measure dubbed the "Boss Bill" was unanimously reported out of the Senate labor committee. … Manhattan Democrat Sen. Liz Krueger, the bill's sponsor, says it will close a loophole in the state's anti-discrimination law, regardless of the Supreme Court [Hobby Lobby case] decision (6/4).

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N.C. Cuts Could Mean 15,000 Lose Medicaid Coverage

Advocates railed against the $60 million shortfall -- created after federal regulators rejected a plan to tax Medicaid managed care providers -- and urged lawmakers to reject a budget that includes the cuts.

North Carolina Health News:  Advocates For Seniors, Disabled Rail Against State Medicaid Cuts
About a hundred seniors and people with disabilities and their advocates descended on the General Assembly to buttonhole legislators over proposed Medicaid cuts passed in last week’s Senate budget. Red-shirted groups of people crowded the doors of House members asking them not to concur with the Senate budget and asking them to restore cuts to the state and county special assistance program that provides services to thousands of seniors and people with disabilities who live in adult-care homes and receive in-home assistance that’s subsidized by Medicaid (Hoban, 6/4).

Raleigh News & Observer: McCrory Says His Medicaid Budget Has $60 Million Shortfall
Federal regulators have rejected a plan from Gov. Pat McCrory’s administration to tax some managed-care Medicaid providers as a way to draw down more federal money for the state budget. The result is a $60 million hole in the Medicaid budget that McCrory acknowledged Tuesday -- and some angry state senators who included the maneuver in the spending plan they approved last week (Neff, 6/3).

The Associated Press: Senior-care Groups Criticize Senate Medicaid Cuts
Advocates for seniors and the disabled urged N.C. House lawmakers on Tuesday to reject a state Senate budget that could take more than 15,000 disabled and elderly people off the Medicaid rolls. About 50 people spoke out against the Senate budget plan Tuesday at a news conference held by the N.C. Coalition on Aging, comprising 30 groups from across the state. Lou Wilson of the N.C. Association of Long Term Care Facilities said the Medicaid cuts would force adult-care homes to discharge residents whose benefits are cut because of a lack of money to operate the facility (Ferral, 6/3).

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Citing Patient Danger, Minn. Takes Over Nursing Home

The state health department says it took over the Camden Care Center because of serious violations that endangered patients and a high number of regulatory violations.

Pioneer Press: Minnesota Takes Control Of Troubled Nursing Home
The Minnesota Health Department has taken control of a Minneapolis nursing home due to "dire management problems," state officials announced Tuesday. The department took over management of Camden Care Center under a receivership order granted by Ramsey County District Court, according to state officials. Volunteers of America -- National Services, a Minnesota nonprofit, is serving as managing agent during the receivership. The Health Department said in a statement that it "used its emergency powers to assume control of the nursing home due to serious violations putting its residents at risk and an unacceptably high number of regulatory violations” (Snowbeck, 6/3).

Minnesota Public Radio: State Takes Over Nursing Home Said To Endanger Patients
The Minnesota Department of Health has taken over management of a nursing home in north Minneapolis after state investigators found conditions that were dangerous to patients. Ramsey County District Court granted the agency's request to take over the Camden Care Center on Thursday, and new managers were on site Friday afternoon. The nursing home cares for about 67 patients, many of whom have behavioral issues including psychiatric disorders, dementia or substance abuse, according to the agency's filing with the court (6/3).

The Star Tribune: Citing 'Dire Problems,' State Seizes Control Of Mpls. Nursing Home
The Minnesota Department of Health has seized control of a Minneapolis nursing home, saying numerous health and safety violations posed “an immediate and serious threat” to the well-being of its vulnerable residents. In a highly unusual step, state regulators on Friday took over the direct management of Camden Care Center, an 87-bed nursing home that cares for elderly and mentally ill patients, after recent inspections turned up 80 violations, many of them serious. In March, regulators found that two residents required hospitalization after accessing drugs or alcohol while under the facility’s care. The state also had concerns that Camden Care Center’s financial condition had deteriorated to such an extent that caregivers might quit their jobs due to nonpayment of wages, leaving vulnerable residents without care (Serres, 6/3).

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Highlights: Calif. Insurance Commissioner Battle; Food Stamps and Medicaid In Calif.; Mo. And Experimental Drug Therapies

A selection of health policy stories from California, Missouri, Washington state, Florida and Connecticut.

Los Angeles Times: Insurance Commissioner Replay Set For November
Incumbent Democrat Dave Jones held a strong lead in Tuesday's primary election voting for state insurance commissioner, but he still faces a rematch in November against Republican challenger Ted Gaines (Lifsher, 6/3).

Los Angeles Times: Can Food Stamps Help Improve Diets, Fight Obesity And Save Money
In so doing, the $79.8-billion Supplemental Nutrition Assistance Program (SNAP) might also reap taxpayers untold future savings for the federally funded care of diabetes and other obesity-related ills among Medicaid recipients. The benefits of making such changes to the program -- more commonly known as food stamps -- would be small and might take a decade to see. But while food stamp recipients often respond to rule changes by paying for disallowed items from their own pockets, such directives can, on balance, nudge their purchasing and consumption habits in positive directions, says a group of medical and health economics researchers from Stanford University and UC San Francisco (Healy, 6/3).

St. Louis Post-Dispatch: Missouri Could Join Push For Experimental Drugs For Terminally Ill
Should a dying person have the right to try a potentially life-saving drug even if its effectiveness is unproven? For Missouri legislators, the answer to that question was easy. In unanimous votes last month, the House and Senate passed a bill that would let drug companies provide terminally ill patients with medications that are still being tested and remain unapproved for general use. If Gov. Jay Nixon signs the bill, Missouri would become the third state to enact such a law. Governors in Colorado and Louisiana signed so-called “Right to Try” measures last month. A similar proposal is slated for a statewide referendum in Arizona this fall (Young, 6/4).

Seattle Times: State Tells Dental Provider To Pay $72M Over Improper Medicaid Claims 
The state attorney general has told a Puget Sound-area health-care provider to pay $72 million for allegedly making improper Medicaid claims for dental care to children and young adults. Officials of the provider, Sea Mar Community Health Centers, reject the allegations, and on Monday its attorneys filed a complaint in U.S. District Court in Seattle asking the court to decide if the billing was proper. The amount that Sea Mar charged Medicaid for the services in question is $7 million since 2006. Because of new rules associated with the Affordable Care Act meant to reduce Medicaid fraud, the attorney general was able to add $51 million in civil penalties, plus a $21 million penalty allowed by previous rules (Stiffler, 6/3).

Miami Herald: New Hospital Price Data Released For South Florida, Nation
The average price for a major hip or knee replacement increased by more than $9,000, or about 8 percent, at South Florida hospitals over one year, with Aventura Hospital and Medical Center charging the highest fee of any facility offering that procedure in 2012: $205,442. A few miles north of Aventura, at Broward Health Medical Center in Fort Lauderdale, the same procedure costs $78,685. That’s about $6,000 less than the national average price of $84,798 for a hip or knee replacement with major complications, according to new data released this week by the U.S. Department of Health and Human Services (Chang, 6/3).

The CT Mirror: Malloy Signs For-Profit Hospital Bill, E-Cigarette Ban For Minors
Gov. Dannel P. Malloy has signed a bill that clears the way for nonprofit hospitals to convert to for-profits, a measure that grew out of intense, last-minute negotiations involving hospitals, unions and lawmakers from both parties. In addition to removing a barrier that could have kept for-profit hospitals from operating in Connecticut, the bill expands state oversight over the sale of nonprofit hospitals and gives the state more oversight on transactions involving physician practices. The change was prompted by the effort by the national for-profit hospital chain Tenet Healthcare to acquire Waterbury, Bristol, Rockville General and Manchester Memorial hospitals, in partnership with the Yale New Haven Health System (Becker, 6/3).

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Editorials and Opinions

Viewpoints: VA's Lessons For Private Health Care; Court Should Protect Abortion Clinic Buffers

Reuters: VA Scandal Is No Mark Against Big Government
This is the full quote from ... former neurosurgeon Ben Carson: "What's happening with the veterans is a gift from God to show us what happens when you take layers and layers of bureaucracy and place them between the patients and the healthcare provider." Perhaps, as a brain surgeon, Carson is given special treatment when he visits the doctor. But the rest of us endure "layers and layers of bureaucracy" whenever we try to access the healthcare we have so expensively bought. One reason American healthcare is two-and-a-half times more expensive than in comparable countries is because of the "layers and layers" of insurance sales agents, ID checkers, referral faxers, hospital debt collectors from insurance companies and all the other expensive bureaucrats with no medical knowledge who are employed to administer and police the system (Nicholas Wapshott, 6/3).

The Wall Street Journal: Health Care Is Our Other Afghanistan
Mr. Obama cannot be blamed for the unworkability of the VA health-care program. Government never will be able to satisfy demand for a valuable service given away free or nearly free. That would be true even if the department did not suffer all the infirmities of a politicized bureaucracy captured by organized labor. As long as the system takes anything like its present form, Secretary Sisyphus will have endless employment. But you'd expect the president, since domestic policy and health care are so close to his political heart, to be more on top of matters. It's hard to escape the impression, as with Afghanistan, that the administration has become lost in its own disingenuousness (Holman W. Jenkins Jr., 6/3). 

Des Moines Register: Putting The VA Scandal Into Perspective
Although Eric Shinseki has resigned as secretary of the Department of Veterans Affairs, the crisis is so deep that it will take many years to fix. But the scandal is not something new that has just burst onto the national scene. And the problems are not confined to veterans hospitals. The problems are going to spread to civilian hospitals and clinics. More than a year ago, I wrote that we needed to pay attention to the shortage of doctors in the United States. The shortage was not a secret then, and the problem hasn't gone away (Steffen Schmidt, 6/3). 

Los Angeles Times: Abortion Clinic Buffer Zones Should Be Protected By The Supreme Court
Within days, the justices of the Supreme Court will hand down their ruling on the constitutionality of buffer zones at abortion clinics, and I hope they will remember that these zones came out of a desire to prevent violence and harassment, not to hinder free speech (Carla Hall, 6/3). 

The New Republic: The Latest Obamacare Glitch And Why It's (Probably) No Big Deal
A new Affordable Care Act controversy may be on the way. It seems a substantial fraction of people who bought private insurance through an Obamacare marketplace submitted personal information that’s inconsistent with federal records. ... The problems could very well [reflect] clunky program design, poor implementation, or some combination of the two. But the "vast majority" of people with these applications appear to be getting the proper amount of financial assistance, senior Administration officials tell The New Republic. The government just hasn't been able to verify their status (Jonathan Cohn, 6/3).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Lisa Gillespie
Shefali Luthra

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