Ky. Health Plan Audit; Employee Costs In Massachusetts; State Reform Implementation Politics

Associated Press/BusinessWeek: "An organization that manages taxpayer-funded health services for Kentucky's poor and disabled spent freely on luxury hotels, meals, salaries, lobbying and consulting, a state auditor" found in a "200-plus-page report [which] calls for stricter accountability for Passport Health Plan, a Medicaid managed-care provider that serves 164,000 people in Louisville and more than a dozen nearby counties." In a statement, Passport "Chairman and CEO Larry Cook said the organization's board had reviewed the report and 'is taking actions, as appropriate, that are consistent with recommendations made by the auditor'" (Schreiner, 11/9).

Boston Globe: "Municipal officials hoping for increased control over employee health care costs will have to wait a little longer for a signal from the Patrick administration about plans to curb soaring premiums. Governor Deval Patrick's budget chief, Jay Gonzalez, speaking to an audience of municipal officials at a State House meeting yesterday, steered clear of addressing their specific demands, saying only that the governor is looking for ways to control health care costs across Massachusetts. … [Gonzalez added] that rising costs are 'unsustainable'’ for everybody in Massachusetts" (Cheney and Norton, 11/10).

Detroit News: In Michigan, "Vanguard Health Systems Inc. is working to ensure Medicare and Medicaid reimbursement procedures are in place before it takes ownership of the Detroit Medical Center. … As part of its purchase agreement, Vanguard must have applied for government certifications and Medicare provider numbers, and have confidence that they will be approved. … 'We're working to try to have no interruptions in the payment stream,' said Keith Pitts, Vanguard's vice chairman" (Burden, 11/10).

Denver Post: "Colorado regulators have done the math on health insurance premium hikes and are warning insurers and consumers that blaming steep increases on health care reforms is a convenient myth. While insurers and politicians said new benefits and consumer protections were helping drive premium hikes of 10 percent to 30 percent for 2011, the actual requests for such new items in mandatory rate filings often required no increase at all. … The real driver of big insurance hikes remains high inflation for hospital care, doctor fees, new medical devices and increased testing, regulators and consumer advocates said" (Booth, 11/10).

Atlanta Journal Constitution: "Georgia's newly elected leaders must decide how to implement a sweeping law that they strongly oppose. While state officials can't modify the law, Georgia's new governor, insurance commissioner and attorney general — who are all Republicans — will influence how the law works in Georgia. Democratic lawmakers worry that Republican opposition to the Patient Protection and Affordable Care Act will prevent the state from making the necessary plans to implement provisions they say many Georgians desperately need. Even experts who oppose the law say it's smart for Georgia's new leadership to plan for the law as passed. Otherwise, they say, they risk being forced to take what Washington devises instead of using the influence they have to shape what Georgia consumers end up with" (Teegardin, 11/9).

Palm Beach Post: "When the Florida Legislature convenes a special session on Tuesday, the House leadership has said their agenda will include a 'memorial' to the Senate: an endorsement of major changes to Medicaid, setting the stage for a battle of Republican ideas in 2011. Incoming House Speaker Dean Cannon said in a memo posted online Tuesday that the Medicaid program should require all enrollees to get their benefits via an HMO, or use their benefit to purchase coverage through some other private insurer. He would also protect physicians who take Medicaid from malpractice lawsuits" (Singer, 11/10).

WKYC-TV in Cleveland: "The U.S. Department of Health and Human Services (HHS) released a list of additional employers and unions accepted into the Affordable Care Act's Early Retiree Reinsurance Program, including 17 in Ohio. … Today's announcement brings the total number of organizations participating in the program to nearly 3,600 nationwide and 127 in Ohio" (11/9).

Los Angeles Times: "Overcrowding remains a persistent problem at Los Angeles County-USC Medical Center's emergency room even as conditions deemed dangerous have eased in the last two months, county officials said Tuesday. 'Dangerously' overcrowded conditions in the 600-bed hospital's emergency room decreased to an average of about five hours a day in October, down from a high of 16 hours a day in August, county health officials told supervisors Tuesday" (Hennessy-Fiske, 11/10).

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