Florida likely to seek waiver on medical loss ratio; Ariz. cuts back Medicaid benefits

Sep 29 2010

The Hill Healthwatch: "Florida's 14-member insurance advisory board has unanimously passed a resolution to seek a waiver from the health law's medical loss ratio. An official with the Florida Office of Insurance Regulation tells The Hill that the board's vote means it's a 'done deal' that the state will formally seek some kind of waiver but the board is gathering public input through Oct. 8. The resolution was adopted Friday during a hearing on the medical loss ratio, requested by Insurance Commissioner -- and board chairman -- Kevin McCarty. Florida would become the third state to request a waiver, following Maine and Iowa. The health reform law requires health plans to spend at least 80 percent of premiums (85 percent in the large-group market) on care or give consumers rebates starting in 2012" (Pecquet, 9/27).

Arizona Republic: "Health benefits for low-income adults enrolled in the state's Medicaid program will be significantly scaled back beginning this week. The Arizona Health Care Cost Containment System will cut coverage for basic health services such as physicals, most dental care, podiatry, some organ transplants and other programs. The state also will slash benefits for medical equipment such as insulin pumps, hearing aids, cochlear implants, computer-controlled lower limbs and joints, and other equipment. Administrators say the cuts, which take effect Friday, are necessary to deal with the state's budget crisis and an increase in the number of enrollees during the bad economy. The benefits cuts will save an estimated $20 million through the end of June" (Alltucker, 9/26). 

Dallas Morning News: "As U.S. costs have risen, North Texas seniors on fixed incomes say they are faced with no other option than to get prescriptions filled online from Canada. … Every year, 68,000 Texans order more than 200,000 drug shipments online from Canada, according to the Canadian International Pharmacy Association. Top-selling medications for high-cholesterol and arthritis, like Lipitor and Celebrex, can be found online for half the prices seen at local pharmacies. Importing drugs from Canada is illegal, but the U.S. Food and Drug Administration does not prosecute people importing a 90-day supply of prescription drugs for personal use. … Aware of the trend, U.S. pharmaceutical companies are warning online drug shoppers of the risk in unknowingly purchasing counterfeit medications" (Roberson, 9/28). 

Kansas Health Institute: "The Kansas Medicaid program is expected to spend $150 million on prescription drugs this year. … More than 40 percent of the Medicaid drug costs are for mental health prescriptions, surpassing the combined costs for antibiotics, pain medicine, and those for treating gastric disorders and asthma. In the fiscal year that ended June 30, 2010, Kansas Medicaid spent $166.4 million on prescriptions and $68.9 million of that -- more than 40 percent -- was for mental health drugs for adults and children" (Ranney, 9/27).

The Arizona Republic reports on Proposition 203, which would legalize marijuana for medicinal use. "Licensed physicians would be able to recommend medical marijuana to patients with debilitating medical conditions, which include cancer, glaucoma, HIV/AIDS, hepatitis C and Alzheimer's disease. Other conditions can be added to the approved list by the Arizona Department of Health Services through a public-petition process. Patients would register for ID cards with the department and receive up to 2 1/2 ounces of marijuana every 14 days from non-profit dispensaries or cultivate up to 12 marijuana plants if they live 25 miles or farther from a dispensary. The department would be responsible for implementation" (Lee, 9/26).

Wisconsin State Journal reports that officials are studying a Kentucky program to see what lessons they might be able to use in Wisconsin. Kentucky Homeplace is "a state-funded program that helps people in a region with the worst life expectancy in the country navigate the complicated health care system. Organizers of Wisconsin's rural free clinics are paying attention to the program, saying they could develop a similar navigator role if the new health care reform law reduces demand for free care. … Free clinics in rural Wisconsin could offer similar assistance to patients in coming years, said Wally Orzechowski, executive director of Dodgeville-based Southwest Community Action Program, which helped set up free clinics in Boscobel, Dodgeville and Richland Center" (Wahlberg, 9/27).