Mass. Court Orders State's Two Largest Health Insurers To Submit Insurance Rates; N.C. Governor Restores Funding For Some Mental Health Programs

The Boston Globe: "A Suffolk Superior Court judge yesterday ordered two of the state's largest health insurers to submit April 2009 rates for insurance covering individuals and small businesses, the latest development in an ongoing dispute between the state and carriers over premium increases. Both companies said they would comply, even as they proceed with administrative appeals in an effort to charge higher rates. Judge Stephen E. Neel said Harvard Pilgrim Health Care of Wellesley and Fallon Community Health Plan of Worcester must follow orders from the state's Division of Insurance to submit premium increases formulated using last April's base rates, instead of the higher figures the companies were seeking to use" (Lazar, 4/22).

The Associated Press/Boston Herald: "Attorney General Martha Coakley is getting more involved in the Patrick administration's dispute over small business health insurance premiums. Her office is now representing the rights of consumers in the Division of Insurance's administrative hearings about the rate hike proposals" (4/21).

Winston-Salem (N.C.) Journal: "Even as the state braces for another tight budget year, Gov. Bev Perdue and legislators appear ready to stitch up one area of recent cuts deemed too deep and painful. In the governor's proposed $19.1 billion budget, released Tuesday, she is recommending restoring $40 million for community mental-health programs that was eliminated last year. The proposal also includes $12 million for the state to buy more local private-hospital beds for mental-health patients who require short-term care. ... The N.C. Department of Health and Human Services had proposed that transfer of expenses as part of its budget cuts. Eliminating the $40 million last year drew widespread criticism from behavioral-health officials and advocates" (Craver, 4/22).

The (Baton Rouge, La.) Advocate: "Lawmakers got their first opportunity Wednesday to publicly question the Jindal administration about the governor's plan to close a $319 million budget gap and promptly started reworking it. The move puts the state Senate and Gov. Bobby Jindal at odds over whether to use $172 million from the state's 'rainy day' fund, which was set up to tide the state over during revenue downturns. ... Jindal wants to use health department savings, a drug settlement and the proceeds of earlier cutbacks to balance the budget for the fiscal year that ends June 30. An unexpected drop in revenues caused the budget juggling" (Millhollon, 4/22).

The Washington Post: "The Virginia General Assembly on Wednesday accepted proposals from Gov. Robert F. McDonnell to restrict state funding for abortions. ... On a 20 to 19 vote, the Democratic-led Senate agreed to an amendment proposed by McDonnell (R) that would limit state funding for abortions to those performed in cases of rape or incest or when the life of the mother is at risk. Nothing in state law previously prohibited Medicaid-funded abortions in instances when the health of the mother was in jeopardy. … McDonnell argued that his proposal would bring Virginia into line with federal law on the issue" (Helderman and Kumar, 4/22).

The Times-Picayune: "Health Secretary Alan Levine said last week that he was open to limited amendments to a bill that would block all Louisiana insurers from selling policies that cover 'elective' abortions. But no such changes are likely Thursday when the House of Representatives takes up House Bill 1247." The definition of the term "elective" has been an issue. "The bill calls 'elective' any abortion that is not necessary to 'preserve the life of the mother when her life is endangered by' physical illness or injury. Doctors and women's health advocates noted that such a definition excludes termination of a pregnancy that physicians have determined to be non-viable. Levine said at the time that it is a valid point to consider a pregnant woman's overall health, including mental health, in such a state" (Barrow, 4/21).

Columbia Missourian: "A bill that would allow private citizens to take legal action on cases of Medicaid fraud stalled in the Senate on Monday. Under current statute, only the attorney general is authorized to take up Medicaid fraud cases. But the bill's sponsor, Sen. Eric Schmitt, R-St. Louis County, said the system left many important cases ignored. … However, legislators opposed to the action said the bill was not necessary without a request from the attorney general for additional resources in fighting Medicaid fraud" (Berg, 4/21). 

Health News Florida: "Florida House and Senate negotiators appear ready to slash Medicaid funding for nursing homes and are considering cuts to numerous other health programs to balance the budget. Lawmakers said they are particularly concerned about a proposed 7 percent cut --- totaling about $200 million --- in Medicaid payment rates for nursing homes. … Nursing homes likely would be able to offset at least part of the $200 million in cuts during the 2010-11 fiscal year, which starts July 1. Among other things, they expect to receive additional money because of an increase in a nursing-home tax that draws down more federal matching money. But industry officials worry that a 7 percent rate cut would carry through to future years and create deeper financial holes" ( Saunders, 4/22).

Kansas Health Institute reports on how some disabled children have found themselves caught in "a policy dispute between the Kansas Health Policy Authority and the four companies that make [wheel] chairs. … In Kansas, families looking for help in figuring out how to design a wheelchair that best meets their child's disabilities are referred to one of four locations ... [and] their recommendations are subject to prior authorization, a process designed to make sure the wheelchair is necessary and will meet the child's needs. After a wheelchair is authorized, Medicaid contracts with one of four for-profit companies to build the chair. Since January, these contracts have stalled. The four companies have stopped building wheelchairs for children on Medicaid" (Ranney, 4/21).

Bloomberg BusinessWeek: "A program providing health care to thousands of children would be saved from elimination and 310,000 low-income people would remain eligible for Medicaid coverage for at least six more months under new legislation endorsed Wednesday by an Arizona House committee. ... The bill conditionally appropriates nearly $400 million to prevent the June 15 repeal of the KidsCare health care program for children and to reverse the planned Dec. 31 cut of roughly a quarter of the enrollment in Arizona's Medicaid program, the Arizona Health Cost Containment System." State officials have recently concluded "that Arizona needs to undo both cuts to remain eligible for its entire Medicaid funding under terms of the federal health care overhaul" (Davenport, 4/21).

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