First Edition: June 9, 2014

Jul 9 2014

Today's headlines include a status report on GOP discussions and debate over plans to replace the health law as well as coverage of emerging legislation to override the Supreme Court's Hobby Lobby decision.

Kaiser Health News: Lawsuit Accuses Anthem Blue Cross Of 'Fraudulent' Enrollment Practices
Kaiser Health News staff writer Julie Appleby reports: "California insurance giant Anthem Blue Cross misled "millions of enrollees" about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn't cover care outside its approved network, according to a class action lawsuit filed Tuesday" (Appleby, 7/9). Read the story, which also appeared in the San Jose Mercury-News and the Los Angeles Daily News.

Kaiser Health News: Study: Hospitals Not Bilking Medicare Using Electronic Medical Records
Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: "A new study says there's no need to worry about hospitals using their new electronic medical records to generate bigger bills and boost their income. It's been a concern since at least 2012, when the Departments of Justice and Health and Human Services sent hospitals a strongly worded letter warning them against using electronic records inappropriately" (Whitney, 7/8). Read the story.

Politico: House GOP Stuck On Obamacare Replacement
The repeal part of their "repeal and replace" promise was easy; the House has voted dozens of times to repeal or defund all or some of the law since its passage in 2010. It's the replace part that's a challenge. Republicans are divided over whether they should commit to a specific plan before November -; and precisely what policies a GOP health bill should include (Winfield Cunningham, 7/8).

The New York Times: Democrats Push Bill To Reverse Supreme Court Ruling On Contraceptives
Democrats in Congress said Tuesday that they had developed legislation to override the Supreme Court decision on contraceptives. The bill would ensure that women had access to insurance coverage for birth control even if they worked for businesses that had religious objections (Pear, 7/8).

The Wall Street Journal: Democrats Line Up Challenge To Supreme Court's Contraception Ruling
Senate Democrats plan to push back against the Supreme Court's Hobby Lobby decision last week with legislation designed to restore employers' responsibility to provide contraception coverage under the health law. Sens. Patty Murray of Washington and Mark Udall of Colorado are expected to introduce legislation on Wednesday seeking to prevent companies from relying on a religious freedom law to avoid complying with the Affordable Care Act's requirement to cover all forms of contraception approved by the government without charging workers a copayment (Petersen and Crittenden, 7/8).

The Wall Street Journal: Report Raises Red Flags On Medicare Lab Billing
Medicare allowed $1.7 billion in 2010 payments to clinical laboratories for claims that raised red flags, according to a report to be released Wednesday, the latest example of how the federal insurance program for the elderly and disabled is susceptible to misspending and abuse. The report, by the Department of Health and Human Services' Office of Inspector General, found that more than 1,000 laboratories showed five or more measures of questionable billing during that year, the latest available when the office began compiling the data. That includes various metrics signifying higher-than-average billing, using ineligible physician identification numbers and administering duplicate tests, among other things (Adamy, 7/9).

The Washington Post: Federal Employees Give Their Savings, Health-Insurance Plans Top Ratings
Federal employees rank their retirement savings and health insurance programs as the most important of their benefits, and large majorities say those programs meet their needs and provide value for the money. Those were among the main findings of the 2013 Federal Employee Benefits Survey whose results the Office of Personnel Management recently released (Yoder, 7/8).

The Wall Street Journal: Agency Examines 67 Claims Of Retaliation Against VA Whistleblowers
An independent federal investigative agency is pursuing 67 active complaints about VA health facilities from employees, according to testimony given at a House panel Tuesday evening. Special counsel Carolyn Lerner said the complaints have come from 28 states and 45 separate facilities, including 25 complaints filed since June 1 (Schwartz, 7/8).

The Associated Press: VA Is Accused Of Retaliating In 67 Complaint Cases
A federal investigative agency is examining 67 claims of retaliation by supervisors at the Department of Veterans Affairs against employees who filed whistle-blower complaints -; including 25 complaints filed since June 1, after a growing health care scandal involving long patient waits and falsified records at department hospitals and clinics became public (7/8).

USA Today: VA Whistle-Blowers Take Turn Ripping Agency
Department of Veterans Affairs whistle-blowers took turns ripping their own agency during a congressional hearing Tuesday, not only for failing America's veterans and falsifying appointment records, but for retaliating against employees who try to expose safety and ethics violations. Among those testifying before the House Committee on Veterans' Affairs was Dr. Katherine Mitchell, a physician at the Phoenix VA Health Care System, who told the committee some patients died because of medical-care breakdowns. By trying to stand up for veterans, Mitchell added, she became the target of sham investigations, smear campaigns, job transfers and other reprisals (Wagner, 7/9).

Politico: Lawmakers Laud VA Whistleblowers
House lawmakers charged Tuesday that a culture of corruption at the Department of Veterans Affairs allowed the agency to freely retaliate against whistleblowers. At a hearing of the House Committee on Veterans' Affairs, lawmakers peppered four federal whistleblowers on ways to fix the VA's reputation of acting against employees who raise concerns about health care quality or fraud and said the VA needed a broad cultural change (French, 7/8).

NPR: Will This Tech Tool Help Manage Older People's Health? Ask Dad
Aging 2.0 may not sound like the hippest start-up in San Francisco, but it's part of an industry worth $2 billion and growing fast -; technology to help older adults. Katy Fike, 35, is the company's co-founder. She's devoted to making sure that older adults who are supposed to use the products are involved in their development. That's especially important, because the creators of tech startups tend to be much younger than the intended users of their products (Jaffe, 7/8).

The Wall Street Journal: Study On Cancer Care Yields Mixed Results
A closely watched study that aimed to remove the financial incentive for doctors to prescribe expensive cancer drugs delivered a contradictory result, with lower overall treatment spending but higher chemotherapy medication costs. The results of the study, which involved UnitedHealth Group Inc.'s insurance arm and five oncology practices, raise questions about the most effective way to trim the rapidly growing tab for cancer care. The U.S. spent more on cancer drugs last year -;$37 billion, up 19% in five years-;than any other category, according to the IMS Institute for Healthcare Informatics, a unit of IMS Health. Overall costs for treating cancer are well over $100 billion annually and mounting, according to researchers at the National Cancer Institute (Wilde Mathews, 7/8).

The New York Times: Rapid Price Increases For Some Generic Drugs Catch Users By Surprise
For patients, that meant the prices at pharmacies often tripled from last October to this June, according to Doug Hirsch, chief executive of GoodRx.com, a website that tracks drug pricing to help consumers find good deals. And while the average price tag at the pharmacy for a month of digoxin this year is still relatively cheap, about $50, he said, some patients are now encountering costs of more than $1,000. That can translate into co-pays of hundreds of dollars (Rosenthal, 7/8).

The Wall Street Journal: Charlie Crist Tries A New Embrace Of Obama
On the campaign trail, Mr. Crist, who took heat from Republicans for hugging Mr. Obama in 2009 before his split from the GOP, has vigorously defended the president's health-care law, called for expanding Medicaid coverage under it-;which Florida hasn't done-;and backed the administration's high-speed-rail plan (Camp-Flores, 7/8).

The Associated Press: NY Lawmakers Back Coverage For Ostomy Supplies
The New York Legislature has voted to require that health insurers provide coverage for equipment and supplies for treating ostomies, intended to help ease the financial burden for people with the chronic condition (7/9).

The Wall Street Journal: Insurer, New York State To Settle Claims
New York Attorney General Eric T. Schneiderman on Wednesday is set to announce a settlement with EmblemHealth Inc. that requires the health-insurance company to change the way that it deals with behavioral-health and substance-abuse claims, his office said. The attorney general's office said its investigation found that since at least 2011, EmblemHealth, through a subcontractor, issued 64% more denials of coverage in behavioral-health cases than in medical cases (Vilensky, 7/8).