First Edition: Aug. 12, 2013

Aug 12 2013

Today's headlines include reports about state action on the health law's implementation and other news from the health insurance marketplace.

Kaiser Health News: How Poor Might Qualify For Obamacare Subsidies In States That Don't Expand Medicaid
Kaiser Health News staff writer Phil Galewitz reports: "Some of the millions of poor people expected to lose out on Obamacare coverage next year because their states are not expanding Medicaid might have a way to get help, but the strategy carries risk. Experts say the key is for them to project their 2014 income to at least the federal poverty level, about $11,500 per person or $23,500 for a family of four" (Galewitz, 8/11). Read the story.

Kaiser Health News: Capsules: More High-Deductible Plan Members Can't Pay Hospital Bills
Now on Kaiser Health News' blog, Jay Hancock writes: "As employers and insurance companies shift more health costs into workers' pockets, hospitals are making a discovery. The pockets aren't bottomless" (Hancock, 8/12). Check out what else is on the blog.

Kaiser Health News also tracked weekend health policy headlines, including the Sunday news programs' discussions about the health law's implementation during Sunday's morning news programs (8/11).

USA Today: States Scramble To Drive Down Medicaid Drug Costs
A little-known provision of the 2010 health care law has states and their governors scrambling to take advantage of potential savings in how states distribute medication to Medicaid patients. The Affordable Care Act (ACA) allows states to receive drug rebates even if they move their Medicaid prescription benefit to managed-care organizations. The federal government has also asked states to fix the wide disparities in dispensing costs for drugs distributed through Medicaid (Kennedy, 8/11).

The Washington Post: Uninsured Will See Differing Levels Of Help For Obamacare In Maryland, Virginia, D.C.
Maryland consumers who want to buy health insurance under Obamacare in the fall will be able to read glossy fact sheets that spell out the law in simple language. Or talk to one of 325 specially trained workers who will explain the intricacies and help them enroll. Or get information via Facebook, Twitter and YouTube. In Virginia, it's a different story. People can seek assistance from about two dozen special guides. Or they can go to their state legislators, who might refer them to phone numbers and Web sites operated by the federal government (Sun, 8/9).

The Wall Street Journal: Oregon To Debug Insurance Exchange
Oregon's health-insurance exchange-;the marketplace created by federal law to let consumers shop online for coverage-;will open for business on Oct. 1, but with a glitch: Consumers won't be able to access it online. Officials at Cover Oregon, as the exchange is called, said people will be able to use the new website at home by the end of October. They decided to limit access for two to four weeks while they debug the site, fixing flaws before opening it up to the general public (Weaver, 8/9).

Los Angeles Times: Health Insurance Ratings To Be Dropped From State Website
Californians shopping for health insurance in a new state-run market this fall may not see quality ratings for those health plans alongside the monthly price. To the dismay of consumer groups, state officials are dropping plans to post those insurance company ratings in their online enrollment system, which opens Oct. 1 under the federal healthcare law (Terhune, 8/9).

The Associated Press: Blue Cross Reaches Out Over Insurance Law Changes
Just down from the Target and Gander Mountain big-box stores and between a nail salon and dental office, North Carolina's largest health insurer opened its first retail store. It has some exercise offerings -; step aerobics classes and stationary bike workouts -; but for now, its main product is providing in-person information about changes coming in October with the health insurance overhaul law. Blue Cross and Blue Shield of North Carolina is opening half a dozen of these offices in strip malls statewide to first educate and then, starting in October, enroll consumers shopping for coverage because of the federal Affordable Care Act, also known as "Obamacare." Blue Cross affiliates in Florida and Pennsylvania have had similar stores open for years (Dalesio, 8/10).

The Wall Street Journal: Lost Amid Health Policies
People can only handle so much complexity. And few things in life seem more complex than the American health-care system. How complex? A new paper suggests that even those who have health insurance have a poor understanding of their coverage. Researchers commissioned two surveys of covered Americans and found that only 14% could explain all four key health insurance concepts: deductible, copay, coinsurance and out-of-pocket maximum. Only 11%, given all the necessary information, could calculate the cost of a four-day hospital stay to within $1,000 (Akst, 8/9).

The New York Times: Path To United States Practice Is Long Slog To Foreign Doctors
The involved testing process and often duplicative training these doctors must go through are intended to make sure they meet this country's high quality standards, which American medical industry groups say are unmatched elsewhere in the world. Some development experts are also loath to make it too easy for foreign doctors to practice here because of the risk of a "brain drain" abroad (Rampell, 8/11).

The Wall Street Journal: U.S. Probes Use Of Antipsychotic Drugs On Children
Federal health officials have launched a probe into the use of antipsychotic drugs on children in the Medicaid system, amid concern that the medications are being prescribed too often to treat behavioral problems in the very young. The inspector general's office at Department of Health and Human Services says it recently began a review of antipsychotic-drug use by Medicaid recipients age 17 and under. And various agencies within HHS are requiring officials in all 50 states to tighten oversight of prescriptions for such drugs to Medicaid-eligible young people (Lagnado, 8/11).

USA Today: FDA: New Voluntary Recall From Compounding Pharmacy
The Food and Drug Administration has announced a voluntary nationwide recall of all sterile products from a Texas compounding pharmacy, the latest in a series of recalls since last year's outbreak of fungal meningitis. Fifteen patients at two Texas hospitals have developed bacterial bloodstream infections after receiving injections from Specialty Compounding from Cedar Park, Texas, the FDA said Sunday (Szabo, 8/11).

Politico: Government Accountability Office Probing Planned Parenthood
Spurred by a group of anti-abortion lawmakers, the Government Accountability Office is investigating how Planned Parenthood, the Guttmacher Institute, and other prominent family planning-related organizations spend public funds, the GAO confirmed Friday. ... Chuck Young, GAO managing director of public affairs, said the scope of the investigation was still being determined, and no completion date had been set. Planned Parenthood Federation of America Vice President Eric Ferrero said in a statement that the move was not an investigation, but instead "a routine report by GAO in response to a request by opponents of Planned Parenthood in Congress" (Drusch, 8/9).

The Wall Street Journal: Medtronic Expands Into Disease Management
The $200 million, all-cash deal puts Medtronic in the business of working with hospitals and insurers to limit the costs of treating patients with chronic diseases, such as heart failure and diabetes, and gives it a hand in the care of patients who don't need costly, high-tech implantable devices that are Medtronic's core offerings (Weaver, 8/11).

The Wall Street Journal: MyFitnessPal App Gets Venture Backing
While Weight Watchers struggles to keep its membership rolls from shrinking, its upstart challengers are beefing up. The popular health-monitoring app MyFitnessPal LLC is getting $18 million in new funding from Kleiner Perkins Caufield & Byers and Accel Partners, a bet by the venture-capital firms that Americans are ready to take more control over monitoring their health. The investment values MyFitnessPal-;which claims 40 million users and is profitable-;at between $100 million and $120 million, a person familiar with the matter said (Ziobro, 8/12).

The Washington Post: Hundreds In D.C. Lost Medicaid Assistance Without Cause, Attorneys Say
The Washington Post found that the District cut 366 people from all or some of the services they may have been eligible to receive in the nine months ended March 2012, according to records on file at the D.C. Attorney General's Office. About a third of those people died, the office said. The District doesn't know how they died because the program doesn't get copies of death certificates, officials said (Campbell, 8/11).

Los Angeles Times: Oxycontin Maker Closely Guards Its List Of Suspect Doctors
Over the last decade, the maker of the potent painkiller OxyContin has compiled a database of hundreds of doctors suspected of recklessly prescribing its pills to addicts and drug dealers, but has done little to alert law enforcement or medical authorities. Despite its suspicions, Purdue Pharma continued to profit from prescriptions written by these physicians, many of whom were prolific prescribers of OxyContin (Glover and Girion, 8/11).

USA Today: New Abortion Restrictions Take A Digital Turn
The war over abortion is going digital. Missouri last month joined six other states that have enacted bans this year on abortion by telemedicine. That's a process in which women take pregnancy-ending medication that a doctor remotely administers during a video conference. The practice, available to women in their first nine weeks of pregnancy, is now prohibited in 11 states, according to the Guttmacher Institute, a research group that supports abortion rights (Railey, 8/11).

The New York Times: Two Firms Accused Of Using Political Ties To Bilk Medicaid
A Congressional committee released letters on Friday alleging that a pharmacy and a nutrition company in New York State "got away with inappropriately billing the Medicaid program by millions of dollars" by using political connections in the Democratic Party, including Edward G. Rendell, the former governor of Pennsylvania, to influence the Cuomo administration (Bernstein, 8/9).

The New York Times: Public Unions Fight New York's Effort To Curb Health Costs
In his final months in office, Mayor Michael R. Bloomberg set himself an ambitious goal: tackling New York's rapidly rising health care costs by finding cheaper insurance for the city's nearly 300,000 employees, 200,000 retirees and their families. On Friday, his chances of accomplishing that appeared dimmer than ever. The Municipal Labor Committee, a coalition of unions that negotiates with the city on health benefits, filed a complaint against the city and obtained a temporary restraining order stopping the administration for now from seeking new coverage (Taylor, 8/9).

The Associated Press: Court Stalls NYC Plan To Get Health Insurance Bids
A judge told the city Friday to hold off seeking bids for health insurance for its huge workforce, days after Mayor Michael Bloomberg spotlighted the plan in a speech about safeguarding the city's fiscal health. ... New York's health insurance bill has doubled since 2002, to $6.3 billion this year. The request for proposals will look to save up to $400 million a year, he said (8/9).

Los Angeles Times: California Cites 'Massive Prisoner Release' In Supreme Court Appeal
California lawyers late Friday filed the state's full appeal to the U.S. Supreme Court, asking the high court to set aside orders to reduce prison crowding by the end of December. ... The appeal cites the great progress the state has made in improving medical and mental health care of inmates. It says the three federal judges who in June issued the current prison population reduction order showed a "conspicuous insensitivity" to the powers Congress tried to give states when dealing with court orders to release inmates (St. John, 8/10).

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