Mass. legislation to push poor seniors into managed care plans stirs concerns

The Boston Globe: "Legislation that could push more than 100,000 low-income senior citizens in Massachusetts into managed care health plans spurred intense lobbying yesterday, as consumer advocates argued the measure would strip patients of their freedom to stay in traditional Medicare, while proponents said it could save the state significant money. At issue is a bill sponsored by Representative Peter J. Koutoujian, a Waltham Democrat, which would require elders who are receiving both state-subsidized Medicaid health benefits and federal Medicare coverage to be automatically enrolled in managed care health plans. ... A legislative committee yesterday delayed action on the bill for several weeks to give lawmakers more time to study the highly charged issue" (Lazar, 4/28).

NPR: "The Oklahoma Senate voted Tuesday to override the governor's veto of two anti-abortion laws that are considered some of the strictest in the country. One of the laws, which became effectively immediately, requires women to have an ultrasound and listen to a detailed description of the fetus before getting an abortion. The other prevents women from suing doctors who knowingly withhold information about the fetus, including whether there's a fetal abnormality. Supporters of that measure have said it is an attempt to keep pregnant women from discriminating against fetuses with disabilities." Gov. Brad Henry, a Democrat, has said that the law will likely be found unconstitutional (Lohr, 4/27).

The Wall Street Journal: Oklahoma's "ultrasound law drew an immediate suit, filed in state court and backed by the Center for Reproductive Rights, which said it violated abortion providers' free-speech and equal-protection rights. In addition to requiring whatever type of ultrasound would present the clearest image—often a vaginal one—the law says doctors or technicians must describe the ultrasound results to the woman. Stephanie Toti, a staff attorney for the center, said this goes further than laws in 21 other states that require or suggest ultrasound for women seeking abortions. The center is considering a legal challenge to the other Oklahoma law as well, she said" (Mathews, 4/28).

Kansas Health Institute reports on the proposed tax on licensed nursing home beds in Kansas: The legislation "calls for using a $1,325-per-year tax on licensed nursing home beds to generate about $30 million which, in turn, would be used to draw down $56 million in additional federal Medicaid funding. Ninety-nine percent of the $86 million would be returned to the nursing homes, depending on how many of their residents are on Medicaid. Homes with more Medicaid residents would get more money. … The bill's supporters ... have been quick in pointing out that more than 90 percent of the state's nursing homes will either break even or come out ahead. It makes little sense, they say, to leave $56 million on the federal table at a time when many nursing homes, especially those with high numbers of Medicaid residents, are reeling from the 10 percent cut in Medicaid reimbursement earlier this year." There is also plenty of resistance to the tax (Ranney, 4/28).

Florida Health News: "State lawmakers appear ready to pass a bill to crack down on pain-management clinics that have become a magnet for drug abusers --- including placing restrictions on doctors who dispense more than a 72-hour supply of controlled substances. The bill would bar clinic patients from getting more than the three-day supply if they pay with cash, checks or credit cards. By requiring payment with insurance or workers-compensation coverage, lawmakers hope to reduce the number of people who walk into clinics, plunk down cash and leave with large quantities of painkillers such as oxycodone. The ease of getting drugs at Florida clinics has drawn users and traffickers from states such as Ohio and Kentucky" (Saunders, 4/28).

The Tennessean: "The state legislature may take up the question next year of whether marijuana should be available by prescription in Tennessee, after agreeing to send the question to a study group. The House Health and Human Resources Committee voted Tuesday to call on state health, agriculture and law enforcement officials to study medical marijuana and deliver a report to the legislature no later than Feb. 15, ending a two-week debate over the issue. But the committee did not approve any additional funding for the study, leaving it to the state's Board of Pharmacy to decide whether to take up the matter. If it goes forward, the study could set up a debate over medical marijuana next year" (Sisk, 4/28). 

The Wall Street Journal: "Two New York-Presbyterian Hospital officials and two contractors who did business with the prestigious hospital were indicted on fraud charges Tuesday in the latest cases stemming from a federal investigation into bid-rigging and fraud. The indictment alleges that the hospital officials—Santo Saglimbeni of Armonk, N.Y., and Emilio Figueroa, whose hometown wasn't given—received payments and gifts in exchange for awarding contracts to certain companies. The contractors, Michael Yaron of Meadowbrook, Pa., and Moshe Buchnik of Richboro, Pa., received some of the rigged contracts. The four individuals couldn't be reached for comment. … The indictment, which was returned by a federal grand jury in the Southern District of New York, said more than $42 million in hospital contracts was involved" (Rockoff, 4/28).

St. Louis Globe-Democrat: "Gov. Jay Nixon signed House Bill 1498, which requires health insurance companies in Missouri to speed up claims payments to doctors, hospitals and other health care providers. John Huff, director of the Missouri Department of Insurance, joined Nixon at the bill signing. … According to Nixon, a 2009 report from the Missouri Department of Insurance showed health care providers across the state are dealing with significant payment delays in the claims filed with insurance companies for treatment of patients. The report on Missouri's 'prompt pay' law showed more than 26 percent of claims at Missouri hospitals are past due by 90 days or more, Nixon said. The problem of late payment was even worse for rural hospitals, he added" (4/27).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.