State news: Mass. seeks Medicaid waiver extension; Calif. payment reform

Dec 3 2011

A selection of health policy stories from California, Georgia, Texas, Colorado, Massachusetts and Louisiana.

Bloomberg: Texas Kicks 5% of Dependents Off State Health Plan Found to Be Ineligible
The Employees Retirement System of Texas removed about 5 percent of those receiving state health benefits as dependents after they couldn't prove their rights to get the aid, the pension plan said in a report, citing an audit. Health care cost the $23.6 billion fund $2.29 billion in fiscal 2011 (Mildenberg, 12/2).

Boston Globe: State Officials Request Another Medicaid Waiver Extension
Despite more than six months of negotiations, state officials and the Obama administration still don't see eye to eye on federal funding for the state's safety-net hospitals, which care for many of the remaining uninsured patients in Massachusetts. This week, Massachusetts Health and Human Services Secretary Dr. JudyAnn Bigby requested another extension of the state's so-called Medicaid waiver -- until Dec. 31 -- to give the two sides more time to negotiate a new agreement. The waiver is crucial to the success of the state's mandatory health insurance law (Kowalczyk, 12/1).

San Francisco Chronicle: Judge Grants Reprieve To 372,000 On Cuts In In-Home Care
A federal judge has apparently granted at least a temporary reprieve to 372,000 elderly and disabled Californians who faced a 20 percent cut in their in-home care on Jan. 1. U.S. District Judge Claudia Wilken of Oakland issued a temporary restraining order Thursday that prohibits the state from taking any immediate steps to carry out the reductions -; in particular, from mailing out notices to all recipients, starting next week (Egelko, 12/1).

California Healthline: California Leading Payment Reform Effort
Steve McDermott is a physician, but it's his role as patient that makes him an expert on payment reform, he said. "I had hip replacement surgery ... The cost is about $70,000 -; not including surgery," McDermott said. ... [He] is CEO of Hill Physicians Medical Group in Sacramento. ... The Hill group has taken a new tack with payments, McDermott said. Faced with competition from Kaiser Permanente, it decided to pilot a pay-for-performance model of care and to draw a line on premium cost (Gorn, 12/2).

Georgia Health News: Medicaid Anti-Fraud Effort Shows Success
Georgia's Medicaid fraud unit recovered $57 million last fiscal year, the largest amount ever, a state official says. Part of the reason for the higher collections is the fact that Georgia is now getting more money from settlements involving pharmaceutical companies, produced in joint investigations with other states and the federal government. The state also has enhanced data-mining capability to detect cases of fraud and improper billing (Miller, 12/1). 

Denver Post: Five Competing Bids Made For Colorado Springs Memorial Hospital
Bids to run Colorado Springs' city-owned Memorial Hospital were opened Thursday, with major systems such as Sisters of Charity of Leavenworth and HealthOne dangling hundreds of millions of dollars. ... A Colorado Springs task force unveiled five competing bids for Memorial's future (Booth, 12/2).

Denver Post: CenturyLink Will Let Union Review Books After Retirees Bemoan Skyrocketing Health Premiums
CenturyLink has agreed to open its books to the Communications Workers of America, which sought access to the financial records last month after the company blindsided some retirees with health care premium hikes of up to three times for 2012. "We have an independent actuary that's actually going to run through the numbers," said CWA District 7 spokesman Al Kogler, adding that the review is expected to take weeks (Vuong, 12/2).

Houston Chronicle: UTMB Reaches Tentative Deal With TDCJ
The Texas prison system and the University of Texas Medical Branch in Galveston have reached a tentative agreement on a $430 million contract calling for UTMB to continue providing health care for prisoners through August 2012. ... [UTMB's] officials have complained for at least two years that the medical school on Galveston Island has been losing money on its contract with the Texas Department of Criminal Justice (Tolson, 12/1).

Boston Globe: City Puts Restriction On Use Of E-Cigarettes
Boston health officials voted yesterday to treat electronic cigarettes, known as e-cigarettes, like tobacco products, banning use of the increasingly popular products in the workplace and restricting their sale to adults only. ... The Boston Public Health Commission also prohibited the sale of individual cigars, which, health officials say, have become an attractive option for teenagers looking for less expensive alternatives to cigarettes (Lazar, 12/1).

New Orleans Times-Picayune: 39 Lawyers Fight To Keep Records Secret In Memorial Medical Center Case
A state probe into whether 34 patients were euthanized at Memorial Medical Center after Hurricane Katrina has been dormant for years and the public should get to see the records of the investigation, an attorney for The Times-Picayune argued in court Wednesday. ... The key issue in the case is a state law allowing prosecutors to keep secret records in criminal cases where prosecution is "pending or reasonably anticipated" (12/1).