Health Care Reform News

Insurance commissioners propose ideas to minimize 'rate shock'
Modern Healthcare
April 5, 2013
http://www.modernhealthcare.com/article/20130405/NEWS/304059957/insurance-commissioners-propose-ideas-to-minimize-rate-shock
A group of insurance commissioners is sharing ways states can minimize the likelihood of large premium increases, particularly for young adults, as major provisions of the Patient Protection and Affordable Care Act go into effect in 2014. Several provisions of the law affecting the individual and small-group markets—such as essential health benefits, limits on age-rating factors, guaranteed issue and single risk-pool ratings—could make claims costs spike for insurers, leading to premium hikes, according to draft paper titled “Rate Increase Mitigation Strategies” (PDF) presented today at the National Association of Insurance Commissioner's annual spring meeting in Houston.
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6 Characteristics of Those Gaining Medicaid Coverage by 2021
Becker’s Hospital Review
April 5, 2013
http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/6-characteristics-of-those-gaining-medicaid-coverage-by-2021.html
Medicaid is expected to absorb more than 11 million new enrollees over the next decade under the Patient Protection and Affordable Care Act, according to a report called "Medicaid Expansion: New Patients, New Challenges," by PwC's Health Research Institute. For the report, researchers analyzed government data and projections by the Congressional Budget Office to develop a detailed portrait of the new Medicaid population.
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Patient Experience Roundtable: Raising and Maintaining Patient Satisfaction
Becker’s Clinical Quality & Infection Control
April 5, 2013
http://www.beckershospitalreview.com/quality/patient-experience-roundtable-raising-and-maintaining-patient-satisfaction.html
One of the driving forces behind the changes taking place in the healthcare industry is the increasing importance of patient experience. The Patient Protection and Affordable Care Act and other changes in healthcare have led patients to take a more consumerist approach to deciding where to receive care. It is thus essential for hospitals and health systems to ensure that patient satisfaction at their organizations remain high. Here, leaders and patient experience coordinators from various organizations with high scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey offer advice on how to improve patient experience and maintain high patient satisfaction.
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Barking up the wrong tree on Medical Loss Ratio reform
Healthcare Finance News
April 5, 2013
http://www.healthcarefinancenews.com/blog/barking-wrong-tree-medical-loss-ratio-reform
The Affordable Care Act (aka ObamaCare) requires health plans to spend at least 80 or 85 percent of premiums on medical expenses and quality improvement - 80 percent for small groups and individuals and 85 percent for large groups. This minimum Medical Loss Ratio (MLR) rule means that health plans must squeeze all their administrative costs and profits into the remaining 15 or 20 percent. Health plans are making adjustments. Not surprisingly they are looking at ways to cut administrative costs, just as the law intends. One easy target is commissions for agents and brokers, and those commissions are in fact being cut.
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Curb Health Care Costs
The Huffington Post
April 5, 2013
http://www.huffingtonpost.com/a-barry-rand/health-care-costs-curb_b_3001164.html
Medical costs are threatening both the middle class and future retirees. One of the biggest challenges we face as a nation is the rising costs of health care. It is driving people out of the middle class and driving up the costs of Medicare and Medicaid, as well as on the budgets of state governments and employers. Looking ahead, steadily rising out-of-pocket medical and health care costs will overwhelm the retirement savings that many Americans have tried to accumulate. Clearly, the standard of living for future retirees is threatened. All because of rising health care costs.
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High Court’s Health-Law Decision
The Wall Street Journal
April 4, 2013
http://stream.wsj.com/story/supreme-court-health-law-decision/SS-2-24938/SS-2-204350/
The hospital industry should get a boost once the health-care overhaul takes full effect next year, but a lot will depend on various factors affecting how the nation’s caretakers get paid. That’s the finding from Fitch Ratings, which said in a report issued Thursday that the industry’s future will rely on payment structures and contracts in the state health exchanges, as well as the expansion of Medicaid programs.
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CMS Proposes Help For Consumers Navigating The Health Insurance Marketplace
The Paramus Post
April 4, 2013
http://www.paramuspost.com/article.php/20130404105649791
The Centers for Medicare & Medicaid Services (CMS) released a proposed rule today outlining standards that Navigators in Federally-facilitated and State Partnership Marketplaces must meet, and clarifying earlier guidance about the Navigator program. Navigators are organizations that will provide unbiased information to consumers about health insurance, the new Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program. “Navigators will be an important resource for consumers who want to learn about and apply for coverage in the new Marketplace,” said CMS Acting Administrator Marilyn Tavenner.
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CMS Releases Update to Meaningful Use Quality Measures for Hospitals
iHealthBeat
April 4, 2013
http://www.ihealthbeat.org/articles/2013/4/4/cms-releases-update-to-meaningful-use-quality-measures-for-hospitals.aspx
On Tuesday, CMS published an update to the 2014 clinical quality measures for hospitals participating in the meaningful use program. Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments. To participate in the meaningful use incentive program for 2014, hospitals initially were required to use EHR systems that met the clinical quality measure specifications included in a December 2012 interim final rule
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Obama's budget to spare Medicaid from deep cuts
Boston Herald
April 4, 2013
http://bostonherald.com/business/healthcare/2013/04/obamas_budget_to_spare_medicaid_from_deep_cuts
President Barack Obama's budget next week will steer clear of major cuts to Medicaid, including tens of billions in reductions to the health care plan for the poor that the administration had proposed only last year. Big cuts in the federal-state program wouldn't go over too well at a time that Health and Human Services Secretary Kathleen Sebelius is wooing financially skittish Republican governors to expand Medicaid coverage to millions who now are uninsured. That expansion in the states is critical to the success of Obama's health overhaul, which is rolling out this fall and early next year.
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Survey: Small businesses most concerned about healthcare law
The Hill
April 4, 2013
http://thehill.com/blogs/on-the-money/economy/291873-survey-small-businesses-most-concerned-about-healthcare-law
A majority of small businesses say the healthcare law is their biggest concern, finally eclipsing their long-held worry over economic uncertainty. The U.S. Chamber of Commerce’s latest quarterly small-business survey finds that 77 percent say the Affordable Care Act will make coverage for their employees more expensive, while 71 percent say it will be harder to hire more employees under the law.
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Grassley demands info on Advantage rate leak
Modern Healthcare
April 4, 2013
http://www.modernhealthcare.com/article/20130404/NEWS/304049949/grassley-demands-info-on-advantage-rate-leak
A senior Senate Republican is demanding a complete timeline and details on communications between the CMS and a financial consulting firm after the firm told clients the agency will be turning a planned cut in Medicare Advantage payments into a small increase. An analyst at Height Securities e-mailed his report shortly before markets closed on Monday, which sent the stock of insurance companies that sell Medicare Advantage plans soaring. “This raises questions regarding political intelligence brokers' ability to gather information from CMS in order to predict market-moving events,” Sen. Chuck Grassley (R-Iowa) wrote in a letter (PDF) to Marilyn Tavenner, acting administrator of CMS whose confirmation hearing will take place April 9.
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CMS clarifies physician delegation of tasks in skilled nursing facilities
McKnight’s Long-Term Care News & Assisted Living
April 4, 2013
http://www.mcknights.com/cms-clarifies-physician-delegation-of-tasks-in-skilled-nursing-facilities/article/287386/#
Nursing home operators can now download a brief clarifying which tasks physicians may delegate to other practitioners caring for Medicare beneficiaries in skilled nursing facilities, the Centers for Medicare & Medicaid Services announced in a document released Wednesday. The focal point is certain tasks that a doctor can delegate to a non-physician practitioner (NPP), such as a nurse practitioner, physician assistant or clinical nurse specialist.
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CMS reverses course on cuts
Politico
April 3, 2013
http://www.politico.com/story/2013/04/insurance-medicare-advantage-cuts-health-care-89569.html
The insurance industry chalked up one of its greatest political victories in recent memory on Monday as the Obama administration reversed course on a proposal to cut Medicare Advantage rates. After intense lobbying, the agency said Monday that it would change the proposed 2.3 percent cut to those plans to a 3.3 percent boost. That’s a significant swing worth billions of dollars to the industry next year alone.
“It’s a major victory for health plans,” said Dean Rosen, a partner at Mehlman Vogel Castagnetti. But the decision — and reasoning – are going to have broader implications.
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HHS Delays Requirement for Small Business Exchanges
Becker’s Hospital Review
April 3, 2013
http://www.beckershospitalreview.com/news-analysis/hhs-delays-requirement-for-small-business-exchanges.html
Although small businesses were supposed to be able to select from multiple health plans offered on the health insurance exchanges beginning next year to comply with the employer coverage mandate of the health reform law, HHS announced it would allow employers to choose from just one option until 2015. HHS will run 33 states' exchanges next year and is operating on a constricted timetable to roll out the online marketplaces that are a hallmark of the Patient Protection and Affordable Care Act. The agency granted a one-year extension to small businesses and exchanges in all states to meet the requirement to offer multiple plans on the small business health options program, commonly dubbed SHOP.
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Va. Amendment Barring Health Care Exchange Plans From Covering Abortions Approved
NBC
April 3, 2013
http://www.nbcwashington.com/blogs/first-read-dmv/Virginia-General-Assembly-Approves-McDonnell-Amendment-Barring-Federal-Exchange-Health--201354651.html
Virginia Gov. Bob McDonnell's controversial amendment to bar health insurance plans sold through a federal exchange from covering most abortions won approval from both the House and Senate in the General Assembly's one-day, reconvened session. Senate Democrats had hoped to block the measure and thought they had the votes to do it in the evenly divided chamber but fell one vote short when two Democrats broke ranks.
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Chamber: S.C. should take Medicaid money
The Times and Democrat
April 3, 2013
http://thetandd.com/news/local/chamber-s-c-should-take-medicaid-money/article_6843f19e-9c16-11e2-94be-001a4bcf887a.html?comment_form=true
The Orangeburg County Chamber of Commerce says South Carolina should expand its Medicaid program. “Our chamber supports Medicaid expansion as it will improve the quality of life through providing health care and increased employment opportunities available in Orangeburg County,” board Chairman Drexel Ball said in a prepared statement.
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John Kasich’s Billion-Dollar Medicaid Expansion Bluff
RedState
April 3, 2013
http://www.redstate.com/jasonahart/2013/04/03/john-kasichs-billion-dollar-medicaid-expansion-bluff/
Governor John Kasich has wagered he can pressure the Republican-controlled Ohio General Assembly into expanding Medicaid by telling legislators they cannot stop billions in federal Patient Protection and Affordable Care Act (PPACA) spending. With the complicity of Ohio’s media, he may be right. The governor, a Republican with a reputation for fiscal conservatism, insists Medicaid expansion would keep “Ohio’s tax dollars” in the state instead of letting them be spent elsewhere. It’s a simple argument – federal spending will be the same regardless, so only a fool would oppose keeping some of it in Ohio – that also happens to be completely false.
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Gov. Tom Corbett describes federal meeting on health care, Medicaid as cordial
The Patriot News
April 3, 2013
http://www.pennlive.com/midstate/index.ssf/2013/04/corbett_sebelius_medicaid_1.html
Gov. Tom Corbett described Tuesday's meeting with U.S. Department of Health and Human Services Kathleen Sebelius as "meaningful." But it remains unknown whether Pennsylvania residents with lower incomes will benefit from the Medicaid expansion contained in the Affordable Care Act.
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Obamacare `Repeal and Replace' Still Light on `Replace'
Bloomberg
April 3, 2013
http://www.bloomberg.com/news/2013-04-03/obamacare-repeal-and-replace-still-light-on-replace-.html
Yuval Levin and Bloomberg View columnist Ramesh Ponnuru argue in the cover story of the current National Review that “repeal and replace” should remain the conservative mantra on the Patient Protection and Affordable Care Act. The law is so unworkable, they say, that it can’t be molded into something workable; conservatives must focus on outright replacement. This puts Levin and Ponnuru in opposition with conservative think-tankers such as Tevi Troy and Paul Howard, who are now arguing for a political strategy of reforming the law. When someone tells you a health-care policy is terrible, the most important question is “compared with what"? And so it’s disappointing that Levin and Ponnuru devoted just three paragraphs of their 3,100-word piece to discussing how a replacement for the Affordable Care Act might look. They provide too little detail to convince the reader that their plan for “replace” would be less horrible than the parade of horribles they spend much of the piece arguing are reasons for repeal.
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Medicaid expansion bill sent to full Senate for vote
Grand Forks Herald
April 3, 2013
http://www.grandforksherald.com/event/article/id/260473/group/homepage/
Lawmakers on two Senate committees recommended passing the proposed Medicaid expansion program that would provide insurance coverage to an estimated 20,000 North Dakotans who are currently living without. The final recommendation by the Senate Appropriations Committee on Wednesday sends House Bill 1362 to the full Senate for a final vote. If approved, the measure will be sent to Gov. Jack Dalrymple for his signature.
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Oregon exchange to let 22 carriers seek slots
LifeHealthPro
April 3, 2013
http://www.lifehealthpro.com/2013/04/03/oregon-exchange-to-let-22-carriers-seek-slots
Managers of the Patient Protection and Affordable Care Act (PPACA) exchange program in Oregon have given 22 carriers permission to put products on its shelves. Cover Oregon has invited 10 carriers to offer medical plans, or "qualified health plans" (QHPs); seven to offer stand-alone dental plans; and five to offer both medical and dental plans.
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Committee hears arguments over Medicaid expansion
The Bismarck Tribune
April 3, 2013
http://bismarcktribune.com/news/local/govt-and-politics/committee-hears-arguments-over-medicaid-expansion/article_77f87356-9c8b-11e2-af56-0019bb2963f4.html
The Senate Appropriations Committee spent more than an hour Wednesday discussing a bill that would allow for accepting funding for expanding Medicaid under the federal health care law. House Bill 1362 would authorize the expansion of Medicaid coverage in North Dakota under the federal Patient Protection and Affordable Care Act. The bill also asks for an interim study on the impacts of the ACA and to study potential alternatives for health care coverage. Maggie Anderson, interim executive director of the North Dakota Department of Human Services, gave the committee an update on the potential impacts of HB1362.
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Grand strategy on health care
The Philadelphia Inquirer
April 3, 2013
http://articles.philly.com/2013-04-03/news/38251634_1_obamacare-insurance-exchanges-committee-chairman-paul-ryan
When the Supreme Court upheld the Affordable Care Act and President Obama won reelection last year, the die was cast: "Obamacare" became the law of the land. While Republican players want to re-litigate the issue, the new federal guarantee of health-care insurance for every American family is here to stay. Until Republicans embrace this reality - and persuade the voters that they can deliver universal coverage on far better terms - the Party of Lincoln will never sustain a comeback. In implementing insurance exchanges and expanding Medicaid, many Republican governors have come to terms with the new normal. Yet GOP members of Congress, pushed by conservative think tanks, continue to mount a rearguard action against Obamacare while advancing the notion that nothing is broken in the health-care system that free-market reforms cannot fix.
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The Michigan Healthcare Exchange ain't Travelocity
The Detroit News
April 3, 2013
http://blogs.detroitnews.com/politics/2013/04/03/the-michigan-healthcare-exchange-aint-travelocity/
Echoing Governor Snyder, a Michigan Blue Cross spokesman told WJR-Radio Tuesday that the State Health Care Exchange proposed by Governor Snyder to satisfy Obamacare is a marketplace “just like Orbitz or Travelocity.” No, it’s not. A public school is not a private school. The Post Office is not FedEx. Obamacare exchanges are not Travelocity. The Orbitz and Travelocity companies are private travel booking sites offering deals free of government interference. By contrast, the Obamacare Exchanges – whether set up by states or the feds – will be regulated by Washington from services provided right down to expensive subsidies to attract customers.
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Government reverses plan to cut Medicare Advantage rate
CNN
April 2, 2013
http://www.cnn.com/2013/04/01/health/medicare-advantage-rates/
The federal government has reversed a proposed cut that could have left millions who get their health insurance through the Medicare Advantage plan paying more for coverage. The Centers for Medicare and Medicaid Services (CMS) announced Monday the final Medicare Advantage rates for 2014.
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Hobby Lobby Case Against Obamacare Mandate Moves to 10th Circuit Court of Appeals
Christian Post
April 2, 2013
http://www.christianpost.com/news/hobby-lobby-case-against-obamacare-mandate-moves-to-10th-circuit-court-of-appeals-93108/
The 10th Circuit of the U.S. Court of Appeals is granting Hobby Lobby a full court hearing challenging the Obamacare regulation that requires religious employers to cover Plan B and Ella One emergency contraceptives that can cause an early abortion.
Kyle Duncan, general counsel for The Becket Fund for Religious Liberty who's representing Hobby Lobby in its case Hobby Lobby v. Sebelius, told The Christian Post on Tuesday that the 10th Circuit's decision is significant, because "very rarely does the court grant a full court hearing."
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State reform update: Pa. governor latest to seek Medicaid changes
Modern Healthcare
April 2, 2013
http://www.modernhealthcare.com/article/20130402/NEWS/304029966/state-reform-update-pa-governor-latest-to-seek-medicaid-changes
Governors continue to make pilgrimages to HHS as states keep trying to craft custom versions of the healthcare reform law's Medicaid expansion and avoid leaving new federal funding on the table. Pennsylvania Gov. Tom Corbett planned to meet with HHS Secretary Kathleen Sebelius Tuesday evening to explore his state's options, according to spokeswoman for the governor.
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Republicans labeled as 'anti-health care'
Des Moines Register
April 2, 2013
http://www.desmoinesregister.com/article/20130403/NEWS10/304030041/-1/MARKETPLACE/Republicans-labeled-anti-health-care-?nclick_check=1
Iowa Senate Democrats blasted Gov. Terry Branstad and Republican lawmakers in pointed remarks on the Senate floor Tuesday, labeling the state GOP as the “anti-health care party.” The frustration over the Republicans’ rejection of an expansion to the state’s Medicaid program appeared to be reaching the boiling point . Sen. Joe Bolkcom, D-Iowa City, underscored his party’s concern by saying he’s been hearing speculation that the 2013 session will adjourn without resolving the issue of providing health care insurance for low-income Iowans.
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Ted Cruz says health care would be bad for people who don't have it
Daily Kos
April 2, 2013
http://www.dailykos.com/story/2013/04/02/1198650/-Ted-Cruz-says-health-care-would-be-bad-for-people-who-don-t-have-it
Sen. Ted Cruz isn't going to let all the stupid in Texas belong to Gov. Rick Perry. At Monday's press conference, Perry, Cruz and Sen. John Cornyn joined forces to inform uninsured Texans that they're just going to have to stay uninsured because it was all just a shifty Obama trick and because freedom. Cruz took it up a notch, though, telling those uninsured that being insured would be bad for them.
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CMS releases State 2 Meaningful Use CQM update for hospitals
EHR Intelligence
April 2, 2013
http://ehrintelligence.com/2013/04/02/cms-releases-stage-2-meaningful-use-cqm-update-for-hospitals/
The Office of the National Coordinator for Health Information Technology (ONC) has announced the availability of an update from the Centers for Medicare & Medicaid Services (CMS) for eligible hospitals concerning clinical quality measures (CQMs) in Stage 2 Meaningful Use. Here’s the ONC announcement:
In the final rule for Stage 2 of Meaningful Use (MU), CMS outlined the timeline for reviewing and publishing updates to the Clinical Quality Measure (CQM) specifications used in the EHR Incentive Program. CMS determined that the specifications should be updated more frequently than the rulemaking cycle for the Medicare and Medicaid EHR Incentive Programs in order to ensure that specifications maintain alignment with current clinical guidelines and ensure that the CQM remains relevant and actionable within the clinical care setting.
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CMS softens Medicare Advantage funding changes
AP
April 2, 2013
http://www.google.com/hostednews/ap/article/ALeqM5j3r3OGSkOi9NaBJ8ZW4qiIFpjhGw?docId=ccbdac058e294afaaae8709d7e368185
Medicare Advantage customers may not see the drastic benefit cuts or premium hikes next year that insurers have been warning about after all. Health insurers had predicted big, painful changes for many of their Medicare Advantage customers after the federal government said in February that the amount it pays per person for the popular coverage could fall more than 2 percent in 2014.
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CMS To Rescind MA Plan Payment Cut; Will Boost Payments Instead
California Healthline
April 2, 2013
http://www.californiahealthline.org/articles/2013/4/2/cms-to-rescind-ma-plan-payment-cut-will-boost-payments-instead.aspx
On Monday, the Obama administration announced that it is rescinding a proposed 2.2% cut in federal payments to Medicare Advantage plans and instead will revise its reimbursement calculation method to increase payments by 3.3%, the Washington Post reports . In February, CMS proposed several rules, including the 2.2% payment cut to MA plans in 2014. Lawmakers and health care stakeholders immediately criticized the proposal. Officials from America's Health Insurance Plans said the cut would have reduced payments by about $11 billion, while insurers suggested that MA plans would have to make $50 to $90 worth of benefit cuts or premium hikes to offset the difference in payments.
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CMS backs off Medicare Advantage cuts that were to help pay for Obamacare
The Examiner
April 2, 2013
http://washingtonexaminer.com/cms-backs-off-medicare-advantage-cuts-that-were-to-help-pay-for-obamacare/article/2526051
At least on paper, President Obama’s health care law is shown by the Congressional Budget Office to reduce deficits slightly, because its roughly $1.7 trillion in new spending is more than offset by accompanying tax increases and cuts to the projected growth of Medicare. One of the major uncertainties surrounding Obamacare has been whether those Medicare cuts for which Democrats are counting on to help pay for the new expansion of insurance coverage will actually go into effect. If the cuts do not get implemented, instead of reducing the deficit, the health care law would actually add $6.2 trillion to the nation’s long-term deficits, according to a recent analysis by the Government Accountability Office.
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Federal government slashes New York's Medicaid payments
Chicago Tribune
April 1, 2013
http://www.chicagotribune.com/news/sns-rt-us-usa-nys-budget-medicaidbre9300fk-20130401,0,6528173.story
Federal authorities have dramatically lowered the amount that New York state can claim from the federal government for certain medical services, costing the state an estimated $1.2 billion. The Center for Medicaid Services (CMS), the federal agency that administers the nation's medical insurance system for people on low incomes, cut the per-patient reimbursement rate for patients in developmental centers to $1,200 from $5,100 from April 1, according to CMS documents seen by Reuters.
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Medicaid budget bill blocked
Northeast Mississippi News
April 1, 2013
http://djournal.com/bookmark/22121997-Medicaid-budget-bill-blocked
House Democrats, trying every option available to force a vote by the full chamber on expanding Medicaid, blocked from passage Sunday the bill that would fund the state-federal health care agency. The Republican majority is expected to try again today to garner the votes needed to pass the Medicaid appropriations bill that includes $840 million in state funds.
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Nebraska: Non-exchange states have choices to make
LifeHealthPro
April 1, 2013
http://www.lifehealthpro.com/2013/04/01/nebraska-non-exchange-states-have-choices-to-make
State governments that decide not to set up their own Patient Protection and Affordable Care Act (PPACA) exchanges have to decide just how much they want to cooperate, or not cooperative, with the "federally facilitated exchanges" (FFEs). Martin Swanson and John Paul Sabby, policy specialists with the Nebraska Department of Insurance, talk about some of the choices facing non- "HIX" states in a presentation posted on the department website.
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Vermont posts exchange plan proposals
LifeHealthPro
April 1, 2013
http://www.lifehealthpro.com/2013/04/01/vermont-posts-exchange-plan-proposals
Vermont carriers might charge about as much for individual coverage in 2014 as they charge for comparable coverage today, but residents could have a harder time using high deductibles to hold down premiums. That conclusion comes from a comparison of preliminary Vermont Health Connect exchange 2014 rates with actual 2013 plan premium data.
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Dem says Gov. Perry's rejection of Medicaid expansion will hurt him in 2016
The Hill
April 1, 2013
http://thehill.com/blogs/floor-action/house/291151-dem-says-gov-perrys-rejection-of-medicaid-expansion-will-hurt-him-in-2016
Freshman Rep. Joaquin Castro (D-Texas) warned Texas Gov. Rick Perry (R) on Sunday that his refusal to expand Medicaid to low-income people in Texas will hurt his presidential chances in 2016. "Governor, being tough on people with no health insurance won't win you the Republican presidential primary in 2016," Castro wrote in a Dallas Morning News op-ed. "It definitely won't win you the presidency."
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What companies need to do to prepare for health care reform
Smart Business
April 1, 2013
http://www.sbnonline.com/2013/04/what-companies-need-to-do-to-prepare-for-health-care-reform/?full=1
The Patient Protection and Affordable Care Act (PPACA) mandate for employers to provide employees health care or pay a penalty takes effect Jan. 1, 2014, and many businesses aren’t sure how to prepare. “We regularly talk with people in various industries about what is important to them. For the past six months, every person from every industry has mentioned the employer mandate. There’s a lot of uncertainty,” says Joseph R. Popp, JD, LLM, tax supervisor at Rea & Associates.
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GOP-led states comparing notes on details of plans for Medicaid
Cincinnati.com
April 1, 2013
http://news.cincinnati.com/article/20130401/NEWS/304010098/GOP-led-states-comparing-noteson-details-plans-Medicaid?nclick_check=1
As Ohio lawmakers consider whether to expand Medicaid coverage to hundreds of thousands residents, the state is among a handful of mostly Republican-led states considering alternative options. Details could emerge early next month on a plan that would use federal money meant for Ohio’s Medicaid expansion to pay for private insurance for some low-income individuals. But questions remain as to how affordable those plans might be, and whether it’s even an approach the federal government will allow.
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Vt. is first state to post health insurance rates
Boston Globe
April 1, 2013
http://www.boston.com/news/local/vermont/2013/04/01/first-state-post-health-care-exchange-rates/0KaMxdxApTXAfz06XKx8HK/story.html
Vermont became the first state in the country Monday to let people without health insurance see how much they could have to pay to get coverage through the federal health overhaul beginning next year. The state released the proposed rates that would be charged for a variety of coverage levels through the state’s health insurance marketplace. The rates range from an average high of about $1,700 a month for a family to an average of $745 for catastrophic coverage — only available to people under age 30 — for a family.
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Lawsuit over health care tax could kill ‘Obamacare’
The Washington Times
March 31, 2013
http://www.washingtontimes.com/news/2013/mar/31/obamacare-lawsuit-over-health-care-tax-will-test-c/
“Obamacare” looks increasingly inevitable, but one lawsuit making its way through the court system could pull the plug on the sweeping federal health care law. A challenge filed by the Pacific Legal Foundation contends that the Affordable Care Act is unconstitutional because the bill originated in the Senate, not the House. Under the Origination Clause of the Constitution, all bills raising revenue must begin in the House.
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Healthcare an obstacle as Republicans court Latinos
Los Angeles Times
March 31, 2013
http://www.latimes.com/health/la-na-latinos-healthcare-20130401,0,4843950.story
As Republican leaders try to woo Latino voters with a new openness to legal status for the nation's illegal immigrants, the party remains at odds with America's fastest-growing ethnic community on another key issue: healthcare. Latinos, who have the lowest rates of health coverage in the country, are among the strongest backers of President Obama's healthcare law. In a recent national poll, supporters outnumbered detractors by more than 2 to 1. Latinos also overwhelmingly see guaranteeing healthcare as a core government responsibility, surveys show.
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CMS considering waivers for private coverage Medicaid alternative
Modern Healthcare
March 31, 2013
http://www.modernhealthcare.com/article/20130331/NEWS/303319991/cms-considering-waivers-for-private-coverage-medicaid-alternative
The Obama administration is showing willingness to let some states steer new Medicaid funding to private coverage in the new individual insurance marketplaces in order meet the coverage goals of the healthcare reform law. The CMS will consider granting a “limited number” of state waivers for demonstration that test what happens when states give Medicaid enrollees the option of taking a subsidy to buy a private plan, according to new guidance issued Friday.
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Some states can steer Medicaid funds to exchanges
Modern Healthcare
March 31, 2013
http://www.modernhealthcare.com/article/20130331/NEWS/303319991/cms-considering-waivers-for-private-coverage-medicaid-alternative
The Obama administration is showing willingness to let some states steer new Medicaid funding to private coverage in the new individual insurance marketplaces in order meet the coverage goals of the healthcare reform law. The CMS will consider granting a “limited number” of state waivers for demonstration that test what happens when states give Medicaid enrollees the option of taking a subsidy to buy a private plan, according to new guidance issued Friday.
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GOP seeks to benefit from Sebelius admission on healthcare cost hikes
The Hill
March 31, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/291043-gop-seeks-to-benefit-from-sebelius-admission-on-healthcare-costs
Republican campaign officials are claiming new momentum for 2014 after the Obama administration admitted that some consumers could see their health insurance premiums rise under healthcare reform. This week's surprise concession from federal Health secretary Kathleen Sebelius played into the GOP's No. 1 message against the Affordable Care Act — that it will raise healthcare costs.
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Ohio, 12 other states call for contraceptive exemption to Obamacare
The Plain Dealer
March 30, 2013
http://www.cleveland.com/open/index.ssf/2013/03/ohio_12_other_states_call_for.html
Ohio Attorney General Mike DeWine, along with 12 other attorneys general, has urged the federal government to broaden religious exemptions under the Patient Protection and Affordable Care Act, or Obamacare, claiming the policy violates religious freedoms.
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Jindal health secretary resigns amid investigation
Modern Healthcare
March 30, 2013
http://www.modernhealthcare.com/article/20130330/INFO/303309964/jindal-health-secretary-resigns-amid-investigation
Louisiana Gov. Bobby Jindal's health secretary and close ally, Bruce Greenstein, is resigning amid ongoing state and federal investigations into the awarding of a Medicaid contract to a company where Greenstein once worked, officials said Friday. The Jindal administration canceled the nearly $200 million contract with Maryland-based CNSI last week after details leaked of a federal grand jury subpoena involving the contract award.
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Okla. governor releases documents on Medicaid decision
Modern Healthcare
March 30, 2013
http://www.modernhealthcare.com/article/20130330/INFO/303309965/okla-governor-releases-documents-on-medicaid-decision
Oklahoma Gov. Mary Fallin's office refused Friday to release dozens of documents surrounding decisions she made connected to the federal healthcare law, citing exemptions to the state's Open Records Act that media experts say do not exist. In response to a request from several media outlets, including the Associated Press, the governor's office released in digital form more than 50,000 pages of documents relating to the Patient Protection and Affordable Care Act.
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Last chance: If ACA fails, single payer is next
The Salt Lake Tribune
March 30, 2013
http://www.sltrib.com/sltrib/opinion/56079343-82/care-health-insurance-cost.html.csp
The Patient Protection and Affordable Care Act should be seen as what it is: One last opportunity for the private health insurance market to prove that it can offer a service that covers the millions of Americans who were previously left out, at a cost that we — as individuals, employers and taxpayers — can afford.
If that is a goal beyond the grasp of the existing system, then it needs to be finally swept aside in favor of something that will meet those needs.
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Okla. governor releases health care documents
AP
March 30, 2013
http://www.kjrh.com/dpp/news/state/okla-governor-releases-health-care-documents
Governor Mary Fallin's office has released more than 50,000 pages of documents related to decisions surrounding the federal health care law. But her legal counsel claims some information is being withheld because of various exemptions. An attorney in Fallin's office, Rebecca Frazier, released CDs containing the requested documents to several media outlets on Friday. In a letter to reporters accompanying the discs, Fallin's General Counsel Steve Mullins claims about 100 pages were withheld. He said these documents "fall within a privileged category."
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Health care law divides Mass. Senate candidates
AP
March 30, 2013
http://www.boston.com/news/local/massachusetts/2013/03/30/health-care-law-divides-mass-senate-candidates/nJAKMPREzGRu7gQI66rtSN/story.html
Three years after it split Massachusetts voters in the 2010 special U.S. Senate election, the debate over President Barack Obama’s health care law has lost little of its political punch. Of the five candidates vying to fill the seat left vacant by John Kerry’s resignation, just one has offered a full-throated defense of the law. Democratic U.S. Rep. Edward Markey has described his vote for the Affordable Care Act as ‘‘the proudest vote of my career.’’
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Florida Hospital Association endorses Patient Protection and Affordable Care Act
News-Press
March 29, 2013
http://www.news-press.com/article/20130329/HEALTH/130329011/Florida-Hospital-Association-endorses-Patient-Protection-Affordable-Care-Act?nclick_check=1
The Florida Hospital Association on Friday called on state lawmakers to change course and endorse an expansion of Medicaid insurance coverage as outlined in the 2010 Patient Protection and Affordable Care Act. It also released a revised report from the University of Florida Food and Resource Economics Department predict that an extension of coverage, funded in part by $51 billion in federal support, would create 121,000 “high-wage” jobs over the next decade. Nearly 6,600 of them would be in Lee and Collier counties, according to the study.
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Obama administration finalizes key Affordable Care Act rule
The Hill
March 29, 2013
http://thehill.com/blogs/regwatch/healthcare/290995-obama-administration-finalizes-key-affordable-care-act-rule-
The federal government will reimburse states for 100 percent of the costs for some newly eligible Medicaid patients, under new regulations finalized Friday as part of the Obama administration’s implementation of the Affordable Care Act (ACA). The healthcare law authorizes states to expand Medicaid to adults under 65 with incomes up to 135 percent of the federal poverty level — roughly $15,000 for a single adult in 2012.
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Medicaid expansion in Pennsylvania can boost federal revenue, health care coverage
News Medical
March 29, 2013
http://www.news-medical.net/news/20130329/Medicaid-expansion-in-Pennsylvania-can-boost-federal-revenue-health-care-coverage.aspx
Expanding Medicaid in Pennsylvania under the Affordable Care Act would boost federal revenue to the state by more than $2 billion annually and provide 340,000 residents with health insurance, according to a new RAND Corporation study. The increased federal spending on health care in Pennsylvania would provide a $3 billion boost in economic activity and sustain more than 35,000 jobs, according to the analysis.
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Bump in the road for healthcare law
Los Angeles Times
March 29, 2013
http://www.latimes.com/news/opinion/editorials/la-ed-health-premiums-aca-study-20130329,0,5270434.story
One figure in a new report neatly summarizes the potential pitfalls for Obamacare: 30.1%. That's how much premiums could rise next year, on average, for the roughly 1.3 million moderate- and upper-income Californians who buy individual health insurance policies. Most of that increase is attributable to the insurance reforms in the 2010 law, also known as the Affordable Care Act. The bill's title is not ironic — its provisions will slow the growth of healthcare costs and lead over time to a more rational and efficient system. But the transition will have some rough patches, and we're about to hit one.
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Oklahoma Gov. Mary Fallin's emails detail health care exchange decisions
NewsOK
March 29, 2013
http://newsok.com/oklahoma-gov.-mary-fallins-emails-detail-health-care-exchange-decisions/article/3778159
Already facing pressure from national conservative organizations and others to reverse the state's decision to participate in the federal Affordable Care Act, Gov. Mary Fallin's position appeared to become untenable when she lost legislative support for a key provision of the program. On March 31, 2011, Fallin's chief of staff sent a one-word email to after learning the Senate would not take up a bill that Fallin championed to create a state health insurance exchange.
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Will the GOP’s plan to fight Obamacare in the states backfire?
The Washington Post
March 29, 2013
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/29/will-the-gops-plan-to-fight-obamacare-in-the-states-backfire/
Obama’s Patient Protection and Affordable Care Act celebrated its third birthday last weekend. This particular anniversary was a big deal, because it was often unclear whether the law would reach it. In the first place, it was imperiled by the Supreme Court; in the second, by the Republican Party’s promise to kill it if Republicans won the White House in 2012. Over the past year, Obamacare survived both challenges, and next year it will begin its core mission of insuring tens of millions of Americans.
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CMS, CA partner on dual-eligible demonstration
AHA News
March 29, 2013
http://www.ahanews.com/ahanews/jsp/display.jsp?dcrpath=AHANEWS/AHANewsNowArticle/data/ann_032913_duals&domain=AHANEWS
The Centers for Medicare & Medicaid Services will partner with the state of California on a new project to provide better coordinated care for individuals who are dually eligible for Medicare and Medicaid, the agency announced this week. Under the demonstration, the fifth state project the agency has approved, California and CMS will contract with selected health plans that will provide both the Medicaid and Medicare benefits and evaluate the effectiveness of a capitated model of care. Eligible beneficiaries will be passively enrolled, with the option to opt out of the Medicare portion of the demonstration beginning no earlier than Oct. 1, 2013. Enrollment will be phased in over 15 months. The state estimates that the demonstration project will include 456,000 Medicare-Medicaid enrollees in eight counties.
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Pennsylvania's Rejection Of Medicaid Expansion May Cost The State Millions: Study
The Huffington Post
March 29, 2013
http://www.huffingtonpost.com/2013/03/29/medicaid-expansion-cost-rejection_n_2979099.html?utm_hp_ref=business
Pennsylvania Governor Tom Corbett (R) announced last month that he would reject Medicaid expansion -- a key provision of President Barack Obama's health care reform law that would have made health care available to many more of the state's poorest residents. A new study has found that Corbett's decision might end up costing the state hundreds of millions of dollars.
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Ohio, 12 other states call for contraceptive exemption to Obamacare
Plain Dealer
March 29, 2013
http://www.cleveland.com/open/index.ssf/2013/03/ohio_12_other_states_call_for.html
Ohio Attorney General Mike DeWine, along with 12 other attorneys general, has urged the federal government to broaden religious exemptions under the Patient Protection and Affordable Care Act, or Obamacare, claiming the policy violates religious freedoms.
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BREAKING NEWS: President Obama, House Republicans Discussing Combining Medicare’s Parts A and B
Healthcare Informatics
March 28, 2013
http://www.healthcare-informatics.com/news-item/breaking-news-president-obama-house-republicans-discussing-combining-medicare-s-parts-and-
The New York Times reported that President Obama and congressional Republicans are discussing seriously the possibility of combining Parts A and B of the Medicare program, with the aim to “produce significant savings and end the politically polarizing debate over Republican plans to privatize the insurance program for older Americans.” The report, by Jackie Calmes and Robert Pear, noted that, “While the two remain far apart on the central issue of new tax revenue, recent statements from both sides show possible common ground on curbing costs of Medicare, suggesting some lingering chance, however small, for a budget bargain.”
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Health Care Law Will Raise Some Premiums, Study Says
The New York Times
March 28, 2013
http://www.nytimes.com/2013/03/29/health/health-care-law-will-increase-some-premiums-study-says.html?_r=0
A study commissioned by the State of California says that the new federal health care law will drive up individual insurance premiums, but that subsidies will offset most of the increase for low-income people. The study, issued Thursday in the midst of a growing national debate over the impact of the law, is significant because California is far ahead of most states in setting up a competitive marketplace, or exchange, where people can buy insurance this fall.
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Healthcare law could raise premiums 30% for some Californians
Los Angeles Times
March 28, 2013
http://www.latimes.com/business/la-fi-calif-health-rates-20130329,0,6971020.story
About 5 million Californians got a first glimpse at what they might pay next year under the federal healthcare law. For many, that coverage will come with a hefty price tag. Compared with what individual policies cost now, premiums are expected to rise an average of 30% for many middle-income residents who don't get their insurance through their employers.
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Medicaid expansion good for healthcare and economy
St. Louis Post-Dispatch
March 28, 2013
http://www.stltoday.com/news/opinion/mailbag/letters-to-the-editor/medicaid-expansion-good-for-healthcare-and-economy/article_b607260d-128c-58f4-a021-ad3cd1866193.html
As a professional registered nurse and advanced practice nurse, I fully endorse Medicaid expansion because it will provide needed and timely health care to persons who work but are unable to purchase health care. As a Missouri citizen, I fully endorse Medicaid expansion because I believe Governor Jay Nixon and the business community. Specifically, Medicaid expansion will add more than 21,000 jobs, reduce the cost of insurance premiums, and contribute about 8.2 billion dollars to Missouri’s economy.
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CMS approves California dual eligible demonstration
Healthcare Payer News
March 28, 2013
http://www.healthcarepayernews.com/content/cms-approves-california-dual-eligible-demonstration
California's three-year demonstration program for Medicare-Medicaid dual eligibles has been approved by the federal government. Managed by the California Health and Human Services Agency and called the Cal MediConnect, the program will provide an integrated health plan to an estimated 456,000 Californians in eight counties, mostly in Southern California and the Bay Area.
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Gov. John Kasich argues health care access for poor is a problem for all of society
March 28, 2013
http://www.cleveland.com/open/index.ssf/2013/03/kasich_argues_health_care_acce.html
Ohio Gov. John Kasich used the kickoff for the statewide Minority Health Month Thursday as a chance to restate his push for expanding health care for the poor. Kasich, who has proposed expanding Medicaid to cover Ohioans who earn up to 138 percent of the poverty line, has been firing back at fellow Republicans who oppose his plan and pitching the proposed expansion around the state in hopes of building support. It faces a tough sell with conservative GOP lawmakers.
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Obamacare Should Make Health Care Cheaper—Just Not Right Away
Bloomberg Businessweek
March 28, 2013
http://www.businessweek.com/articles/2013-03-28/obamacare-should-make-health-care-cheaper-just-not-right-away
This week, the Society of Actuaries threw a wrench into President Obama’s persistent assertions that his health-care overhaul is driving down the cost of health care. The nonpartisan professional association for insurance assessors came out with a report saying that medical claims—the biggest driver of premiums—will rise 32 percent (PDF) over the next three years because of Obamacare. In states such as Ohio and Wisconsin, the group expects the cost of claims to go up by 80 percent.
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Medicare and health care savings
USA Today
March 28, 2013
http://www.usatoday.com/story/news/politics/2013/03/28/obama-health-care-medicare-state-of-the-union/1955189/
In Februrary 2010, President Obama issued an executive order creating the National Commission on Fiscal Responsibility and Reform. The group was chaired by Erskine Bowles, a former White House chief of staff to President Clinton, and former Republican senator Alan Simpson of Wyoming. The commission was tasked with crafting policy recommendations to address the nation's long-term fiscal challenges. Released in late 2010 , their report called for several changes to Medicare, including modifications to the payment formula for physicians and a call to overhaul or repeal the Community Living Assistance Services and Supports Act, which was a provision of the Affordable Care Act that instituted an insurance program for voluntary long-term care. Although the White House never endorsed the Bowles-Simpson Commission's plan, the group proposed a measure that Obama mentioned in his State of the Union Address: requiring pharmaceutical companies to offer the same rebates on drugs given to Medicaid recipients to Americans who are eligible for both Medicare and Medicaid. Obama also proposed requiring wealthy Medicare beneficiaries to pay higher premiums in his address to Congress.
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A one-size-fits-all is the wrong approach for healthcare reform
The Hill
March 28, 2013
http://thehill.com/blogs/congress-blog/healthcare/290811-a-one-size-fits-all-is-the-wrong-approach-for-healthcare-reform
Wednesday, Gov. Bill Haslam (R-Tenn.) announced that the state of Tennessee would not expand Medicaid as envisioned by President Obama under the Affordable Care Act. The federal government’s insistence on a one-size-fits-all approach under Medicaid is a poor solution for solving our health insurance access problems, especially given the access problems so many of our citizens already face under this program. The governor’s preferred approach – to use federal dollars to expand Tennesseans’ access to private coverage – seems like it may be a better solution for access to health insurance, and it seems to me he deserves an opportunity to put this plan to the test.
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CMS’s Innovation Center Evaluates New Care and Payment Models
Health Affairs
March 27, 2013
http://healthaffairs.org/blog/2013/03/27/cmss-innovation-center-evaluates-new-care-and-payment-models/
Today, Health Affairs released a Web First article by William Shrank describing the new rapid-cycle approach to program evaluation at the recently established Center for Medicare and Medicaid Innovation. The Affordable Care Act created the Innovation Center within the Centers for Medicare and Medicaid Services (CMS) to test payments and service delivery models, reduce costs in Medicare and Medicaid, and improve quality. As the Innovation Center moves ahead with innovative payment and service delivery models, the center’s Rapid Cycle Evaluation Group, led by Shrank, delivers frequent feedback to providers while evaluating the outcomes of each model tested. When a model is considered for testing, staff from the Rapid Cycle Evaluation Group and CMS’ Office of the Actuary are immediately assigned to help create the model. The Office of the Actuary provides timely and impartial actuarial, economic, and statistical estimates–and monitors Innovation Center initiatives once testing has begun. This group’s rigorous and speedy assessment and evaluation is driven by performance metrics and robust new methodologies.
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Some health care costs may rise when ObamaCare is implemented, US official says
Fox
March 27, 2013
http://www.foxnews.com/health/2013/03/27/some-health-care-costs-may-rise-when-obamacare-is-implemented-us-official-says/
President Barack Obama's top health care adviser acknowledged that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year. U.S. Health and Human Services Secretary Kathleen Sebelius said definitive data on costs will not be available until later this year when private health plans become authorized to sell federally subsidized coverage on new state-based online marketplaces, known as exchanges.
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Obama's Health Care Reform Is Coming — With $1 Trillion In New Taxes
Fiscal Times
March 27, 2013
http://www.businessinsider.com/health-care-reform-costs-1-trillion-2013-3
Three years after enactment of the landmark legislation extending health care coverage to 27 million uninsured people, many in Congress and a majority of Americans are coming face to face with a daunting reality. Consumers will face higher insurance premiums, insurers will see a 32 percent increase in medical claims costs, and almost everyone in the upper middle class or higher will pay a slew of new taxes.
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Wyden: Healthcare law's 'family glitch' leaves dependents without coverage
The Hill
March 27, 2013
http://thehill.com/blogs/floor-action/senate/290537-wyden-healthcare-laws-family-glitch-leaves-dependents-without-coverage
Sen. Ron Wyden (D-Ore.) said Tuesday that millions of workers’ dependents would still be left without options for affordable family health insurance under the Affordable Care Act. “Without action, millions of hard working Americans are going to be squeezed by the family glitch,” Wyden said. “Many people will be left with a false choice of taking family coverage through work they can’t afford or struggling to find a better plan in the exchange without a subsidy.”
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Markey, Lynch spar on healthcare, bailout at Massachusetts debate
The Hill
March 27, 2013
http://thehill.com/blogs/ballot-box/senate-races/290701-markey-and-lynch-spar-on-healthcare-bailout-at-massachusetts-debate-
Reps. Edward Markey (D-Mass.) and Stephen Lynch (D-Mass.) faced off Wednesday night for the first televised debate of the Democratic primary in the Massachusetts special election for the U.S. Senate. The two Democrats jockeyed to clarify their positions and paint their opponent’s record as counter to the best interests of Bay Staters.
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Premiums could rise under healthcare law, Sebelius concedes
The Hill
March 27, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/290523-sebelius-says-some-could-see-insurance-premiums-go-up
The Obama administration acknowledged Tuesday that some people could see their premiums rise under the healthcare reform law. Health and Human Services (HHS) Secretary Kathleen Sebelius told reporters that “there may be a higher cost associated with getting into that market” where “folks will be moving into a really fully insured product for the first time.”
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Health care law will raise insurers' costs, actuaries say
CNN
March 27, 2013
http://politicalticker.blogs.cnn.com/2013/03/27/health-care-law-will-raise-insurers-costs-actuaries-say/
Republican opponents of President Obama's Affordable Care Act got some new ammunition this week: A study released by the Society of Actuaries on Tuesday predicts that costs could rise an average of 32% by 2017 for insurers serving the individual health care market. Insurers in some states could see costs rise significantly more than that, the study reports, with increases estimated to top out at 80% in Ohio and Wisconsin, and 60% in California, Idaho, Maryland and Indiana. These increases could then be passed on to consumers through higher premiums.
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Why Democrats and Republicans will never agree on health care
The Washington Post
March 27, 2013
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/27/why-democrats-and-republicans-will-never-agree-on-health-care/
“Remember, anyone who attacks our Medicare proposal without offering a credible alternative is complicit in the program’s demise,” wrote Rep. Paul Ryan (R-Wis.) in the Wall Street Journal. This is a key argument Republicans use to deflect criticism of their health-care plans. It’s classic politics of conviction: You might not like what they’ve proposed, but at least they’ve proposed something. As Treasury Secretary Timothy Geithner used to say, “plan beats no plan.”
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Massachusetts Senate rivals from both parties scrap over health care, abortion in first televised debate
MassLive
March 27, 2013
http://www.masslive.com/politics/index.ssf/2013/03/senate_rivals_from_both_partie.html
In a sometimes-contentious debate, U.S. Reps. Edward J. Markey and Stephen F. Lynch tangled over health care, abortion, and a law to bail out banks. The 30-minute showdown on live television between the two Democrats in the U.S. Senate election followed a debate among the three Republican candidates, also vying to fill the unexpired term of Secretary of State John F. Kerry.
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Medicaid Petitions Urge Lawmakers To Expand Health Care Access
WIBW
March 27, 2013
http://www.wibw.com/home/headlines/Medicaid-Petitions-Urge-Lawmakers-To-Expand-Health-Care-Access-200329191.html
One group advocating for health care access to more Kansans gathered at the statehouse Wednesday in hopes their message was heard. The Kansas Medicaid Access Coalition delivered almost 3,000 petition signatures to Governor Sam Brownback's office Wednesday. They hope he and other lawmakers will consider using federal dollars in 2014 to expand access to Medicaid.
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Kathleen Sebelius: Obamacare Implementation May Cause Some Health Care Costs To Rise
The Huffington Post
March 27, 2013
http://www.huffingtonpost.com/2013/03/26/kathleen-sebelius-obamacare_n_2959227.html
President Barack Obama's top healthcare adviser acknowledged on Tuesday that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year. U.S. Health and Human Services Secretary Kathleen Sebelius said definitive data on costs will not be available until later this year when private health plans become authorized to sell federally subsidized coverage on new state-based online marketplaces, known as exchanges.
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Do you think ‘Biosimilars’ Will Reduce Healthcare Expenditures? Think again.
Forbes
March 27, 2013
http://www.forbes.com/sites/henrymiller/2013/03/27/do-you-think-biosimilars-will-reduce-healthcare-expenditures-think-again/
Generic medicines are a critical element of Americans’ health care. Since 1984, the marketing of generic version of chemically synthesized, relatively simple “small molecule” drugs such as those used commonly to control diabetes, blood pressure, cholesterol and pain has been expedited by legislation commonly known as the Hatch- Waxman Act. By allowing approval of generics through an abbreviated and less costly pathway than for innovator, or brand-name drugs – a route that does not require new clinical trials – this legislation has balanced the need to preserve industry’s incentive to innovate with the benefits of competition.
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Tavenner reaffirms CMS will look into improper billing by EHR users
Fierce EMR
March 27, 2013
http://www.fierceemr.com/story/tavenner-reaffirms-cms-will-look-improper-billing-ehr-users/2013-03-27
The Centers for Medicare & Medicaid Services will begin to conduct billing audits of providers who use electronic health records, according to a news alert issued this week by law firm Mintz Levin. The firm, reporting on a presentation by CMS Acting Administrator Marilyn Tavenner at a March 5 meeting held by the Federation of American Hospitals, noted that "small, targeted" audits would be held in parallel with the Meaningful Use audit program, which began last July. The news alert also reported that CMS will hold a summit in May with providers and EHR vendors to address upcoding issues associated with EHRs. Billing improprieties with EHR use has been a recent concern for CMS and other government entities, as EHRs enable providers to capture additional billing codes, and often suggest which codes to enter on claim forms
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Hospitals to CMS: No more patient surveys, please
Fierce Healthcare
March 27, 2013
http://www.fiercehealthcare.com/story/hospitals-cms-no-more-patient-surveys-please/2013-03-27
The American Hospital Association is asking the Centers for Medicare and Medicaid Services to drop plans to create two more types of patient surveys in favor of adding supplemental questions to existing surveys. In a letter sent yesterday, the AHA said adding surveys about patient experiences at hospital outpatient surgery departments and ambulatory surgical centers creates potential confusion "as well as excessive survey administrative burden."
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Healthcare Reform Law Creates 111M Hours of Paperwork: Study
Becker’s Hospital Review
March 26, 2013
http://www.beckershospitalreview.com/hospital-management-administration/healthcare-reform-law-creates-111m-hours-of-paperwork-study.html
The Patient Protection and Affordable Care Act has imposed approximately 111.4 million hours of paperwork, according to a new study from American Action Forum, a conservative think tank. Based on that finding, the AAF said it would take 55,742 employees working 2,000 hours in a year to complete the red tape required in the PPACA. Some of the most time-consuming provisions of the law, according to the AAF, are: • Final inpatient prospective payment — 6.84 million hours • Final outpatient prospective payment — 1.01 million hours • Final billing for skilled nursing facilities — 0.91 million hours.
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Insurers eager to maintain authority over healthcare premiums
Los Angeles Times
March 26, 2013
http://www.latimes.com/business/la-fi-hiltzik-20130327,0,1556563.column
While most of us face uncertainty with the rollout of healthcare reform, some insurance companies in California have been feeling their oats lately. Here's how they're responding to Insurance Commissioner Dave Jones' warnings that their latest rate increases are unreasonable: Stuff it, Dave. That essentially was the response of Blue Shield of California and Anthem Blue Cross after Jones flayed their proposed premium hikes — up to 20% for Blue Shield customers and up to 18% for Anthem. The companies moved to implement the increases anyway, although Anthem thought better of it after it started charging the higher rates, and reduced them a bit. Anthem further said it would start passing on to customers a fee related to the federal Affordable Care Act this year, which Jones considered unlawful since the government fee doesn't go into effect until next year.
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Obamacare Affordability Glitch Prices Millions Of Americans Out Of Health Care, Advocacy Group Says
The Huffington Post
March 26, 2013
http://www.huffingtonpost.com/2013/03/26/little-hope-seen-for-mill_n_2958592.html
Millions of Americans will be priced out of health insurance under President Barack Obama's healthcare overhaul because of a glitch in the law that adversely affects people with modest incomes who cannot afford family coverage offered by their employers, a leading healthcare advocacy group said on Tuesday. Tax credits are a key component of the law and the White House has said the credits, averaging about $4,000 apiece, will help about 18 million individuals and families pay for health insurance once the Affordable Care Act takes full effect, beginning in January 2014.
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Electronic Health Records: Doctors Want to Keep Patients Out
Everyday Health
March 26, 2013
http://www.everydayhealth.com/healthy-living/electronic-health-records-doctors-want-to-keep-patients-out-7727.aspx
According to a new Harris Poll survey, conducted on behalf of the management consulting firm Accenture, less than one-third of U.S. doctors think patients should have full access to their own electronic health records. As a patient, you may literally trust your doctor with your life, and the doctor-patient relationship relies on this level of trust. The relationship should be one of give and take, even if the exchange is sometimes dominated by the professional.
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21 graphs that show America’s health-care prices are ludicrous
The Washington Post
March 26, 2013
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
Every year, the International Federation of Health Plans — a global insurance trade association that includes more than 100 insurers in 25 countries — releases survey data showing the prices that insurers are actually paying for different drugs, devices, and medical services in different countries. And every year, the data is shocking. The IFHP just released the data for 2012. And yes, once again, the numbers are shocking.
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Analysis finds Medicaid expansion will benefit veterans
The Hill
March 26, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/290327-analysis-finds-medicaid-expansion-will-benefit-vets
Veterans stand to benefit substantially from President Obama's healthcare law, particularly in states that choose to expand their Medicaid programs, a new analysis found. Researchers with the Urban Institute reported that as many as 40 percent of uninsured U.S. veterans would be eligible for healthcare under the law's insurance exchanges or its expanded Medicaid program.
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Re-engineering Health Care
The New York Times
March 26, 2013
http://www.nytimes.com/roomfordebate/2013/03/26/re-engineering-health-care
The chief executive of Kaiser Permanente, which is often hailed as a model of health care reform and cost control, said in a Times article recently that “the future of health care is going to be rationing or re-engineering.”
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White House defends voter registration through ObamaCare
The Hill
March 26, 2013
http://thehill.com/blogs/regwatch/healthcare/290399-white-house-defends-obamacare-voter-registration
White House press secretary Jay Carney on Tuesday defended a section of the application for health insurance subsidies under the president's signature healthcare law where applicants can register to vote. Carney said that similar provisions had existed for years on federal Medicare applications.
“The linkage of, you know, checking off whether or not you want to register to vote goes back to a 1993 law regarding Medicaid,” he said.
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When the Affordable Care Act Becomes Unaffordable
Bloomberg
March 26, 2013
http://www.bloomberg.com/news/2013-03-26/when-the-affordable-care-act-becomes-unaffordable.html
The New York Times reports that U.S. President Barack Obama's administration is encouraging Republican-led states to follow Arkansas’s lead and use Medicaid expansion dollars to buy private insurance for people with low incomes. This is going to make a lot of people happy. But it's not good for taxpayers or for the project of making medical costs sustainable. Many Republicans are drawn to the Arkansas plan because, though it is an expansion of government-funded health care, it works through private channels. Doctors and hospitals, who already liked the Medicaid expansion because it was going to give them more customers and diminish the problem of uncompensated care, like this plan even better because it will pay them more. Low-income patients will probably be better off, too, because private insurance is more widely accepted than Medicaid, though some could be hurt by the need to make higher co-payments. And the Obama administration will be happy because more states will participate in the Medicaid expansion.
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Study: Health law has imposed 111 million hours of paperwork
The Hill
March 25, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/290173-study-health-law-has-imposed-111-million-hours-of-paperwork
In its first three years, President Obama's healthcare law has imposed more than $30 billion in costs and 111 million hours of paperwork burdens, according to a new study from the American Action Forum.
The forum, a conservative think tank led by former Congressional Budget Office Director Douglas Holtz-Eakin, said the law will raise premiums and hurt small businesses.
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GOP lawmaker wary of voter registration questions in Obama health law forms
The Hill
March 25, 2013
http://thehill.com/blogs/regwatch/healthcare/290187-gop-lawmaker-wary-of-voter-registration-in-healthcare-app
A Republican lawmaker is concerned about voter registration questions buried in a draft application to receive benefits under President Obama's healthcare law.
Rep. Charles Boustany (R-La.), who leads a House subcommittee on oversight, said the questions' placement could lead some to believe that voter registration is tied to eligibility for the law's insurance exchanges.
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Only 3 Years Old, the Affordable Care Act Is Already Having a Big Impact
Center for American Progress
March 25, 2013
http://www.americanprogress.org/issues/healthcare/news/2013/03/25/57946/only-3-years-old-the-affordable-care-act-is-already-having-a-big-impact/
This past Saturday marked the third anniversary of the enactment of the Patient Protection and Affordable Care Act, also known as Obamacare, which includes sweeping reforms of our health care system. Although health care consumers will see some of the landmark law’s biggest changes beginning in 2014, many of the law’s reforms have already benefited millions of Americans. Below we document the many ways in which the Affordable Care Act is helping millions of Americans by ensuring they have access to high-quality affordable coverage.
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Why Do Some States Spend More on Health Care?
Health Affairs
March 25, 2013
http://healthaffairs.org/blog/2013/03/25/why-do-some-states-spend-more-on-health-care/
One of the interesting features of the Affordable Care Act is that reform basically takes place at the state level. Yet the states are very different. Some spend more than twice as much on health care as others, as a percent of state income. For example, health care spending in three states — Maine, West Virginia and Mississippi — accounts for one out of every five dollars of state GDP. Conversely, Wyoming spends less than 9 percent. (See the table at the end of this post.) If every state were like Wyoming, the United States as a whole would be spending less of its income on health care than about three-fourths of the other developed countries.
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Tennessee Race for Medicaid: Dial Fast and Try, Try Again
The New York Times
March 24, 2013
http://www.nytimes.com/2013/03/25/us/tennessee-holds-health-care-lottery-for-the-poor.html?pagewanted=all&_r=0
Two nights a year, Tennessee holds a health care lottery of sorts, giving the medically desperate a chance to get help. State residents who have high medical bills but would not normally qualify for Medicaid, the government health care program for the poor, can call a state phone line and request an application. But the window is tight — the line shuts down after 2,500 calls, typically within an hour — and the demand is so high that it is difficult to get through.
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Opponents mark Obamacare's third anniversary with lobbying surge
Reuters
March 24, 2013
http://www.reuters.com/article/2013/03/24/us-usa-healthcare-lobbying-idUSBRE92N0B620130324
Eight months before President Barack Obama's health care law goes prime time, a confederation of industry and business groups is ramping up its lobbying apparatus for an 11th-hour assault on the web of new taxes and regulations. Medical device makers, health insurers, retailers and restaurants are waging what lobbyists call a coordinated effort to gain Senate Democratic support for overturning $130 billion in taxes that will be used to fund the new law, and repealing a mandate requiring employers to provide insurance coverage for full-time workers or pay a fine.
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