Roundup: No new policies from cross-border insurance law; Dental Medicaid abuse in Texas?

Apr 12 2012

News outlets across the country report on a variety of health policy issues.

Georgia Health News: Out-Of-State Insurance Law Does Nothing Yet
Proponents said these out-of-state policies, stripped of Georgia's mandates, would have lower premiums – and allow more people to afford individual health insurance coverage. ... But a year later, nothing has happened. No insurer here has started selling a non-Georgia health plan. ... Experts speculate that health insurers, here and elsewhere, have their focus squarely on the pending Supreme Court decision on the 2010 federal health care (Miller, 4/11). 

The Associated Press/Wall Street Journal: NY Auditors Cite Medical Insurance Overpayments
State auditors say the New York State Health Insurance Program erroneously paid up to $11 million for special items like implants, drugs and evaluation procedures for public employees ... contract insurers Blue Cross and Blue Shield and United Health Care failed to effectively monitor bills (4/11).

Boston Globe: Mass. To Save $91M In Health Insurance Costs
Massachusetts will save approximately $91 million -- and thousands of residents who receive state-subsidized health insurance will keep the same benefits with no co-payment increases -- thanks to renegotiated contracts with insurers, regulators announced Wednesday. ... Commonwealth Care is the Health Connector's health insurance program for uninsured adults who meet income and other eligibility requirements (Lazar, 4/12).

Boston Globe: Health Advocates Say New Fund Needed To Improve Public Health In Massachusetts
A coalition of Massachusetts health advocates and civic leaders is lobbying for a new pool of money, possibly funded by a tax on insurers, that would pay for programs to stem preventable illnesses such as diabetes, asthma, and heart disease that are fueling medical costs. Under the plan, insurers would be assessed a tax on what they now pay each year to cover the hospital bills of their subscribers (Lazar, 4/12).

The Dallas Morning News: Texas Board Says It's Falling Short In Regulating Bad Dentists
The agency that polices Texas dentists told lawmakers Wednesday that it doesn't have enough resources or legal authority to crack down on careless and abusive dentists. An advocacy group led the charge against the Texas State Board of Dental Examiners, telling a legislative panel that the regulatory board doesn't do enough to discipline bad dentists or alert the public which dentists have been sanctioned (Ingram, 4/11).

The Texas Tribune: Texas Dental Board Is Accused Of Ineptitude
The clinics in question often serve only Medicaid patients and pay one dentist to act as a prop by claiming ownership. The real owners of the clinics -; usually private equity firms -; are in the dental business for profit, and encourage overutilization of Medicaid services by dictating a "one-size-fits-all treatment plan" or setting quotas for the number of procedures that dentists should perform, said [the Texas Dental Association's Richard] Black (Aaronson, 4/12). 

Stateline: Computer Matching System Could Limit Safety Net 'Double Dipping'
States could cut costs by millions of dollars a year if they took full advantage of a computerized matching system that can determine whether people are getting welfare, food stamps and other public assistance in more than one state at a time. ... The process, called Public Assistance Reporting Information System (PARIS), is a set of computer matches that relies on Social Security numbers and other personal data. ... New York, for example, saved an estimated $65 million in 2011 by removing more than 12,000 people from its welfare and food stamps programs, based on PARIS matches (Prah, 4/12).

Earlier, related KHN coverage: Different Takes: Shifting Vets From Medicaid To The VA Is A Win-Win (11/9/11).  

St. Louis Beacon: Insurance Consortium Keeps Costs Down For County Municipalities
While competition, usually for shopping centers, may grab the headlines, the 90 municipalities of St. Louis County actually cooperate in many ways, some of which are largely invisible to residents. ... the St. Louis Area Insurance Trust may be one of the most important ways cities have come together to help each other. ... Although Missouri has its own insurance purchasing pool, founding members felt that their needs would be better served by joining forces with similar cities (Davidson, 4/11).

Kansas Health Institute News: KanCare Bidder Settles With U.S. Justice Department
A company that is among the five bidding on the state's Medicaid managed care contract has agreed to pay $137.5 million to settle claims it defrauded Medicaid programs in nine states. The U.S. Department of Justice announced the settlement with WellCare Health Plans Inc. last week. ... WellCare officials said the settlement wiped the slate clean for the company (Ranney, 4/11). 

California Healthline: 'It Can Be Costly To Treat CCS Kids'
Assembly member Cathleen Galgiani (D-Tracy) is well aware of the budget crisis in California. But she's also aware of another crisis in children's hospitals, she said. "It can be costly to treat CCS (California Children's Services) kids," Galgiani said. "All we're asking is for the state to use the CMAC rate for reimbursement. This bill would clarify that rate." The CMAC rate is a hospital rate of reimbursement negotiated by the California Medical Assistance Commission. It was the standard for reimbursement before last year's cuts (Gorn, 4/12). 

Los Angeles Times: California Workers' Comp Overhaul Effort Is Stirring
The two biggest players in California's workers' compensation system -; labor unions and large employers -; are quietly crafting the biggest overhaul of the mandatory insurance program in a decade. The goal: provide more care to injured workers without raising premiums for businesses (Lifsher, 4/12).