Morning Briefing
Summaries of health policy coverage from major news organizations
First Edition: July 16, 2015
The Wall Street Journal: Federal Health Exchange Approved Fake Claims
The federal exchange set up under the Affordable Care Act allowed fictitious applicants to maintain coverage and re-enroll this year, according to a report by a congressional watchdog group that raises questions about the marketplace’s ability to detect fraud. The exchange, HealthCare.gov, last year approved 11 fictitious applications submitted in an undercover operation by the Government Accountability Office, according to the report released Wednesday by the agency. (Armour, 7/15)
The Associated Press: Probe: Bogus Enrollees Kept Getting 'Obamacare'
Phony applicants that investigators signed up last year under President Barack Obama's health care law got automatically re-enrolled for 2015. Some were rewarded with even bigger taxpayer subsidies for their insurance premiums, a congressional probe has found. The nonpartisan Government Accountability Office says 11 counterfeit characters that its investigators created last year were automatically re-enrolled by HealthCare.gov, even though most had unresolved documentation issues. In Obama's terms, they got to keep the coverage they had. (Alonso-Zaldivar, 7/15)
The Washington Post: Report: ACA Plans Have A Third Fewer Providers Than Employer-Based Plans
Consumers who bought insurance on the health exchanges last year had access to one-third fewer doctors and hospitals, on average, than people with traditional employer-provided coverage, according to an analysis released Wednesday. The study by consulting firm Avalere Health provides a statistical basis for anecdotal reports from consumers and others about the more limited doctor and hospital choices in plans offered on marketplaces created by the Affordable Care Act. (Sun, 7/15)
USA Today: Report: IRS Taxpayer Service Goes From Bad To Terrible
Nonetheless, the report said the IRS ran a generally successful filing season under difficult circumstances, processing 126.1 million individual tax returns and issuing 91.8 million refunds while implementing parts of the Affordable Care Act and Foreign Account Tax Compliance Act. (McCoy, 7/15)
The New York Times: Head Of Obama’s Health Care Rollout To Lobby For Insurers
Marilyn B. Tavenner, the former Obama administration official in charge of the rollout of HealthCare.gov, was chosen on Wednesday to be the top lobbyist for the nation’s health insurance industry. Ms. Tavenner, who stepped down from her federal job in February, will become president and chief executive of America’s Health Insurance Plans, the trade group whose members include Aetna, Anthem, Humana, Kaiser Permanente and many Blue Cross and Blue Shield companies. (Pear, 7/16)
The Wall Street Journal: Health Insurance Trade Group Names New CEO
The latest turn of the revolving door between government and health industry comes as government business is exerting a bigger effect on insurers’ bottom lines. Under federal rules designed to minimize the opportunities for officials to pass freely between government and the private sector, Ms. Tavenner will be barred from lobbying her former colleagues for the remaining months of the Obama administration, but she isn’t subject to a similar restriction on lobbying Congress. (Radnofsky and Wilde Mathews, 7/15)
The Washington Post: Former CMS Chief To Become Top Lobbyist For Health Plans
She stepped down from CMS in February 2015. A former hospital executive and Virginia health secretary, Tavenner will replace Karen Ignagni, a highly respected insurance lobbyist with more than two decades of experience at AHIP. Ignagni resigned to become the CEO of insurance company EmblemHealth in May. The change in AHIP’s leadership is a significant moment in the group’s history as insurers adjust to the health care environment created by Obamacare and seek to protect reimbursement rates for Medicare Advantage, a popular alternative to traditional Medicare. (Viebeck, 7/15)
Reuters: Alaska Governor Pushes To Expand Medicaid Program For The Poor
Alaska Governor Bill Walker is set to announce on Thursday plans to expand the Medicaid health program for the poor, which would bring coverage to more than 40,000 uninsured residents. Walker, an independent, has already had several expansion efforts blocked by the Republican-led state legislature since he took office after winning the November 2014 election. The governor's office said Walker would lay out details of the plan on Thursday. (Quinn, 7/15)
USA Today: Medicaid Turns 50 Mired In Controversy
Tennessee farmer Timmy Parks lives without a prosthetic for his amputated arm and endures chest pain so excruciating he sometimes doesn't want to eat — all because he has no insurance and no way to pay for health care. Yet if he lived less than five miles away, in Kentucky, he'd qualify for Medicaid, the government program designed to help the poor. As Medicaid turns 50 years old this month, it's racked with cost over-runs, bitter politics and never-ending controversies that have left millions of people around the country like Parks without health care coverage they desperately need, unable to afford everything from open heart surgery to prescriptions to prevent life-threatening seizures. (O'Donnell and Ungar, 7/15)
The Wall Street Journal: UnitedHealth Boosts Outlook As Results Top Expectations
UnitedHealth Group Inc. on Thursday boosted its full-year outlook as the largest U.S. health insurer reported better-than-expected earnings and revenue in its second quarter. UnitedHealth said it now expects revenue of $154 billion, up from its previous forecast of $143 billion. The company is now calling for earnings of $6.25 to $6.35 per share, up from its prior outlook of $6.15 to $6.30 per share. ... Earlier this month, Aetna Inc. struck a deal to buy Humana Inc. for $34.1 billion after a five-way merger frenzy. Anthem Inc. has bid for Cigna Corp., while UnitedHealth earlier approached Aetna about a deal, The Wall Street Journal has reported. (Dulaney, 7/16)
The Associated Press: UnitedHealth Tops Street 2Q Forecasts
UnitedHealth Group Inc. (UNH) on Thursday reported second-quarter net income of $1.59 billion. The Minnetonka, Minnesota-based company said it had net income of $1.64 per share. The results topped Wall Street expectations. (7/16)
The New York Times: Specialty Pharmacies Proliferate, Along With Questions
As the end of each month nears, Megan Short frets. Her 1-year-old daughter, Willow, cannot afford to miss even a single dose of a drug she takes daily to prevent her body from rejecting her transplanted heart. Because of stringent rules from her drug plan and the pharmacy she is required to use, Ms. Short cannot order a refill until her monthly supply is three-quarters gone. Yet processing a refill takes about seven days, making it touch and go whether the new shipment will arrive before the old one runs out. (Thomas and Pollack, 7/15)
The Wall Street Journal's Pharmalot: Pharma Boosts Support For Continuing Medical Education, But Only A Little
Amid ongoing scrutiny of industry influence over medical practice and research, new figures show that companies increased their spending on continuing medical education last year by 2%. Although this represents a modest uptick, the report suggests that spending by drug and device makers has leveled off in recent years in response to sustained controversy over CME funding. (Silverman, 7/15)
NPR: John Boehner Calls For Probe Of Planned Parenthood After Sting Video
House Speaker John Boehner is calling for an investigation of Planned Parenthood after a sting video alleged the organization sells aborted fetal body parts, which is illegal. (Ludden, 7/15)
The Washington Post: The Mysterious Death Of A Doctor Who Peddled Autism ‘Cures’ To Thousands
Bradstreet offered thousands of autism patients around the globe controversial treatments. He claimed he could effectively cure kids of their autism, cancer and other maladies simply by injecting them with protein shots. When Bradstreet’s body was found last month in the Rocky Broad River in mountainous North Carolina with a bullet wound to the chest, therefore, friends, family members and patients pointed fingers at drug corporations. The FDA. Anyone but Bradstreet. (Miller, 7/16)
Los Angeles Times: Opponents Of New California Vaccination Law Begin Referendum Drive
Opponents of a new state law requiring more children to be vaccinated are moving to stop it from taking effect next year as scheduled. The California secretary of state announced Tuesday that the opponents have been cleared to begin collecting petition signatures for a referendum on the law. Their measure would appear on the November 2016 state ballot. A majority of voters would have to say yes to the referendum, in favor of the new vaccination law, or it would not go into effect. (McGreevy,7/15)
