Roundup: N.J. seeks to recover $10M from adult day care centers after Medicaid bills; Ga. panel to implement provider fee picked; Pa.'s adultBasic in limbo after ruling

Mar 7 2013

A selection of state health policy stories from New Jersey, Arizona, Georgia, Oregon, Pennsylvania and Colorado.

The Associated Press: NJ Comptroller's Office Faults Adult Day Care
A state agency that serves as a watchdog over New Jersey government announced Wednesday that it has found improper billing of Medicaid by five adult day care centers and is asking the centers to pay settlements totaling more than $10 million. The state comptroller's office found that centers were charging the state for caring for patients when they did not receive care in some cases and for providing care that was not needed in others (3/6).

Georgia Health News: Deal Picks Panel To Oversee Provider Fee
Gov. Nathan Deal has appointed a committee to oversee implementation of the provider fee, the financing mechanism for Medicaid that's expected to fill a hole of more than $400 million in the program's budget. Deal recently signed the fast-tracked legislation that facilitated the renewal of the fee, known among critics as a "bed tax."' The oversight panel will consist of six hospital representatives -- three from hospitals that have been "winners" under the current fee formula, and three from "losing" hospitals. The amount currently raised from hospitals is returned to the hospital industry through reimbursements. Individual hospitals get different amounts based on how much Medicaid business they do, so that some hospitals come out ahead under the formula while others lose money (Miller, 3/6).

Philadelphia Inquirer: Uncertainty For Thousands, Corbett After Judge's Health Ruling
Natalie Ross, who is prone to bronchitis, can tell you how her life is different without adultBasic: She put off seeing a doctor in January until her cough got so bad she was almost throwing up. With medication, the cough is better but still there. Her new health insurance covers just four office visits a year. … A judge's decision Tuesday has drawn renewed attention to the plight of Ross and 40,785 other Pennylvanians, most of them in low-income jobs, whose state-funded adultBasic health insurance ended two years ago when Gov. Corbett declined to pursue new funding for the program, saying it was unsustainable (Sapatkin and Worden, 3/7).

Georgia Health News: Health Care Regulatory Changes Fail To Advance
Proposed changes to Georgia's health care regulatory process hit a dead end in a House committee Wednesday, but only after a four-hour hearing that exposed a longstanding divide between physicians and hospitals. The House Health and Human Services Committee debated one bill that would exempt multi-service outpatient surgery centers owned by physicians from the state regulatory process, and then a second bill that would exempt standalone pediatric emergency rooms. The panel adjourned without taking a vote on either House Bill 279 or House Bill 404. Thursday is Crossover Day, the deadline for a bill to be passed by at least one chamber of the General Assembly or lose its chance of becoming law this session. So the two House bills are effectively dead until next year, except in the unlikely event that one of them is attached to legislation that has already moved forward (Miller, 3/6).

Kaiser Health News: In Conservative Arizona, Government-Run Health Care That Works
In a low-slung building in the vast desert expanse east of Phoenix, a small school of tropical fish peer out, improbably, from a circular tank into the waiting lounge of the Apache Junction Health Center. The hallways of the nursing home are still. Only half of the rooms are filled, and the men and women who live here seem surely in life's final season. 'These are folks that have chronic cognitive and physical disabilities that are not going to improve,' said George Jacobson, administrator of the nursing home (Varney, 3/7).

The Lund Report: Nurse Practitioners And Physician Assistants Put Forth Pay Equity Bill
A few years ago, private insurers cut the rates that they pay to nurse practitioners and physician assistants by as much as 25 percent and began paying them less than doctors for the same basic services. That's made it hard for physician assistants like Edwin Weih to leave the lights on at Five Rivers Family Practice where overhead for the clinic is the same regardless if it employs a full physician and a physician assistant. ... Nurse practitioners and physician assistants are getting another try at pay equity this session after legislation demanding that commercial insurers compensate them the same as doctors for the same services failed to pass the last two sessions (Gray, 3/6).

The Associated Press: Legislature Tackles Salem Medicaid Dispute
The Oregon Legislature is stepping into a conflict between Salem Hospital and the local coordinated care organization in charge of providing health coverage for low-income patients on Medicaid. The state Senate on Wednesday unanimously approved a measure creating a mediation process that might help resolve the Salem dispute and any other conflicts that may arise between CCOs and health-care providers (Cooper, 3/7).

Oregonian: Bill Offering Mediation For Medical Errors Passes State Senate Easily
A bill that makes it easier to use mediation instead of lawsuits to address medical errors easily passed the Oregon Senate today. Senate Bill 483 passed 26-3 and is now headed for the House. During floor debate, supporters said the measure could give patients and their families better ways to resolve grievances ithan filing malpractice lawsuits. Sen. Elizabeth Steiner Hayward, D-Portland, said she's been party to a frivolous lawsuit before, and the bill would ease an adversarial culture around medical errors, one "that's tearing us apart." Sen. Larry George, R-Sherwood, called the bill a good first step to addressing policies that hurt patient care. "Real decisions are being made that affect people's lives," George said (Budnick, 3/5).

Health Policy Solutions (a Colo. news service): Colorado Bill Aims To Keep Guns Away From People During Mental Illnesses
Colorado lawmakers plan to introduce legislation by next week to make it harder for people with mental illnesses to buy guns. The legislation, which does not yet have a bill number, marks the last of several measures that Democrats are sponsoring this year to try and curb gun violence in the wake of the Aurora theater shootings and the massacre at Sandy Hook Elementary School. The other bills include measures to limit magazines to 15 rounds, require background checks on all gun transactions, limit guns on campuses and require gun buyers to pay for their own background checks (Kerwin McCrimmon, 3/6).