Daily Health Policy Report

Tuesday, August 7, 2012

Last updated: Tue, Aug 7

KHN Original Reporting & Guest Opinion

Health Care Marketplace

Medicare

Medicaid

Health Reform

Campaign 2012

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Is Magnetic Pulse Treatment An Answer For People Suffering From Drug-Resistant Depression

Kaiser Health News staff writer Julie Appleby, working in collaboration with The Washington Post, reports: "An increasing number of psychiatrists and hospitals - as well as entrepreneurs opening rTMS centers around the country – are betting that there are millions of people like Curtis, discouraged by depression treatments that have proved unsuccessful and willing to pony up thousands of dollars for the possibility of relief. The treatment, which has been approved by the Food and Drug Administration, is covered by Medicare in five states, but few private insurers pay for it routinely" (Appleby, 8/6). Read the story and the related sidebar.

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Insuring Your Health: Some Plans Deny Pregnancy Coverage For Dependent Children

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "The health care overhaul provides a safety net for young adult children, who can now stay on their parents' health plans until they reach age 26. But it doesn't guarantee that their parents' plan will cover a common medical condition that many young women face: pregnancy" (Andrews, 8/6). Read the column.

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Study: Nearly A Third Of Doctors Won't See Medicaid Patients

Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Philadelphia Inquirer, reports: "About 69 percent of doctors nationally accept new Medicaid patients, but the rate varies widely across the country, according to a study published Monday in the journal Health Affairs" (Galewitz, 8/6). Read the story.

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Capsules: Survey: 2013 Medicare Drug Plan Premiums Will Be Similar To This Year — On Average; Employers Expect 7 Percent Growth Cost Of Health Benefits

Now on Kaiser Health News' blog, Marilyn Werber Serafini reports on 2013 Medicare Part D premiums: "Premiums for private Medicare prescription drug plans will be about the same in 2013 as they have been over the past two years, according to the Department of Health and Human Services. Based on drug and health plan bids, the average monthly premium for an individual next year will be about $30 for basic prescription drug coverage. That's close to what it was in both 2011 and 2012" (Werber Serafini, 8/7).

Also on Capsules, Matthew Fleming reports on a new empoyer survey regarding employee health benefits: "As employers brace to absorb cost increases in employee health benefits, many are also experimenting with new ways to control these expenses, according to a new survey from the National Business Group on Health, a non-profit association of 342 large employers" (Fleming, 8/6). Check out what else is on the blog.

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Political Cartoon: 'Doctor Who?'

Kaiser Health News provides a fresh take on health policy developments with "Doctor Who?" by Jerry King.

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

WHITHER THE DOG DAYS?

'09 writing law
'10, '11 fighting law
'12 still no time off
-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 Care Marketplace

HCA Faces Scrutiny About Need For Some Cardiac Procedures

HCA Holdings Inc., the biggest for-profit U.S. hospital operator, told investors that federal prosecutors in Miami are probing the "medical necessity" of cardiology procedures performed at several of its hospitals in Florida. The company made an unusual statement defending its operations in anticipation of a New York Times article that appeared online late Monday.

The New York Times: Hospital Chain Inquiry Cited Unnecessary Cardiac Work
HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports (Abelson and Creswell, 8/6).

The Wall Street Journal: HCA Discloses Federal Probe
HCA Holdings Inc. said federal prosecutors in Miami are probing the "medical necessity" of cardiology procedures performed at several of its hospitals ... The company, which is the biggest for-profit U.S. hospital operator with 163 facilities, also made an unusual statement defending its operations in anticipation of a New York Times article that appeared online late Monday. The statement addressed potential questions on its cardiac care, emergency-room billing practices and treatment of uninsured patients. In the wake of the disclosures, HCA shares fell 4% to $25.55 in 4 p.m. composite trading on the New York Stock Exchange, despite second-quarter earnings that were up from last year, largely based on improved patient volumes (Mathews and Weaver, 8/6).

The Associated Press/Los Angeles Times: HCA Holdings Questioned About Need For Some Cardiology Services
Hospital chain HCA Holdings said the Justice Department wants information about heart procedures performed at some of its locations. HCA said it has been asked about reviews that assessed the medical necessity of some cardiology services. The questions came from the U.S. Attorney's office in Miami, the company said. The New York Times published a report late Monday citing evidence that some HCA hospitals in Florida were performing unnecessary, and sometimes dangerous, heart procedures with the aim of driving up profit for the hospital chain (8/7).

Reuters: U.S. Probes HCA Heart Procedures, Hospital Billing
U.S. authorities are probing whether heart procedures performed at HCA Holdings Inc hospitals were medically necessary and are investigating the company's billing practices, the company said on Monday. Shares of HCA, the largest U.S. for-profit hospital chain, fell as much as 10 percent after the news. HCA, in an unusual move, issued a detailed rebuttal defending itself ahead of the publication of a New York Times article that said a complaint by a nurse at an HCA hospital in Florida led to an internal investigation that uncovered evidence of unnecessary heart procedures being performed at some of the company's hospitals (Berkrot and Kelly, 8/7).

Bloomberg: HCA Says Heart Procedures In Florida Scrutinized by U.S.
A U.S. attorney in Miami has asked HCA Holdings Inc. (HCA), the nation's biggest hospital operator, for information on the "medical necessity" of the cardiac procedures done in its Florida hospitals, according to a regulatory filing. The disclosure came as the New York Times reported that Nashville, Tennessee-based HCA had investigated numerous cases in which doctors conducted unnecessary surgeries in its facilities, and didn't contact patients, medical authorities or insurers about the results of those probes ..."I think we have to look at it seriously" in weighing the potential risk for the company, said Sheryl Skolnick, a CRT Capital Group LLC analyst in Stamford, Connecticut, in a telephone interview (Nussbaum, 8/7).

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Employers Expect Health Costs To Go Up, Ready Compliance With Health Law

A new survey of employer health benefits by the National Business Group on Health has found businesses expect their health care costs to jump 7 percent next year as they comply with new parts of the federal health care reform law. Employers also expect to increase workers' share of health care costs 5 percent, the study found.

Politico Pro: Survey: Employers Ditching Annual Limits
Dozens of the nation’s largest employers are making moves to comply with the Affordable Care Act by eliminating annual benefit limits in health plans, according to a new survey by the National Business Group on Health. Half of the 82 large companies surveyed said they had eliminated annual benefit limits in their offerings for the 2013 plan year, although a third said they hadn’t made changes to their limits yet. The most likely benefits to be limited, according to the survey, are services for mental health, substance abuse and rehabilitation. Most businesses reported that they wouldn’t have any health plans that fall short of the law’s requirements but would be eligible to be grandfathered (Cheney, 8/6).

The Hill: Businesses Predict 7 Percent Jump In Health Care Costs
Businesses expect their health care costs to grow by about 7 percent next year -- a bigger jump than they've seen in the past three years -- according to a new survey. The National Business Group on Health, which conducted the survey, did not directly attribute the expected jump to President Obama's health care law, though it noted that employers are changing their health plans to comply with the new law. Sixty percent of employers surveyed said they plan to shift more health care costs to employees, but most said their workers' costs would rise by less than 5 percent next year. Companies are also trying to cut costs by beefing up programs that reward workers for healthy behavior (Baker, 8/6).

CQ HealthBeat: Big Employers Eye Wider Use Of Wellness Bonuses, Reference Pricing To Control Costs
A health benefits survey of some of the nation’s largest corporations released Monday in a sense is just more of the same -- costs will rise, employees will pay more. But it does show some interesting new wrinkles when it comes to cost containment. For example, it says that a number of employers plan to sharply increase the amount of money they pay employees to maintain a healthy lifestyle or participate in a program that promotes good health. And the survey by the National Business Group on Health (NBGH) also shows growth in the use of "reference pricing," said Helen Darling, the president of the business group, referring to a system under which employers pay a certain amount for a particular health service and employees who want to see a doctor or get a procedure that costs more than the reference point must pay the difference out of their pockets (Reichard, 8/6).

Kaiser Health News: Capsules: Survey: Employers Expect 7 Percent Growth Cost Of Health Benefits
As employers brace to absorb cost increases in employee health benefits, many are also experimenting with new ways to control these expenses, according to a new survey from the National Business Group on Health, a non-profit association of 342 large employers (Fleming, 8/6).

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Medicare

No Medicare Drug Plan Cost Increases For Seniors In 2013

The Obama administration announced that costs for seniors' Medicare Part D premiums will remain stable -- marking the third year in a row with little or no change.

The Associated Press: Gov't: Medicare Drug Plan Premiums Stable For 2013
It's an economic indicator of sorts for seniors: The Obama administration says the average premium for basic Medicare drug coverage will stay the same next year, $30 a month. That's the third year in a row of little or no change. In addition, Medicare recipients with high prescription costs are saving an average of $629 apiece thanks to a provision of the new health care law that gradually eliminates a coverage gap called the "doughnut hole." There is a caveat on premiums. Because the number is an average, some beneficiaries may see their monthly cost go up, while others get a decrease (8/6).

Bloomberg: Medicare Drug Plan Premiums To Stay At $30 In Coming Year
Medicare beneficiaries will pay the same premium for prescription drugs next year as they did this year, the U.S. Department of Health and Human Services said. Premiums for drug plans that accompany basic Medicare coverage for the elderly and disabled will be an average of $30 in 2013, the department said today in a statement. The estimate is based on bids from private insurers who offer the plans to Medicare patients (Wayne, 8/6).

Reuters: No Increase In Medicare Drug Costs For Seniors
Medicare participants enrolled in the health insurance program's prescription drug benefit should see their premium cost remain steady next year, health officials said.The Department of Health and Human Service on Monday forecast a $30 average monthly premium for Medicare Part D, similar to the cost in 2012. In 2011, premiums were $30.76.HHS attributed the low premiums to President Barack Obama's healthcare reform law, known as the Affordable Care Act, which includes some measures to lower the cost of medications for seniors (8/6).

The Hill: HHS: No Change In Premiums For Medicare Drug Benefit
Flat premiums help highlight the savings that seniors have seen because of President Obama's healthcare law. The law provides a discount for seniors who hit the Medicare "doughnut hole" — the coverage gap in which seniors have to pay for their prescriptions out-of-pocket. Those discounts have already saved seniors nearly $4 billion, HHS said. Rising premiums might muddle the picture somewhat, but flat premiums mean that the discounts are the only price change seniors will see (Baker, 8/6).

CQ HealthBeat: CMS Projects $30 A Month Average In 2013 For Prescription Drug Plans
Medicare enrollees should pay about the same monthly premium for their prescription drug plans in 2013 as they did this year, under projections released Monday by the Centers for Medicare and Medicaid Services. The average basic premium is expected to be about $30 a month, the same projection that was made last year for 2012. The 2012 average turned out to actually be $29.67 (8/6).

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Medicaid

Safety-Net Hospitals Brace For Funding Changes, Adjustments

Meanwhile, a new Health Affairs study suggests these facilities may need to rethink their business models.

Modern Healthcare: Variation Seen In Margins At Safety Net Facilities
Safety net hospitals governed by elected officials reported higher profits than those governed by political appointees, not-for-profit boards or for-profit directors, according to a study. … Public hospitals governed by elected officials operated in competitive markets reported the highest operating margin, on average, at 7%. Hospitals governed by political appointees reported a slim average 0.7% operating margin. Safety net not-for-profit and for-profit hospitals reported margins of -0.9% and -2%, respectively (Evans, 8/6).

Politico Pro: Safety Net Hospitals Likely To Struggle
Safety net hospitals that rely on local government subsidies are likely to struggle as the Affordable Care Act takes root, and will be in jeopardy without a major overhaul of their business model, according to a study published Monday in Health Affairs. But at least more doctors are likely to be willing to take new Medicaid patients, a second study in the August edition suggests, when the Medicaid reimbursement rates in 2013 and 2014 will be raised to match Medicare for primary care services (Norman, 8/6).

The Wall Street Journal: Study Finds 31% Of Doctors Shun Medicaid
About one in three doctors across the country doesn't accept new patients who are covered by Medicaid, the federal-state insurance program that is supposed to enroll millions more low-income Americans as part of the Obama administration's health overhaul, according to a new government study (Radnofsky, 8/6).

Kaiser Health News: Study: Nearly A Third Of Doctors Won't See Medicaid Patients
About 69 percent of doctors nationally accept new Medicaid patients, but the rate varies widely across the country, according to a study published Monday in the journal Health Affairs" (Galewitz, 8/6).

CQ HealthBeat: Study Shows A Patient's Insurance Still Determines Physician Access
About 69 percent of physicians nationwide accepted new Medicaid patients last year, compared to the 83 percent who took new Medicare patients or the nearly 82 percent who saw new privately insured patients, according to a study in the journal Health Affairs published Monday. The study is extrapolated from an annual Centers for Disease Control and Prevention (CDC) survey of 4,326 doctors (Adams, 8/6).

Meanwhile, in California -

California Healthline: Safety-Net Hospitals Face Funding Cuts On Two Federal Fronts
The Affordable Care Act will reduce by at least half the amount of Medicaid money set aside to help safety-net hospitals provide uncompensated care for patients with no insurance and no cash. Hospitals serving a high percentage of uninsured, low-income patients -- or disproportionate share hospitals -- are reimbursed at a higher rate by Medicaid. The federal government pays about $20 billion a year in DSH payments. In California, 21 public hospitals receive approximately $1.1 billion a year in DSH funding. Private DSH hospitals in California receive additional DSH funding from the state, but that, too, will be reduced. The reductions make sense, hospital officials agree, because more people will become paying customers under ACA. But exactly how those reductions are made will be critical, according to representatives of California's safety-net hospitals (Lauer, 8/6).

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Health Reform

Medicaid Official Outlines State Flexibility In Health Law's Medicaid Expansion

Politico Pro reports that Centers for Medicare & Medicaid Services official Cindy Mann outlined Monday how states could choose to expand their coverage under the health law and then later drop it if they choose. This is the first time states will be allowed to drop such new coverage. Meanwhile, Modern Healthcare reports on how employers might be impacted if states opt not to expand their Medicaid programs.

Politico Pro: Mann: States Can Drop Medicaid Expansion
CMS Medicaid Director Cindy Mann said Monday that if states decide to expand Medicaid to new populations under the Affordable Care Act, they can later drop the coverage, according to sources who attended the meeting. Mann made the remarks at the National Conference of State Legislatures meeting in Chicago on Monday and outlined the new policy in a PowerPoint presentation obtained by Politico.  She acknowledged that that was the first time she said states will be allowed to drop the new coverage later if they want, according to several attendees (Haberkorn, 8/6).

Modern Healthcare: Reform's Reduced Effect On Medicaid Could Impact Employers
Employers could be liable for stiff financial penalties as a result of a portion of the U.S. Supreme Court's health care reform law ruling that invalidated massive federal sanctions against states that fail to expand eligibility for their Medicaid programs. In addition, the Medicaid part of the ruling could result in a much smaller reduction in the number of uninsured U.S. residents compared with earlier projections, according to estimates by the Congressional Budget Office. If those projections hold true, the effect of one of the big positives of the Patient Protection and Affordable Care Act for employers -- a reduction of uncompensated care costs, which providers now shift to employer health plans -- could be much smaller than employers had hoped (Geisel, 8/6).

Meanwhile, news outlets continue to report on the federal role in creating and operating health exchanges --

The Associated Press: Governors Aside, Feds Building Health Care Markets
Don't look now: The feds may be gaining on GOP governors who've balked at carrying out a key part of President Barack Obama's health care overhaul law. Opponents of the law say they won't set up new private health insurance markets called exchanges. But increasingly it's looking like Washington will just do it for them. That means federal officials could be calling the shots on some insurance issues that states traditionally manage, from handling consumer complaints to regulating plans that will serve many citizens (Alonso-Zaldivar, 8/7).

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Campaign 2012

Presidential Candidates Use Tough Ads To Court Single Women Voters

The competition for these votes has led President Obama's campaign ads to highlight GOP presidential hopeful Mitt Romney's positions on issues such Planned Parenthood funding as well as other women's health and contraception issues.

The New York Times: In Weak Economy, An Opening To Court Votes Of Single Women
But the Obama campaign, needing their support to offset traditional Republican strength among married women, is lavishing attention on them. Mr. Obama and his allies are highlighting issues like Mr. Romney's support for cutting federal funds to Planned Parenthood, which they say resonate with single women and that help draw a contrast between the two sides. A new Obama ad calling Mr. Romney "out of touch" with average women on health and contraception issues began running last weekend in battleground states (Dewan, 8/7).

CNN: Romney Outdated On Women's Issues, Obama Ad Says
Obama's campaign cites Romney's support of a GOP-backed Senate amendment in March, which attempted to confront an Obama administration ruling requiring religiously-affiliated institutions to cover contraception in health care plans for female employees. Republicans, including Romney, argued the administration's policy violated religious freedom. The new spot, "Important," also features clips of Romney vowing to "cut off funding for Planned Parenthood" and saying he was "going to get rid of" the organization. The latter statement came from an interview the Republican candidate gave in March. After taking heat for saying he would "get rid of" the group, his campaign later clarified that he would support ending federal funding to Planned Parenthood, not the institution, itself (Killough, 8/6).

Also, a new pro-Obama ad casts Romney's business background in a very negative light by highlighting what happened to an employee when the plant where he worked was shut down --

Politico: Priorities Ad Ties Romney To Lost Health Insurance, Cancer Death
The Obama super PAC Priorities USA Action is unveiling perhaps the harshest, most personal ad of the 2012 presidential race, featuring a former worker at a Bain-owned company talking about the death of his wife after their family lost health insurance. The commercial casts Mitt Romney's business background in a severely negative light, but it's not a typical slash-and-burn attack ad. Instead, it features former GST Steel employee Joe Soptic speaking to the camera about what happened when the plant where he worked shut down (Burns, 8/7).

And, some fact-checking regarding state senate races and the health law --

Kansas Health Institute News: Campaign Literature Labeled 'Misleading'
A national organization that polices the accuracy of charges made in political campaigns has said mailed materials being used in the coordinated effort to oust some incumbent Republican state senators in Kansas are misleading. FactCheck.org is a nonprofit project of the Annenberg Public Policy Center of the University of Pennsylvania. The group examined direct-mail pieces that accused some incumbent senators of scuttling efforts to pass a state constitutional amendment opposing the federal health reform law commonly known as the Affordable Care Act or Obamacare (McLean, 8/6).

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State Watch

Mass. Governor Signs Health Care Cost-Containment Bill

Massachusetts Gov. Deval Patrick signed a bill Monday that lawmakers hope will rein in health care costs by tying health care cost growth to how fast the state economy grows. But, Moody's said the law could hurt the state's hospital credit ratings since the hospitals' revenue growth would be hampered.

WBUR: Patrick Signs Health Care Cost Containment Bill
A bill that will adjust virtually every piece of the state’s health care system is now law. Gov. Deval Patrick signed the legislation Monday morning in a packed State House hall. "Massachusetts has been a model for access to health care," Patrick reminded the crowd. Now, "we become the first to crack the code on costs." Hundreds of health care leaders joined Patrick Monday to endorse the law… Patrick, who made tackling health care costs a top priority, gave credit to the broad coalition that helped to pass the state’s access law and seems to be holding together to lower costs (Bebinger, 8/6).

Boston Globe: Governor Deval Patrick Signs Health Cost-Control Bill
The first-in-the nation legislation is considered the second phase of the groundbreaking universal health care law that was signed by Governor Mitt Romney in 2006. The new law allows health spending to grow no faster than the state’s economy through 2017. For five years after that, spending would slow further, to half a percentage point below the growth of the economy, although leaders would have the power under certain circumstances to soften that target. The bill also includes provisions to encourage a shift to paying hospitals and doctors for overall patient care rather than for every test and treatment (Levenson, 8/6).

Reuters: Massachusetts Health Care Law May Hurt Hospital Ratings-Moody's
Moody's Investors Service said Massachusetts legislation aimed at curbing health care costs, to be signed into law on Monday, may put a strain on hospitals' credit ratings because it will hamper their revenue growth. Lawmakers passed the legislation last week, making Massachusetts the first state in the nation to curb how much providers and insurers can spend on medical care, and putting the state on course to save up to $200 billion over 15 years. The law will limit revenue growth and reduce operating flexibility for hospitals in the state, Moody's said (8/6).

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ER Overcrowding A Problem At Calif. Hospitals Serving Many Minorities

A new study says California hospitals in areas with large minority populations are disproportionately affected by overcrowding at ERs -- often leading to ambulance diversion, delayed care and poorer health outcomes for patients.

San Francisco Chronicle: Overcrowded ER Points To Larger Problems
California hospitals in areas with large minority populations are disproportionately affected by emergency room overcrowding, making them more likely to ease the congestion by diverting ambulances to other hospitals, according to a UCSF-led study. The study, which looked at 2007 data from 202 hospitals around the state, found hospitals that served the greatest percentage of minority patients turned away ambulances because of overcrowding as much as four times as often as those that served the smallest number of minorities. Health experts say ambulance diversion, the practice of turning ambulances away temporarily when a hospital's emergency department becomes overcrowded, can lead to delayed care and poorer health outcomes (Colliver, 8/6).

KQED: ER Overcrowding Hurts Minorities Most
Overcrowding in California emergency rooms disproportionately affects minority populations, according to a study published Monday in the journal Health Affairs. The findings shed light on flaws in the emergency care system that affect vulnerable populations, including communities of color, lead author Dr. Rennee Hsia says (Lawrence, 8/7).

California Watch: Minorities Hit Hardest By Calif. Hospital Overcrowding, Study Finds
California hospital overcrowding disproportionately affects minority patients, according to a study published today. The study by UC San Francisco, Stanford University and UCLA researchers measured hospital overcrowding in 202 California facilities by analyzing ambulance diversion rates, or how often ambulances are turned away from an emergency department. They found that hospitals that serve large minority populations were more likely to divert ambulances to other hospitals (Young, 8/6).

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Medicaid News: Challenge To Fla. Managed Care Rule; N.Y. Wants Permission To Invest Savings

Florida is seeking to move seniors on Medicaid into a managed care program but one company questions part of the regulations on plans.

Health News Florida: Medicaid Plan To Challenge State
Florida's effort to steer elderly Medicaid patients into managed care is running into its first significant hurdle. A newly formed managed-care plan late last week told state officials that it is ready to challenge the initial contract the state is drawing up as part of a move to hold down the cost of providing long-term care under the state's safety-net program. Aetna Better Health gave notice on Thursday to the state Agency for Health Care Administration that it intends to challenge the contract's requirement that managed-care companies provide as many as three references (Jordan Sexton, 8/6).

Meanwhile, in other Medicaid news -

The Associated Press/Wall Street Journal: NY Seeks Waiver To Invest Medicaid Savings
State health officials say they have applied for a waiver that would enable them to use $10 billion of federal savings from Medicaid changes for other state initiatives meant to improve primary health care for poorer New Yorkers (8/7).

Kansas Health Institute News: Kansas Refiles Section 1115 Waiver Request
Kansas officials today said they resubmitted to federal authorities their request for a Section 1115 Medicaid waiver. The waiver is needed to implement Gov. Sam Brownback's plan to remake the state Medicaid program as KanCare. The application was first submitted in April but then withdrawn to allow for additional input from Native American tribal governments (8/6).

CT Mirror: Malloy Gets Implied OK To Pursue Restrictions On Health Benefits For The Poor
Two state legislative panels will give Gov. Dannel P. Malloy the green light to eliminate Medicaid benefits for more than 13,000 of Connecticut's poorest residents -- but they will do so without a vote. ... [Aug. 18 is] the deadline they face to block an administration application for federal approval to tighten eligibility in the Medicaid for Low-Income Adults program, known as LIA (Phaneuf, 8/6).

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Kansas Considers Disbanding Information Exchange Board; Minn. Rebates Lower Than Expected

The Kansas agency may dissolve and turn its authority over to the state to save money.

Kansas Health Institute News: Regulators Of Health information Exchange To Consider Ceding Authority To State
The board responsible for overseeing the digital exchange of Kansans' health records is scheduled to face Wednesday its biggest decision since it was formed two years ago — whether to dissolve itself and turn its regulatory authority over to a state agency with the goal of saving money. The decision comes at the same time that health information exchange is beginning in Kansas. Since 2005, various Kansas groups have wrangled with how best to ensure the privacy and security of patient health information as doctors and hospitals transition from paper to electronic health records (Cauthon, 8/6).

(St. Paul) Pioneer Press: Minnesota Health Insurance Rebates To Total $8.9 Million
Health insurers are issuing $8.9 million in rebates to Minnesota customers this summer -- a smaller sum than the $14.6 million that companies projected they would provide back in April.  The rebates are required by the 2010 federal overhaul of the nation's health care system, which set a limit on the share of premium revenue that health insurers could dedicate to administration, marketing and profit.  "It looks like there were a few insurers that significantly overestimated their rebates," said Cynthia Cox, a policy analyst with the Kaiser Family Foundation, which in April published a report tabulating rebates based on insurers' preliminary estimates (Snowbeck, 8/6).

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Texas Doctors Oppose State Plans On Abortion

The physicians are objecting to a proposed rule for the Texas Women's Health Program that prohibits them from discussing abortion with patients. Meanwhile, the governor, who says he opposes an expansion of Medicaid, also says he will use such an expansion to justify his cut off of funds to Planned Parenthood.

Texas Tribune: Medical Groups Oppose Women's Health Program Rule
A proposed state rule that would prohibit doctors in Texas' Women's Health Program from discussing the option of abortion with their patients — even if the patient asks about it — has drawn the opposition of Texas medical groups. The groups take issue specifically with a clause that states the provider must not "promote elective abortions." The word "promote" as defined by the proposed rule includes counseling and referrals to abortion providers, as well as the display of any materials from abortion providers (O'Connor, 8/6).

The Dallas Morning News: Texas Medical Groups Protest Proposed Rules Prohibiting Abortion Counseling
Texas medical groups are revolting against a proposed state Health Department rule for the Women's Health Program that would prohibit abortion counseling, saying the state is attempting to impose a "gag order" on physicians. In a nine-page letter released Monday, the Texas Medical Association — in conjunction with associations representing gynecologists, obstetricians, pediatricians and family practitioners — said that the state's proposed rules are so onerous that many physicians, even though they may be morally opposed to abortion, may nevertheless refuse to participate in the Texas Women's Health Program (Hoppe, 8/6).

The Hill: Perry Caught In Medicaid Contradition
Texas Gov. Rick Perry is facing a big contradiction as he pursues two policies important to conservatives — defunding Planned Parenthood and rejecting President Obama's healthcare law. Perry has said he won't implement the healthcare law's Medicaid expansion. But his plan to cut off Planned Parenthood assumes that the Medicaid expansion will happen in Texas (Baker, 8/6).

And in Colorado -

Denver Post: Signatures Turned In For Colorado Anti-Abortion Measure
The Colorado Personhood Coalition Monday submitted more than 121,000 signatures to the secretary of state to get its anti-abortion measure on the November ballot. ... This would be the group's third try since 2008 to amend the state Constitution. Personhood USA founder Keith Mason said the ballot language this year is different. It would extend constitutional rights to all humans at any stage of development by stating that protections of life "apply equally to all innocent persons." It would "prohibit the intentional killing of any innocent person" (Draper, 8/6).

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Roundup: Ky. Judge To Hear Christians-Only Health Insurer Case

A selection of health policy stories from Kentucky, Rhode Island, Connecticut, California, Minnesota and Massachusetts.

The Associated Press: Ky. Judge To Review Christian Health Care Case
A judge has scheduled a hearing for later this month in a longstanding dispute between Kentucky and a Christians-only health care plan. The case pits the Kentucky Department of Insurance against Medi-Share, a Florida-based cost-sharing ministry that helps to pay medical bills for churchgoers across the country. Lawyers for the state have asked Franklin County Circuit Judge Thomas Wingate to hold Medi-Share in contempt of court for continuing to operate in Kentucky. Medi-Share asked for a hearing to explain changes the ministry has made to comply with Kentucky insurance regulations (8/6).

The Associated Press/Boston Globe: 4 R.I. Hospitals Cheer Increase In Medicare Money
Four Rhode Island hospitals on Monday celebrated news that the federal government will pay them more money to care for patients on Medicare. Kent Hospital, South County Hospital, Newport Hospital and Westerly Hospital will collectively receive about $7.1 million more for the 2013 fiscal year after the federal Centers for Medicare and Medicaid Services increased their Medicare reimbursement rates. Previously, different hospitals in the state had three different reimbursement rates, so hospitals in some cases just a few minutes' drive from each other were paid differently. Hospital officials say that created problems retaining the best workers (8/6).

HealthyCal: Got Docs?
A new county health plan for low-income residents, Riverside County Health Care, created in January 2012, was expected to ease the economic burden and address health disparities. So far, however, it’s falling short of expectations. The plan promises a full range of medical services: primary care, mental health services and access to specialists. The idea is that an up-front investment in comprehensive care will have a long-term payoff in fewer emergency room visits and hospital stays. Riverside County, as well as 46 other counties in California, are in the process of rolling out new health plans for the poor—essentially an expansion of Medicaid—in anticipation of the full implementation of the federal Affordable Care Act in 2014 (Urevich, 8/6).

Medscape: Mayo Clinic Settles False-Claim Charges For $1.26 Million
The Mayo Clinic in Rochester, Minnesota, last week agreed to pay $1.26 million to settle federal charges of knowingly billing Medicare, Medicaid, and other government health care programs for nonexistent pathology work. The Mayo Clinic says it inadvertently submitted the errant claims until September 2007, when it discovered and corrected its mistake. It reimbursed the government roughly $260,000 about a year later, after receiving a federal subpoena about its pathology billing practices. The payment was voluntary, according to the Mayo Clinic. The settlement reached last Thursday calls on the Mayo Clinic to pay the government an additional $1 million (Lowes, 8/6).

Boston Globe: State Nursing Shortage Worsened In 2011, Report Says
A nursing shortage appears to be on the rise in Massachusetts, according to the latest workforce report from the Massachusetts Hospital Association and the regional chapter of the Organization of Nurse Leaders (Conaboy, 8/6).

California Healthline: Appropriations Committee OKs Oral Chemo Bill
The Senate Committee on Appropriations yesterday approved AB 1000 by Henry Perea (D-Fresno), which requires insurers to cover oral chemotherapy medication. ... The oral chemotherapy bill, after being approved on a 4-1 vote in committee, now heads to the Senate floor for a vote. The biggest question about AB 1000 has not come directly from insurance companies, but from the state's Department of Finance, which has been concerned about the potential cost to California if oral chemotherapy is not included in the essential health benefits package, a concept that is a central underpinning of the health benefit exchange (Gorn, 8/7).

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Editorials and Opinions

Viewpoints: Medicaid Is Key To Health Law Success; OPM Weighs Changes To FEHB

Los Angeles Times: A Medicaid Opportunity
The Congressional Budget Office recently estimated that 30 million Americans still will be left without health insurance in 2022, after the U.S. Supreme Court ruling that largely upheld President Obama's healthcare plan. The part of the plan that was not upheld by the high court, however, contains the key to lowering that number (Tom Campbell, 8/7).

The Washington Post: OPM Seeks More Competition For Employee Health Plans
This could come from the "why mess with a good thing" department. The Obama administration is considering fundamental changes to the Federal Employees Health Benefits program (FEHB), which is generally regarded as something Uncle Sam does right. ... Specifically, the OPM paper ... expresses concern about the growing dominance and market concentration of Blue Cross Blue Shield and the departure or diminished role of other health plans (Joe Davidson, 8/6).

Lexington Herald-Leader/McClatchy Newspapers: Medicare For Everyone
Under proposed single-payer systems, private doctors and hospitals would provide health care services, but the government would pay the cost from tax revenue. It is the system used in Canada and most European countries, which the World Heath Organization says offers better care for less cost than the United States does. ... Senate Republican Leader Mitch McConnell of Kentucky complains that Obama's health care law is "Europeanizing" America, but he fails to mention that those European systems provide high-quality, universal care with much less administrative cost and hassle (Tom Eblen, 8/7).

Los Angeles Times: Will Humans Lose The Battle With Microbes?
Consider an all-too-common scenario: You're burning up from a high fever after a routine surgical procedure, and an infection specialist is called to help treat your problem. You assume that a short course of antibiotics will quickly turn things around. But the specialist candidly admits: "I'm sorry, I can't treat your infection. You've got a resistant bacteria, a super bug" (Daniel J. Stone, 8/6).

Houston Chronicle: A Small Price To Pay For Students' Health
The Texas Legislature must maintain its focus on protecting our students from meningitis. Let's restore funding for our low-income students needing the vaccine. Let's make sure our colleges and universities have the public and private support they need to efficiently and cheaply immunize their students (Patsy Schanbaum and Greg Williams, 8/6).

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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.