State highlights: Blue Shield could lose exclusive contract for Calif. workers, retirees; Texas health commission asks for increase in Medicaid premiums

Apr 12 2013

A selection of health policy stories from California, Texas, Oregon, Florida and Minnesota.

Los Angeles Times: Blue Shield May Lose Exclusive CalPERS HMO Contract
Blue Shield of California may be losing its longtime grip on one of the health care industry's most coveted insurance contracts. Officials at the California Public Employees' Retirement System are recommending breaking up Blue Shield's current statewide HMO contract and replacing it with as many as four health plans for more than 400,000 public workers and their families (Terhune, 4/11).

The Texas Tribune: Proposal To Raise Medicaid Rates Could Affect Budget
The Health and Human Services Commission has requested that state lawmakers increase Medicaid premium rates -- the amount paid to managed care companies to provide health services for Medicaid recipients. The state's budget leaders are currently evaluating the proposal, which could have a significant impact on the 2014-15 budget (Aaronson, 4/10).

Los Angeles Times: L.A. Jury Sides With Doctor In Anthem Blue Cross Case
In a rare case, a Los Angeles jury awarded $3.8 million in compensatory damages to a Porter Ranch doctor who contended insurance giant Anthem Blue Cross retaliated against him for being a strong patient advocate. The jury ruled late Monday in favor of Jeffrey Nordella, 58, an urgent-care and family-practice doctor who alleged that Anthem barred him from its network in 2010, when he applied to be a preferred provider. The damages could climb higher Friday, when the 12-person panel reconvenes and considers punitive damages against Anthem, a unit of insurance giant WellPoint Inc (Terhune, 4/10). 

The Lund Report: Senate Bill 823 Outlines Courtney's Vision For Mental Health
[Oregon] Senate President Peter Courtney, D-Salem, teamed up with Sen. Brian Boquist, R-McMinnville, on Tuesday to press for Senate Bill 823, a broad-sweeping set of policy guidelines aimed at providing more comprehensive and proactive community mental health across the state of Oregon. Courtney spoke passionately once more before the Senate Health Committee about the need to facilitate mental health services, particularly for young people. He specifically called out the EASA or Early Assessment and Support Alliance program, which provides early intervention for adolescents and young adults who are suffering through a psychosis (Gray, 4/10).

The Texas Tribune: House Panel Debates "Fetal Pain" Bill
The House State Affairs Committee on Wednesday took testimony on the controversial so-called fetal pain bill, a measure backed by Gov. Rick Perry and abortion opponents who argue that 20 weeks is the point at which fetuses can feel pain. House Bill 2364, by state Reps. Jodie Laubenberg, R-Parker, and Jeff Leach, R-Plano, would prohibit abortions after that point (Aaronson, 4/10).

Health News Florida: AIDS Advocates Petition Lawmakers For Sustained Funding
Hundreds of people with HIV and their supporters descended on the capitol complex Tuesday for an all-day conference to learn about the state of HIV policy in North Carolina and to ask their legislators for support. Many said that the release of Gov. Pat McCrory's budget last month had given them a sense of urgency to visit Raleigh. The budget proposed to cut $8 million in funding for the AIDS Drug Assistance Program (ADAP) that provides access to anti-retroviral drugs for low-income patients with HIV (Hoban, 4/10).

MinnPost: Minnesota's Independent Doctors Are In Critical Condition
But the most unusual thing about Metropolitan Internists is its independence. The doctors own the practice, govern it, and love being their own bosses. ... A powerful combination of forces, mostly by for-profit entities, has been squeezing physician-owned practices. The result is their absorption by larger organizations, often large hospitals or other "Big Med" entities. Alternately, some independent practices collapse when a key physician retires or leaves. Why should you care? Minnesota has the best- performing health care system in the country, according to a recent report from the Agency of Healthcare Research and Quality. And comparing quality and costs at independent practices versus Big Med clinics offers no clear answers about superiority. But one recent study suggests that generally, independent practices outperform those owned by hospitals (Beal, 4/10).

California Healthline: Assembly Bill Would Keep Adult Day Program Going
It was a watershed moment for state officials and senior health advocates in March, 2012 when California launched the Community Based Adult Services (CBAS) program, borne of a lawsuit settlement. It was an effort that calmed political waters and dealt with the 35,000 frail and elderly Californians who had been part of the eliminated program for adult day health services. Yesterday, the Assembly Committee on Health took up the subject again, in the form of AB 518 by Assembly member Mariko Yamada (D-Davis). The bill would codify the CBAS program, ensuring that it cannot be dropped when state health officials eventually renew the federal waiver that spawned it (Gorn, 4/10).