Bay Area nonprofit hospitals struggle with finances; Medicaid plan for neighborhood clinics in New Orleans approved

Sep 24 2010

The Wall Street Journal: "When Mountain View's El Camino Hospital last month announced plans to lay off about 140 workers due largely to a rise in nonpaying clients, the medical provider highlighted a debate over the financial health of the Bay Area's nonprofit hospitals. On one side are hospital leaders and industry groups who say the weak economy, declining patient-reimbursement rates and uncertainty posed by the federal health-care overhaul put nonprofit care providers in peril. On the other side are labor groups like the Service Employees International Union, who say the economic environment for hospitals is improving and that care providers are using the recession as an excuse to threaten job cuts and gain negotiating leverage over the unions." The face-off is "playing out" as union reps and hospital management are meeting to discuss the labor situation (Scheck, 9/23).

The (New Orleans) Times-Picayune: "The federal government Wednesday gave its official blessing to a Louisiana proposal to steer a portion of its Medicaid budget from hospitals to the network of primary care clinics that have proliferated since Hurricane Katrina. The move is the final piece of a financing puzzle that will distribute at least $97.5 million to the clinics and bolster their efforts to provide primary medical homes to hundreds of thousands of uninsured and underinsured residents who previously either used the old Charity Hospital or had no regular health care venue" (Barrow, 9/23).

Health News Florida: "Florida might have to pay back $5.3 million because some children were enrolled in Medicaid and the KidCare health-insurance program at the same time, a new inspector general's report says. The report, released this week by the U.S. Department of Health and Human Services (HHS), said the problem stemmed from Florida retroactively enrolling children in Medicaid --- though they were enrolled in KidCare during the same time period. Also, it pointed to a lack of 'internal controls' to quickly correct simultaneous enrollments in the two programs." The state Agency for Health Care Administration plans to contest these findings (Saunders, 9/22).

The News-Gazette: "About 8 percent of Illinois residents will be eligible for help paying for their health insurance, starting in 2014, according to a report released Tuesday. The assistance - to come in the form of insurance premium tax credits estimated to be worth $3.9 billion the first year - will be available under the federal insurance reform law. ... Most of the changes under the law are being rolled out gradually this year and through 2014. The tax credits are expected to benefit largely low- and middle-income people, but eligibility will be determined by more than household income" (Pressey, 9/22).

The Associated Press / Jefferson City (Mo.) News Tribune: "The Missouri insurance department says it has issued more than $1 million in fines in a crackdown on bogus health insurance plans. The insurance department says it issued cease-and-desist orders to 14 companies and individuals who allegedly defrauded consumers by selling plans that appeared to include comprehensive medical insurance, but actually did not" (9/22).

The Wall Street Journal: "A WellPoint Inc. subsidiary in Colorado agreed to repay individual policyholders in that state $20 million after an examination by the state insurance commissioner concluded that several premium increases were unjustified, the insurance commissioner said. The insurer and the state settled the probe last week after the Colorado Division of Insurance investigated three rate filings between 2009 and 2010 that increased individuals' premiums, in some cases by 30% or more, said Marcy Morrison, the state's commissioner of insurance" (Johnson, 9/23).