State News: N.Y. billing for disabled patients questioned

Apr 8 2011

Stateline: Where Labor Is Weak, State Workers Face Huge Cutbacks
While the nation's attention has been focused on state worker battles in union strongholds such as Ohio and Wisconsin, quiet but consequential labor battles are breaking out in Kansas, Texas and other states where collective bargaining rights for public workers were weak or non-existent to begin with. The outcome of these confrontations will have a big impact. ... it also will impact less-visible aspects of these states' relationship with their workers, such as how much employees must pay for their out-of-pocket health costs (Maynard, 4/8). 

The Boston Globe: Senate Leader Vows To Act On Health Payments Plan
Senate President Therese Murray vowed yesterday to take swift action on Governor Deval Patrick's ambitious proposal to overhaul the state's health care payment system, breaking with House Speaker Robert A. DeLeo, who wants to delay action until later this year or next year. "I agree with the governor that something has to be done soon," Murray said. ... Patrick's bill, a cornerstone of his second-term agenda, is intended to reduce rising medical costs by replacing the current fee-for-services system with a payment system in which hospitals and doctors would be given a set budget for each patient's care (Levenson, 4/8). 

Health News Florida: Halfway Through; What's Next?
Just past the halfway point of the 2011 session, the Florida House and Senate approved competing budget plans Thursday that rely heavily on cutting health- and human-services programs. That is only the start, however, of a four-week rush to deal with major health-related issues. The top priorities will be negotiating a final budget and working out differences on mammoth plans to overhaul the Medicaid system (Saunders, 4/8). 

The Texas Tribune: Some Texas Dentists Bad-Mouth Anti-Cavity Bill
Some pediatric dentists are bad-mouthing a bill that would allow mobile dental clinics to be paid by Medicaid for sealing the teeth of low-income kids at school — a cavity-prevention measure these dentists fear would keep children and their parents from seeking more comprehensive oral care. ... [The Texas Dental Association], which declined to comment for this article, argues that oral care should instead be provided in a so-called "dental home" — an established dental practice (Ramshaw, 4/7). 

The Texas Tribune/New York Times: Cuts To Family Planning May Add To State's Expenses
In a series of amendment forays, House conservatives raided the state's family planning programs and sent the money to other areas like autism programs, crisis pregnancy centers and mental health services for children. Most of the conversation was couched as a this-versus-that choice between family planning and another program, often one attractive to Democrats (Ramsey, 4/7).

The Wall Street Journal: The $2 Million Patients
New York's state-run institutions for the mentally disabled are billing the Medicaid program nearly $2 million per patient a year—a rate that goes far beyond the cost of caring for the patients and is attracting the scrutiny of federal regulators. A spokesman for the Centers for Medicare & Medicaid Services, the federal body that administers Medicaid, said the agency is in talks with the state officials about changing the way New York sets the rates. Federal officials haven't accused the state of any wrongdoing (Gershman, 4/7).

NPR: Violence Surges At Hospital For Mentally Ill Criminals (Part 2)
Atascadero State Hospital, on California's central coast, was built from the ground up to treat mentally ill criminal offenders. Violence is on the rise at the hospital, and according to state and federal documents, it's gotten worse since 2006 — the same year the state signed an agreement with the federal government to put in a detailed new treatment plan. ... The new treatment plan was supposed to make things better. And it did. ... But violence has risen at three of the four hospitals covered by the treatment plan (Jaffe, 4/8). 

Minneapolis Star Tribune: Autism Payments Are Under Scrutiny
The state's practice of paying for intensive autism therapy for some children, but not others, has come under legislative scrutiny. Rep. Jim Abeler, R-Anoka, introduced legislation Wednesday calling on the commissioner of human services to review a policy that critics have called a double standard. The Star Tribune reported earlier this week that the state Medicaid program has subsidized a costly and intensive autism treatment for some affluent families while denying it to low-income children in its managed-care plans. The treatment, known as Applied Behavior Analysis, can cost up to $100,000 a year (Lerner, 4/7).

California Healthline: First Exchange Board Meeting Within 'Couple of Weeks'
Just because California doesn't have a full board for the Health Benefits Exchange doesn't mean it can't get to work. "As long as we have a quorum, we can meet," exchange board member Kim Belshé said yesterday. "And we expect to meet in the next couple of weeks, whether we have that fifth person or not." ... The new exchange board also needs to pick an interim executive officer, and hire the exchange's executive director (Gorn, 4/7).

The Connecticut Mirror: State Gets Federal Grant For Care Coordination
The state has received a $1 million federal grant to develop a system for coordinating care for seniors and adults with disabilities who are covered by both Medicaid and Medicare. People covered by both programs, known as "dual eligibles," make up 19 percent of the state's Medicaid beneficiaries but 58 percent of the program's expenses (Levin Becker, 4/7). 

Denver Post: "Hospice" Home Under The Radar
Three years ago, the state of Colorado shut down an assisted-living home in Arapahoe County for endangering the lives of its elderly residents. Yet Colorado law then allowed the owner to take in two new residents at a time, operate the same house with no supervision and charge as much as $5,000 a month for unregulated "hospice" care. That's exactly what Lois Huffman did. In four months of 2009, two women died in Huffman's unlicensed home. No autopsies were performed by the Arapahoe County coroner, which assumed both died in a state-approved facility. Last year, Huffman was charged with felony theft after a third resident discovered her credit card had been used for water and phone bills, in-flight TV charges, and a hotel room in Connecticut (Olinger, 4/8).

The Arizona Republic: Brewer Signs Off On A Slashed Budget
Arizona's $8.3 billion budget for the next fiscal year is now law. Gov. Jan Brewer on Thursday announced that she had signed the budget package late Wednesday, calling the plan "a milestone on the road to recovery." ... She proposes to freeze enrollment in the Arizona Health Care Cost Containment System, require co-pays from patients, and cut reimbursement rates for doctors, hospitals and other health-care providers. The budget cuts $500 million from AHCCCS, although many of the savings are contingent on federal approval of a reform package Brewer submitted to Washington, D.C., last week. Her signing letter made no reference to the transplant program, which was cut in October. Brewer spokesman Matthew Benson said Thursday that, with the budget now signed into law, that coverage is reinstated (Pitzl, 4/8).

The Atlanta Journal-Constitution: Tech Upgrade Critical To Handling Medicaid Expansion
A $100 million effort to upgrade the state's antiquated Medicaid enrollment system is vital to Georgia's ability to handle potentially hundreds of thousands of new enrollees when the program expands in 2014, officials say. Replacing the outdated technology that helps caseworkers determine eligibility will also make the process speedier and easier for applicants, who will be able to apply online, said Jon Anderson, Medicaid deputy chief with the state Department of Community Health. The goal is to eliminate any barriers and make sure people get sent to the right programs the first time around, he said (Williams, 4/7).

The Wichita Eagle: Ideas Abound For Changing Medicaid System
Coverage of stomach-bypass surgery for the chronically obese; increased use of technology to deliver medical care; integrating health, housing and other services for the frail elderly; ending coverage for circumcision. Those are among 120 suggestions the state has received in response to a call for ideas for reforming the Medicaid system in Kansas. The ideas submitted by the public and by health care providers form the groundwork for a series of meetings and discussions to be held this summer, said Lt. Gov. Jeff Colyer. The goal is to build a comprehensive plan to improve services while cutting costs in the system that provides care for poor, elderly and disabled Kansans, he said (Lefler, 4/8).