States: Calif. docs fight health law reimbursements; Wis. and collective bargaining; Kan. navigators restrictions

Feb 25 2014

A selection of health policy stories from California, Wisconsin, Kansas, Virginia, Oregon, Georgia, North Carolina and Maine.

The San Jose Mercury News: Doctors, Insurers Face Off Over Reimbursement Rates
Lowering costs by forcing doctors and insurers to compete for millions of new patients is a primary goal of the nation's new health care law, but a group of gastroenterologists in the East Bay and internists near Chico are exposing a fissure in that plan. There often aren't enough doctors to go around. In parts of the state, the shortage of doctors participating in California's new insurance exchange is providing new leverage for medical providers to hold out for higher reimbursement rates from big insurance companies. And as a game of chicken unfolds behind the scenes between two powerful groups that are key to the law's success, the insurers are often caving in to the doctors, raising concerns that the trend could catch on and drive up the price of health insurance premiums on the exchange (Seipel, 2/23).

The New York Times: Wisconsin's Legacy for Unions
[Gov. Scott] Walker's landmark law -- called Act 10 -- severely restricted the power of public-employee unions to bargain collectively. ... All over the state, public executives are exercising new authority. Instead of raising teachers' salaries, the Mequon-Thiensville School District, near Milwaukee, froze them for two years, saving $560,000. It saved an additional $400,000 a year by increasing employee contributions for health care, said its superintendent, Demond Means (Greenhouse, 2/22).

Kansas Health Institute: Hearing Set For Bill To Restrict Obamacare Navigators
A bill that would add restrictions for the application counselors who help people enroll in health coverage through the new federal marketplace in Kansas has been scheduled for a hearing Tuesday in the Senate Public Health and Welfare Committee. Senate Bill 362 would require Kansas' health insurance "navigators" to be certified by the attorney general's office after undergoing a criminal background check and credit check (Cauthon, 2/21).

The Washington Post: Work Limits May Be Easing For Va. Adjunct College Instructors; Federal Health Law At Issue
Virginia's limits on the work schedule of part-time college instructors, imposed last year to minimize health insurance expenses of public community colleges under the Affordable Care Act, appear to be easing for at least some of the adjunct professors (Anderson, 2/21).

Los Angeles Times: Actors Draw Med School Students Into Caregiver Role
David Solomon lay in bed, a sheet draped over his legs. His darkened bedroom was silent, except for the ticking of a clock on the wall. A box of tissues sat on a bedside table; a Hebrew-and-English siddur, or prayer book, rested on his lap.The cancer that the 70-year-old cosmetics merchant had held at bay for 12 years was no longer responding to chemo. His breathing was labored, and his morphine-addled gaze wandered. It took all his effort to focus on the white-jacketed medical student who stood next to him (Brown, 2/24). 

Los Angeles Times: Mysterious Polio-Like Illnesses Reported In Some California Children
A small number of children in California have come down with polio-like illnesses since 2012 -- suffering paralysis in one or more limbs and other symptoms -- and physicians and public health officials do not yet know why.A virus may play a role, said Dr. Carol Glaser, leader of a California Department of Public Health team investigating the illnesses, which are occurring sporadically throughout the state (Brown, 2/23). 

The Oregonian: Silver Alert, Medicaid Fraud Bill Heads To Gov. John Kitzhaber
Local police agencies would be required to develop Silver Alert policies to locate missing vulnerable adults under a bill that unanimously passed the Oregon House on Friday. Senate Bill 1577 heads to Gov. John Kitzhaber after previously clearing the Senate. The bill would also require the Oregon Health Authority to develop improved electronic systems to detect and prevent Medicaid fraud. The Silver Alert policies would also include people with developmental disabilities, brain injuries and other vulnerable adults (Zheng, 2/21).

Georgia Health News: Panel Backs Autism Coverage Requirement 
The Senate Insurance and Labor Committee on Thursday approved three bills related to health care, including one that mandates private insurance coverage for treatment of children with autism. Committee Chairman Tim Golden (R-Valdosta), the lead sponsor on SB 397, said the costs of the treatment that would be covered under the legislation could not exceed $35,000 per year for each child. The eligible age for coverage would be capped at 6 years old (Craig, 2/21).

North Carolina Health News: Community Fights Closure Of Hospital And Economic Loss
Take Hwy. 264 out of Raleigh and drive east for almost three hours, and you arrive in Belhaven, a coastal town of roughly 1,600 people with a single traffic light. … Robertson cites a number of reasons for the decision to close the hospital, including the deteriorating condition of the facility and the hospital's location in a flood zone. Decreases in reimbursements and the state's rejection of federal Medicaid expansion under the Affordable Care Act are other factors that were considered in the hospital's closure, Robertson said (Namkoong, 2/21).

The Associated Press: Maine Bills Seek 'Narrow' Network Explanations
When Roberta Lane went to her local hospital emergency room, where the doctors she's seen for years practice, she was shocked to find out her insurance wouldn't cover treatment. … Two bills the Insurance and Financial Services Committee will examine again on Tuesday aim to bring more transparency to these narrow provider networks -- both for the consumers and the hospitals that are being excluded (2/23).