First Edition: April 22, 2013

Today's headlines include reports ranging from how state leaders are dealing with the consequences of rejecting the health law's Medicaid expansion to how pending immigration reform proposals could ease the nation's physician shortage.  

Kaiser Health News: Seniors Get Hung Up In Health Care Scams
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Law enforcement agencies are reporting an increase in these sorts of health insurance scams across the country. Many of the fraudsters seem to be preying on the public's confusion over the massive changes taking place in the nation’s health care system" (Gold, 4/22). Read the story.

The Associated Press/Washington Post: State Leaders Deal With Consequences Of Rejecting Medicaid Expansion In Obama Health Overhaul
Rejecting the Medicaid expansion in the federal health care law could have unexpected consequences for states where Republican lawmakers remain steadfastly opposed to what they scorn as "Obamacare." It could mean exposing businesses to Internal Revenue Service penalties and leaving low-income citizens unable to afford coverage even as legal immigrants get financial aid for their premiums. For the poorest people, it could virtually guarantee that they will remain uninsured and dependent on the emergency room at local hospitals that already face federal cutbacks (4/22).

Tampa Bay Times: Moderate House Republicans Key To Any State Health Care Deal
After weeks of posturing and debate, the decision to expand Medicaid in Florida or accept $51 billion in federal health care money might rest with a moderate bloc of a dozen or so House Republicans. And they're not saying a lot, at least publicly. While Senate Republicans appear willing to join Democrats in supporting a massive health care expansion, many House Republicans serving in moderate districts have yet to vocally embrace or reject federal assistance (Mitchell, 4/20).

The Missoulian: Vote That Killed Medicaid Bill Was A Mistake, Lawmaker Says
A contentious Medicaid proposal to fund private health insurance for thousands of low-income Montanans appears dead at the 2013 Legislature, after House Republicans Friday successfully bottled up the bill in committee. A move by Democrats to bring the measure to the floor failed by a single vote, with one Democrat later admitting he voted the wrong way. A later effort to undo the first vote failed by three votes (Dennison, 4/20).

Politico: Mental Health Advocacy Hits Reset
Mental health advocates hitched a ride on the gun control wagon. Now the wagon is stuck. After the Sandy Hook school killings, all sides of the gun control divide agreed that mass shootings — Tucson, Aurora and Newtown, among them — highlighted inadequacies in the U.S. mental health care system. Some opponents of any new gun restrictions framed the problem as primarily a mental health crisis. From their viewpoint, guns don’t kill, mentally ill people do (Kenen and Cunningham, 4/21).

The  New York Times: Cancer Centers Racing to Map Patients' Genes
Major academic medical centers in New York and around the country are spending and recruiting heavily in what has become an arms race within the war on cancer. The investments are based on the belief that the medical establishment is moving toward the routine sequencing of every patient's genome in the quest for "precision medicine," a course for prevention and treatment based on the special, even unique characteristics of the patient's genes (Hartocollis, 4/21).

The Associated Press/Washington Post: Apps And Online Tools Make Tough Life A Bit Easier For Alzheimer's, Autism Caregivers
From GPS devices and computer programs that help relatives track a wandering Alzheimer's patient to iPad apps that help an autistic child communicate, a growing number of tools for the smartphone, the tablet and the laptop are catering to beleaguered caregivers. With the baby boom generation getting older, the market for such technology is expected to increase (4/21).

Politico: Immigration Bill Could Import Foreign-Born Doctors
The immigration bill might have a partial solution to the doctor shortage in underserved areas: import them. Or more precisely, make it easier for foreign physicians who come to the U.S. for their medical residencies to stay on after their training — if they’ll then serve three years where they are most needed (Cunningham, 4/22).

The Wall Street Journal: Bill Bars Health-Care Cost Assistance For Immigrants
Immigrant advocates are upset with a health-care provision of the immigration-overhaul legislation that could force certain immigrants to pay a fee for lacking insurance coverage while excluding them from financial help to buy it. The wrinkle could create the first class of Americans who would face the 2010 Affordable Care Act's penalties without having access to its main benefit. If passed into law, the immigration changes would apply to many of the 11 million immigrants living in the U.S. illegally who would have "provisional" status for a decade before becoming eligible for green cards (Radnofsky, 4/19).

Los Angeles Times: Boston Bombing Amputees Face Tough, Costly Recovery
For many of the injured, even those who have health insurance, the process may also be costly. Health insurance plans often restrict coverage for therapy and prosthetics. But a decade of wars has helped fuel breakthroughs that could help many Boston victims — including those with amputated limbs — live full, active lives (Levey, 4/21).

The Texas Tribune/New York Times: Optometrists Seek Negotiating Power With Insurers
A group of Texas optometrists is lobbying the State Legislature for more power to negotiate contracts with health insurance companies, and the measure they are supporting could hit consumers' wallets, some business advocates say (Aaronson, 4/20).

The New York Times: California Tries To Regain Fuller Control Of Prisons
In 1995, a federal court appointed a special master to carry out reforms in mental health care [at California's prison system], which it found inadequate at the time and in violation of the Constitution. The court ruled this month that the federal overseer was necessary to remedy continuing constitutional violations behind problems like the high suicide rate. The state is arguing that mental health care meets or exceeds constitutional standards. It is spending $400 million a year on mental health care in its prisons, and a dozen new facilities valued at a total of $1.2 billion have been built in the past three years or are under construction. "Despite everything that’s been done, there's no limiting of the case," Mr. Beard said. "How do we ever end this? This has been going on for 20-some years" (Onishi, 4/20).

The Washington Post: Chartered Could Owe D.C. Health Providers $85 Million
The city's doctors, clinics and hospitals could be owed a combined $85 million from the soon-to-be-defunct D.C. Chartered Health Plan, and it remains unclear how the once-dominant city health contractor will be able to pay the vast majority of those claims. ... The $85 million figure, which is about double previous estimates of Chartered’s potential liabilities to providers, represents about $60 million in Medicaid claims that have been incurred but have yet to be paid. An additional $25 million could be owed to providers due to litigation — likely related to a pending battle between Chartered and the MedStar hospital chain (DeBonis, 4/19).

The Washington Post: Problems At Pa. Abortion Clinic Point To Lack Of Facilities Oversight
There was no shortage of red flags about what was allegedly going on in the three-story brick building on a bustling stretch of Lancaster Avenue in West Philadelphia. A routine inspection of Kermit Gosnell's abortion clinic had turned up problems as early as 1989, according to official reports. ... The case has captivated and repulsed a nation where back-alley abortion clinics have become a rarity since 1973, when the Supreme Court legalized abortion. The catalogue of horrors delineated by prosecutors has raised questions about whether there is adequate inspection and regulation of the 1,800 facilities nationwide that provide abortions (Dennis and Somashekhar, 4/20).

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