First Edition: June 28, 2011

Today's headlines include reports from the states about action on public employee benefit reforms and Planned Parenthood funding.

Kaiser Health News: Growing Hospice Care Brings Concerns About Misuse
Kaiser Health News staff writer Jordan Rau, working in collaboration with The New York Times, reports: "Over the 28 years that Medicare has reimbursed providers for hospice services, it has been praised for giving critical medical and emotional support to dying patients and their families. When properly used - that is, at the very end of life - hospice care also has saved the government money. Providing dying patients with palliative care in their own homes, or in a hospice facility or nursing home, is far less expensive than continuing to order up futile medical treatments, studies have shown. But as hospice has moved into the mainstream - it is now serving 1.1 million Medicare patients a year - concerns about excessive costs and misuse have mounted" (Rau, 6/27).

Kaiser Health News: Mistakes In Outpatient Care Raising Concerns
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "The focus of patient safety efforts in recent years has been on problems in hospitals rather than in outpatient settings such as doctors' offices and urgent care centers. Hospitals have come under scrutiny for everything from medication errors and hospital-acquired infections to wrong-site surgeries. But a recent study found that serious errors that result in malpractice awards also occur frequently in outpatient settings, suggesting that more attention needs to be paid to the mistakes that happen outside the hospital" (Andrews, 6/28).

The New York Times: Debt Divide Remains As President Steps In
The high-level meetings on Monday were seen as a "regrouping phase," which an administration official said was likely to set the stage for yet another round of gritty negotiations between the White House and Congressional leaders before Aug. 2, when federal borrowing authority will expire. As the debt talks resumed at the White House, Senator Bernard Sanders, the Vermont independent, took the floor to urge the president to resist Republican pressure to wring most of the savings out of federal programs rather than impose any new taxes on the nation's most affluent (Hulse, 6/27).

The Washington Post: Obama Enters Debt Talks
Some Republicans have demanded that a stringent balanced budget amendment be attached to the debt-increase legislation. House Democrats vigorously oppose such a plan. Other GOP leaders have pushed aggressively to include steep savings from Medicare, and Sen. Joseph I. Lieberman (I-Conn.), along with fiscal hawk Sen. Tom Coburn (R-Okla.), plans to introduce legislation Tuesday that would shave about $500 billion from Medicare's coffers over 10 years, in part by increasing the eligibility age from 65 to 67. Congressional Democrats have vowed to block any plan if it includes reduced benefits for seniors (Kane and Helderman, 6/27).

Politico: Revenue Vs. Cuts In Debt Debate
For their part, Obama and Reid appear prepared to reach much higher, putting substantial Medicare savings on the table if Republicans would accept added revenues. With the House GOP leadership in New York, all of Monday's White House maneuvering was Senate-centric. But Obama's hope is that Speaker John Boehner (R-Ohio), with whom he met privately last week, will be intrigued by a bolder package that might also help neutralize the Medicare issue now hurting the GOP among elderly voters (Rogers, 6/27).

The New York Times: New Drugs Fight Prostate Cancer, But At High Cost
A group of new drugs is promising to prolong the lives and relieve the symptoms of men with advanced prostate cancer, but could also add billions of dollars to the nation's medical bills. In the last 15 months, three new drugs that extended the lives of prostate cancer patients in clinical trials have been approved by the Food and Drug Administration and several other promising medicines are in clinical trials. Before last year, only one drug had been shown to improve survival - docetaxel, which was approved in 2004 (Pollack, 6/27).

Los Angeles Times: Study Finds Mammograms Reduce Cancer Deaths
The longest study yet to examine women who undergo mammography shows that it reduces deaths from breast cancer by at least 30%, a finding that many doctors say may help ease the recent controversy surrounding the procedure. The three-decade study in Sweden showed that one breast cancer death can be prevented for every 414 to 519 women who are screened, a much lower number than the 1,000 to 1,500 that had been projected in previous studies (Maugh, 6/28).

NPR Shots Blog: Study: Doctors More Likely To Drop Private Insurance Than Medicare
There's a lot of chatter about how public policy can influence doctors' decisions about which new patients to see and which to turn away. One big question: Does the squeeze on Medicare that has limited the program's pay increases to doctors lead them to see fewer of those patients? Some researchers decided to look at recent data for clues. And they found a slight drop - a little less than 3 percent in the proportion of doctors taking new Medicare patients between 2005 and 2008. But that drop, which still left 93 percent of docs taking new Medicare patients, wasn't much compared with the hit for patients with typical private insurance (Hensley, 6/27).

Politico: Health Exchanges: A New Gold Mine
More than $300 million in exchange grants has already flowed into the states since the Affordable Care Act passed. That number will grow exponentially in the coming months, as states move from the initial steps of passing exchange legislation to the more lucrative task of setting them up (Kliff, 6/27).

USA Today: Fewer Prosecuted In Benefits Program Fraud
The drop in criminal prosecutions indicates a shift for federal law enforcement agencies, which have increasingly targeted schemes aimed at mortgage lending, financial institutions and Medicare, the government insurance plan for the elderly. It suggests that people who defraud food stamps, Social Security or other benefits programs are less likely to face federal criminal charges (Heath, 6/28).

Chicago Tribune: Quinn To Sign Workers' Comp Overhaul Today
Gov. Pat Quinn today will sign into law an overhaul of the state's workers' compensation system, a move that will slash medical rates, set new standards in determining a worker's disability and put in place more safeguards to prevent abuse (Garcia, 6/28).

The Associated Press: NJ Senate Sends Benefits Reform Bill To Governor
The New Jersey Senate has given final approval to a bill raising pension and health benefits costs to the state's more than 500,000 government workers. The Senate voted Monday to knock out a provision of the bill that would have restricted access to out-of-state health care. The bill now goes to Republican Gov. Chris Christie, who has scheduled a bill signing Tuesday. Christie has said the reforms should serve as a model for other states that are grappling with underfunded public worker pension programs (Delli Santi, 6/27).

The New York Times: Planned Parenthood Fights Kansas' Move To Cut Off Funds
Planned Parenthood filed a federal lawsuit in Kansas on Monday that said the state budget had violated its free speech and due process rights by preventing it from receiving federal family planning money (Williams, 6/27).

The Associated Press/Washington Post: Planned Parenthood Sues Kan. Officials Over Budget Provision Blocking Family Planning Funds
Planned Parenthood filed a federal lawsuit Monday over a provision in Kansas' next state budget that prevents the organization from receiving federal family planning funding, marking the first of what could be several legal challenges to policies successfully pushed by abortion opponents this year (6/27).

Politico: Texas To Defund Planned Parenthood
The Texas Legislature approved a bill Monday that would both compel the state to push the Obama administration to convert Texas's Medicaid program into a block grant and defund abortion providers like Planned Parenthood (Kliff, 6/27).

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