State Highlights: Cash-Only Docs In Texas; Medicaid Funding In La.; Over-The-Counter Syringe Sales In Calif.

A selection of health policy stories from Texas, Louisiana, California, Maine, Pennsylvania, New Jersey, Vermont, Virginia, Georgia, Iowa and New York.

The Texas Tribune: Giving Up on Red Tape, Doctors Turn to Cash-Based Model
For 12 hours a day, the waiting room at Dr. Gustavo Villarreal’s family practice is often packed with patients, people who will pay a flat $50 fee for the convenience -- or necessity -- of a walk-in, quick-turn doctor’s visit. Villarreal’s practice, which does not accept any form of health insurance, has thrived despite its location in a city where nearly one-third of the population lives below the federal poverty line.  At both the state and federal level, efforts are underway to decrease Texas' sky-high rate of residents without health coverage. But Villarreal is among a rising number of primary care practitioners who have given up on the red tape of filing insurance claims, switching to a cash-based model that is growing in popularity among Texas’ insured and uninsured patients (Ura, 4/11). 

The Associated Press: Federal Medicaid Funding Could Be Delayed During Review Of LSU Hospital Deals
Federal officials have warned Gov. Bobby Jindal's administration that they will withhold $307 million in Medicaid money from the state if no agreement is soon reached on whether the state's financing plans for the privatized LSU hospitals meet federal guidelines. The U.S. Centers for Medicare and Medicaid Services, or CMS, notified Gov. Bobby Jindal's administration about the payment delay this week. The state Department of Health and Hospitals released the notice when questioned by The Associated Press (4/10).

Los Angeles Times: Assembly Backs Permanently Allowing Over-The-Counter Sale Of Syringes
The Assembly approved a measure Thursday that would permanently extend a provision allowing pharmacists to sell syringes without a prescription. Assemblyman Phil Ting (D-San Francisco), the bill's author, said expanding access to sterile needles is "the best way to stop the spread of some very deadly diseases." Public health experts say the use of shared needles among intravenous drug users contributes to the spread of HIV, hepatitis B and hepatitis C (Mason, 4/10).

The Associated Press: Maine Medicaid Rules Reduce Narcotic Prescriptions
Maine’s severe restrictions on opioid painkillers for Medicaid patients, requiring many to instead seek alternative pain management treatment for the past year, have sharply reduced the number of people obtaining highly addictive medications blamed for drug abuse and deaths around the nation (4/10).

The Texas Tribune:  Abortion Providers Petition 5th Circuit to Review Decision
Abortion providers filed a petition on Thursday asking the full 5th Circuit Court of Appeals to reconsider the constitutionality of new abortion regulations passed by the Republican-led Texas Legislature in July. The petition, filed on behalf of a coalition representing the majority of abortion providers in Texas, comes on the heels of a unanimous decision made by the court's three-judge panel in March to uphold two requirements recently implemented in the state. Those rules require physicians to obtain hospital admitting privileges within 30 miles of an abortion facility and to follow the U.S. Food and Drug Administration’s protocol for drug-induced abortions rather than a common, evidence-based protocol (Ura, 4/10).

The Associated Press: Nemours Foundation Sues United Health Care Entities
The foundation that owns the Alfred I. du Pont Hospital for Children in Delaware and various pediatric physician practices in the region is suing United Healthcare entities in three states for unpaid bills. Lawyers for the Nemours Foundation filed lawsuits in federal court in Delaware on Wednesday against United Healthcare of Pennsylvania, United Healthcare of the Mid-Atlantic, and United Healthcare Community Plan of New Jersey (4/10).

The Associated Press: Judge: California Mistreating Mentally Ill Inmates
A federal judge ruled Thursday that California’s treatment of mentally ill inmates violates constitutional safeguards against cruel and unusual punishment through excessive use of pepper spray and isolation. U.S. District Court Judge Lawrence Karlton in Sacramento gave the corrections department time to issue updated policies on the use of both methods but did not ban them (4/10).

Kaiser Health News: L.A. County Nursing Home Inspections Chief Reassigned
The Los Angeles County Department of Public Health supervisor in charge of nursing home inspections has been moved to another job days after the release of a highly critical audit of his division. Ernest Poolean, who has been a county employee since 1968 and became the head of the Health Facilities Inspection Division in 2011, has been reassigned to the Baldwin Park headquarters, according to a memo sent to the staff Thursday (Gorman, 4/10).

The Associated Press: Vt. Senate Advances Lyme Disease Bill
Doctors and other health professionals would be immune from professional conduct charges if they pursued a hotly debated course of treatment for Lyme disease under a bill given preliminary approval Thursday by the Vermont Senate. The Senate’s 27-0 vote in support came after an impassioned speech by Sen. David Zuckerman, a Chittenden County Progressive who said his wife, Rachel Nevitt, had suffered from the tick-borne illness for about a dozen years and had also struggled to get medical professionals to recognize and diagnose the disease (Gram, 4/11).

The Richmond Times-Dispatch: Psychiatric Admissions Spike After Deeds Tragedy
State mental hospitals and private psychiatric facilities have experienced a surge in emergency admissions since Jan. 1 in the aftermath of the attack last fall on Sen. R. Creigh Deeds, D-Bath, by his son, who then killed himself. Austin C. “Gus” Deeds, 24, had been released from an expired emergency custody order just 13 hours before he stabbed his father and shot himself at their Millboro home on Nov. 19. At Western State Hospital in Staunton, the closest state institution to Bath County, 23 people have been admitted under temporary detention orders since Jan. 1, compared with six in the previous six months (Martz, 4/11).

Georgia Health News: Report: Developmentally Disabled Need Better Care
An independent reviewer reports that Georgia is failing to provide adequate supervision of individuals with developmental disabilities who are moved from state hospitals to community group homes. The reviewer, in a report dated March 23, says there is an “urgent need to ensure competent and sufficient health practitioner oversight of individuals who are medically fragile and require assistance with most aspects of their daily lives.” The reviewer, Elizabeth Jones, notes in the report that two individuals with developmental disabilities died shortly after being moved from Southwestern State Hospital in Thomasville, which recently closed, to community settings (Miller, 4/10). 

The California Health Report: Nurses Becoming A Rarity In California Public Schools
Each school day, about a fifth of the children in California schools attend class without a nurse in the building. If they get sick during the day, the schools call parents, or in an emergency, 911. ... Researchers conducting a large-scale study from the California State University-Sacramento School of Nursing have released preliminary findings showing that 57 percent of California public school districts have no school nurses whatsoever (Jones, 4/11).

The Des Moines Register:  House Approves Health, Welfare Funding
Iowa House lawmakers on Thursday set aside controversial proposals restricting abortion to approve $1.86 billion in spending on health and welfare programs for the coming year. The chamber passed House File 2463 on a 51-47 vote, funding the state's Medicaid health care program for the poor among many other state agencies and services. (Noble, 4/11).

Modern Healthcare: N.Y. Incubator Startup Health Adds 16 Companies
The New York-based incubator StartUp Health admitted 16 new companies to its current class, the company announced this week. The incubator runs a three-year program that helps healthcare startups develop their products and raise venture capital. The program saw about 350 applicants for the current round, said Unity Stoakes, Startup Health's founder (Ivanova, 4/10).

This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from major news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.