Roundup: Ore. insurance CO-OP readies coverage; N.J. Medicaid liabilities hurt state's fiscal outlook; Wis. AG appeals collective bargaining ruling

Sep 20 2012

A selection of health policy stories from New Jersey, Oregon, California, Wisconsin, Georgia, Minnesota, New York, Texas, Kansas, North Carolina and Indiana.

The Lund Report: Freelancers CO-OP Of Oregon Partners With Providence Health System
Independent workers -- artists, journalists, information technology professionals, craftsmen and even those who earn their living buying and selling on eBay -- will soon have the ability to buy health coverage without having to dicker with a privately-run insurance company such as Regence BlueCross BlueShield. ... people can sign up when enrollment opens for the health insurance exchange in October 2013. The CO-OP anticipates having up to 40,000 members by the end of 2015, and has entered into a partnership agreement with Providence Health System to provide the network of physicians and hospitals throughout the state and handle claims administration and medical management (Lund-Muzikant, 9/18).

The New York Times: Christie's Budget Faulted As Fiscal Outlook Is Called Weak
The ratings agency said it lowered its outlook because it believed the governor's revenue projections for the current fiscal year were overly optimistic, warning that the budget was structurally unsound. In particular, the agency took note of the administration's reliance on one-time transfers of money to fill gaps in the state's $32 billion budget. At the same time, it noted that the state will have to spend more in the coming years to meet pension and Medicaid obligations (Zernike, 9/18).

The Associated Press/Washington Post: Wisconsin Attorney General Appeals Union Law Ruling, Asks Judge For Stay
Wisconsin's attorney general on Tuesday appealed a court ruling repealing major parts of Gov. Scott Walker's law effectively ending collective bargaining for most public workers. … The law as passed by the Republican-controlled Legislature in 2011 applied to all public employees except police, firefighters, local transit workers and emergency medical service employees. It limits collective bargaining on wage increases to the rate of inflation. Other issues, such as workplace safety, vacation and health benefits, were excluded from collective bargaining (9/18).

Los Angeles Times: Brown Signs Bill Revamping Workers' Compensation Insurance
Approved by the Legislature on the last night of the legislative session, the package would boost payments to permanently disabled victims of on-the-job accidents by about $740 million a year and hand employers a major break on workers' compensation insurance premiums (Castellanos, 9/19).

Georgia Health News: Hemophilia Program Could Get The Budget Ax
Through a state contract, Hemophilia of Georgia is helping dozens of patients get or keep health insurance and lifesaving medication for the inherited bleeding disorder. The money "saves lives and saves money," said Jeff Cornett of Hemophilia of Georgia. He noted Tuesday that an uninsured patient with hemophilia can run up huge emergency room bills. But the state's Department of Public Health, in budget recommendations released last week, would eliminate that hemophilia funding next fiscal year (Miller, 9/18).

(St. Paul) Pioneer Press: Blue Cross Forms New Insurance Option With Allina Health System
Health insurers in Minnesota are jumping on the ACO bandwagon. … On Tuesday, Eagan-based Blue Cross and Blue Shield of Minnesota announced a similar product in conjunction with the Minneapolis-based Allina Health System. Blue Cross didn't use the term "ACO" in describing its product -- called Blue Choice featuring the Allina Health Network -- but the description makes sense, said Garrett Black, the company's senior vice president of health management (Snowbeck, 9/18).

Modern Healthcare: Montefiore Forms ACO With Empire Blues In N.Y.
Montefiore Medical Center, New York, has entered into an accountable care agreement with Empire Blue Cross and Blue Shield, New York, the organizations announced. The accountable care agreement will cover fully insured Empire enrollees in New York's Bronx and Westchester counties and Montefiore's employees, according to a news release. Montefiore will be eligible to receive shared-savings payments tied to quality and efficiency targets and a capitated care management fee, said John Caby, vice president of provider engagement and contracting for Empire (Evans, 9/18).

The Dallas Morning News: One-Day Free Clinic At Convention Center Will Serve Dallas-Area Uninsured
For one day next week, hundreds of medical volunteers hope to see and treat some of the thousands of uninsured Dallas-Fort Worth area residents at a free clinic at the Dallas Convention Center. How many people they help depends on how many volunteer health care workers they can round up between now and then. "We have the ability to put their minds at ease," said Nicole Lamoureux, executive director of the National Association of Free and Charitable Clinics. "Just getting them connected to a doctor and to the help they need takes so much worry off their shoulders" (Rosales, 9/18).

Kansas Health Institute News: Kansas REC To Be Spun Off As Independent Non-Profit, Synovim
The regional extension center created two years ago to help Kansas health care providers implement electronic patient records is to be spun off over the next year by its parent organization, the Kansas Foundation for Medical Care. The new non-profit consulting firm -- called Synovim -- will absorb all 15 staff members from the Kansas Regional Extension Center by the time the REC's federal funding runs out September 30, 2013, said REC director Michael Aldridge. Aldridge, who has been named Synovim's chief executive, said that setting up a firm that's wholly independent of KFMC will allow his staff to collect fees for its services without putting KFMC in a position of receiving payments from providers that it's charged with monitoring (Cauthon, 9/18).

North Carolina Health News: Opening Doors To Housing For The Mentally Ill
Four years ago, Nancy ended up in the hospital with pneumonia. While there, she received steroids to reduce the fluid accumulation in her lungs. The steroids made her psychotic, a common side effect. ... Last week, the Housing Subcommittee of the Blue Ribbon Commission on Transitions to Community Living met for the first time to start the work of creating, over the coming decade, more than 3,000 housing units throughout the state for people with mental health problems. Those housing units will need to be accompanied by more community programs to help people with mental health problems stay out of the hospital (Hoban, 9/18).

The Associated Press: S. Ind. Physician Sentenced For Health Care Fraud
A Bloomington physician has been sentenced to 3 1/2 years in prison after pleading guilty to federal charges of unlawful drug distribution and health care fraud. Kamal Tiwari was also sentenced Tuesday to three years of probation and ordered to pay $1.3 million in restitution to Medicare, Medicaid and Anthem Blue Cross (9/18).