First Edition: May 14, 2013

May 14 2013

Today's headlines include reports about an Obama administration plan to delay Medicaid DSH payment reductions.

Kaiser Health News: Hospitals, Testing Companies Face Questions About Value Of Community Screenings
Kaiser Health News staff writer Julie Appleby, working in collaboration with The Washington Post, reports: "Hospitals hoping to attract patients and build their brands are teaming up with medical-screening companies to promote tests aimed at consumers worried about potentially deadly heart disease or strokes. What their promotions don't say is that an influential government panel recommends against using many of the tests on people without symptoms or risk factors" (Appleby, 5/13). Read the story.

Kaiser Health News: Insuring Your Health: Coverage Problems Could Still Remain For Young Adults
Kaiser Health News consumer columnist Michelle Andrews writes: "Supporters and critics of the Affordable Care Act seem to agree on at least one thing: Allowing young adults to stay on their parents' health plans until they reach age 26 is a smart move. The change, which took effect in the fall of 2010, has resulted in more than 3 million young people gaining health insurance" (Andrews, 5/14). Read the column.

Kaiser Health News: Capsules: CMS Won't Penalize Hospitals In States Slow To Expand Medicaid
Now on Kaiser Health News' blog, Phil Galewitz writes: "That sigh of relief you heard Monday was from hospital administrators in nearly two dozen states, including Florida and Texas. That's because the Obama administration announced that for the next two years, it doesn't plan to penalize states that have yet to expand Medicaid coverage under the federal health law by targeting them for reduced Medicaid funding, according to a proposed rule unveiled Monday. That money goes to  hospitals that treat large numbers of poor people" (Galewitz, 5/14). Check out what else is on the blog.

Los Angeles Times: GOP Slams Fundraising, Other Efforts To Promote Obama Health Law
Congressional Republicans have opened a new line of attack on President Obama's healthcare law, charging that the administration has improperly sought help from the healthcare industry and other outside groups to implement the landmark statute. Health and Human Services Secretary Kathleen Sebelius for months has been asking foundations, consumer and business groups, insurance companies and others to help enroll uninsured Americans in health insurance this fall, a key goal of the Affordable Care Act. Administration officials say those actions were entirely appropriate (Levey, 4/13).

The Wall Street Journal: Doc-Owned Hospitals Prep To Fight
The Affordable Care Act aimed to end a boom in doctor-owned hospitals, a highly profitable niche known for its luxury facilities. Instead, many of the hospitals are wiggling around the federal health-care law's growth caps and even thriving. The law, passed in 2010, blocked building any new physician-owned hospitals and prevented existing ones from adding beds or operating rooms in order to qualify for Medicare payments. The drafters wanted to clamp down on a sector that some policy experts contend is prone to perform unnecessary procedures at high prices, driving up overall health spending (Mundy, 5/13).

Politico: W.H. Plans To Delay Medicaid DSH Payment Cuts
The Obama administration has proposed delaying a potentially painful decision on whether to penalize states that refuse to expand Medicaid coverage for low-income populations under Obamacare. The national health care law calls for a gradual reduction in special federal payments -; known as Disproportionate Share Hospital or DSH payments -; to hospitals that take care of large numbers of uninsured patients. The idea of reducing the DSH payments, which totaled $11.3 billion in 2011, was tied to the fact that the health law's coverage expansion would reduce the burden on hospitals. If more people get covered, the hospitals should have to provide less uncompensated care (Millman, 5/14).

The Wall Street Journal: Health Officials Detail Payment Cuts For Uninsured
The Obama administration on Monday published a plan for cuts in payments for hospitals that treat many uninsured patients and said states that decline to expand their Medicaid programs under the 2010 health law won't get preferential treatment. The federal government currently sends about $11 billion a year to states to help cover the costs of uncompensated care. The health law called for cuts in those payments, assuming that most Americans would have insurance coverage after the law took effect (Radnofsky, 5/13).

The Associated Press/Washington Post: Hospitals Could Lose $500M In Federal Money To Pay For Uninsured In 2014
Hospitals nationwide could lose half a billion dollars in federal funding meant to offset the cost of covering the uninsured next year. The loss that will be especially felt in states where lawmakers have decided against expanding Medicaid coverage (5/13).

The Associated Press/Washington Post: Faith Leaders To Gather For Summit To Learn About New Health Options
Maryland faith leaders will be gathering for a summit to learn more about new health insurance options under the federal health care overhaul. Maryland Department of Health and Mental Hygiene Secretary Joshua Sharfstein is scheduled to speak at Tuesday's event in Baltimore (5/13).

The Washington Post: D.C. Nears Decision On Health Insurance Exchange
The D.C. Council could decide as soon as next week whether to require small-business owners to purchase their employee health insurance through a city-run exchange, highlighting a special implication of the federal health-care overhaul that has been strongly opposed by some business interests (DeBonis, 5/13).

Politico: DOJ Appeals For Stay Of Plan B One-Step Order
The federal government's legal fight over the availability of emergency contraception is heating up at the next level in the courts. The Department of Justice is seeking a delay in compliance with a district court order requiring the Food and Drug Administration to make emergency contraception available over the counter without age restrictions while it appeals that decision (Smith, 5/14).

The Wall Street Journal: Health-Policy Move Widely Shared
More people than previously thought predicted a major change in U.S. health-care policy that led to a federal insider-trading probe, according to new documents assembled by congressional investigators. Justin Simon, a policy analyst with Height Securities, said in a previously unreported email that was reviewed by The Wall Street Journal that he heard about the policy change before it was made official from "like 30 people." Mr. Simon sent an alert to Wall Street traders just before markets closed April 1, sending health-insurance stocks on a tear (Mullins and McGinty, 5/13).

The Associated Press/Washington Post: Subsidiary Of Indian Drug Maker Agrees To Pay Record $500 Million US  Penalty For Impure Drugs
A subsidiary of India's largest pharmaceutical company has agreed to pay a record $500 million in fines and penalties for selling adulterated drugs and lying to federal regulators in a case that is part of an ongoing crackdown on the quality of generic drugs flowing into the U.S. Federal prosecutors say the guilty plea by Ranbaxy USA Inc. represents the largest financial penalty against a generic drug company for violations of the Federal Food, Drug and Cosmetic Act, which prohibits the sale of impure drugs (5/13).

The Wall Street Journal: Autism Center Is Set To Target Need
Children and adults with autism will begin arriving this month at a new autism center tucked into a 214-acre mental-health campus in Westchester County, which promises to help provide an answer to the piecemeal care currently available to many. The center, run by NewYork-Presbyterian Hospital and the medical schools at Cornell and Columbia universities, attempts to address what experts say is a significant challenge: autism rates are rising around the country but access to treatment lags well behind (Kusisto, 5/13).