- KFF Health News Original Stories 2
- Medicare Plans Score Higher Ratings And Millions In Bonuses
- TrumpCare Takes It On The Chin
- Political Cartoon: 'Chain Reaction'
- Campaign 2016 2
- Clinton, Sanders Unite Over Flint Water Crisis At Debate
- GOP Health Policy Experts Despair Over Trump Plan, See Chance Of Reshaping Landscape Slipping Away
- Health Law 2
- Health Law Plans Will Be Rated On Provider Network Size
- Talks On Troubled Tribal Hospital May Propel S.D. Medicaid Expansion Plans
- Supreme Court 1
- High Court Temporarily Blocks Louisiana Abortion Law Focused On Doctors' Admitting Privileges
- Veterans' Health Care 1
- Initiative Makes Getting Veterans Cutting-Edge Cancer Technology Top Priority
- Public Health 3
- Heroin Crisis Invading Public Places As Epidemic Gains Momentum Across Country
- With No End In Sight, Flint Residents Defeated, Demoralized
- Potential Weapon On The Zika Battlefront: Genetically Engineered Mosquitoes
- State Watch 4
- Hospice Fraud Is Costing Medicare Millions Of Dollars
- N.M. Faces $417 Million Medicaid Shortfall In Current Budget Crunch
- West Virginia Bill Would Shield Hospitals From State, Federal Anti-Trust Regs
- State Highlights: Fla.'s Proposal To Protect Against Surprise Medical Bills At Risk; Conn. Gov. Holds Back Health Center Funds Due To Budget Squeeze
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Medicare Plans Score Higher Ratings And Millions In Bonuses
The share of Medicare Advantage members enrolled in plans with high star ratings has almost doubled since 2013, earning bonuses for private insurers who offer them. (Phil Galewitz, 3/7)
TrumpCare Takes It On The Chin
GOP health policy analysts skewer front-runner’s health proposal. (Julie Rovner, 3/4)
Political Cartoon: 'Chain Reaction'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Chain Reaction'" by Adrian Raeside.
Here's today's health policy haiku:
TEXAS LAW OPENS UP NEW LINES OF ARGUMENT
Abortion challenge
At the Supreme Court takes twists,
With different tacks.
- Anonymous
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
Summaries Of The News:
Clinton, Sanders Unite Over Flint Water Crisis At Debate
During the seventh Democratic debate, which was held in Flint, Mich., the candidates' focus turned to the city's public health crisis, with Hillary Clinton joining Bernie Sanders' call for Gov. Rick Snyder to resign or to face a recall election.
The New York Times:
In Democratic Debate, Bernie Sanders Pushes Hillary Clinton On Trade And Jobs
Senator Bernie Sanders, anxious that the Democratic nomination is slipping away from him, launched a series of cutting and sarcastic attacks against Hillary Clinton over trade, welfare reform and Wall Street in a debate Sunday night that often felt like a war over Bill Clinton’s legacy and the moderate Democratic policies of the 1990s. ... The focus on the economic fortunes of African-Americans had a powerful setting in Sunday’s debate: Flint, a city in the midst of a public health emergency over lead-tainted water, and a symbol of a middle class that rose to prosperity with the auto industry, but where 42 percent of the majority African-American population now lives below the poverty line. ... Mr. Sanders struck some more aggressive notes on Flint than he had in the past, embracing Mrs. Clinton’s call to have the Centers for Disease Control and Prevention evaluate the health of every adult and child in the city. “Federal government comes in, federal government acts,” Mr. Sanders said. (Chozick and Healy, 3/6)
USA Today:
Sanders, Clinton Take On Flint Water Crisis In Democratic Debate
Hillary Clinton and Bernie Sanders tangled over trade, guns, the auto industry and the water crisis in Flint, Mich., on Sunday in their seventh Democratic presidential debate. ... The candidates came together in a city struggling for the past two years with lead-polluted water that city, state and federal officials recognized and overlooked. The two Democrats both visited Flint in recent weeks to call attention to the water crisis, criticize local officials and vow assistance. On Sunday night, Clinton for the first time joined Sanders in calling for Gov. Rick Snyder to resign or face a recall election. “It is raining lead in Flint, and the state is derelict in not coming forward with the money that is required,” Clinton said. (Wolf, 3/6)
CNN:
Bernie Sanders Says His Policies Aren't 'Fantasy'
Democratic presidential candidate Bernie Sanders defended his policy proposals Sunday, saying that "this is not fantasy -- this is reality" in an interview with CNN's Dana Bash on "State of the Union." The Vermont senator cited other nations as models: Canada, the United Kingdom and France for his Medicare-for-all health insurance proposal and Germany and Scandanavia -- a region that typically includes Norway, Sweden and Denmark -- for free public college tuition. (Bradner, 3/6)
The Washington Post Fact Checker:
Fact Checking The Seventh Democratic Debate
CNN aired the seventh Democratic presidential debate on March 6, a pre-Michigan primary showdown between former secretary of state Hillary Clinton and Sen. Bernie Sanders of Vermont held in the city of Flint. Not every statement could be easily fact-checked, but here are 13 suspicious or interesting claims. ... “Five hundred thousand children today have lead in their bodies," [Hillary Clinton said]. Clinton is citing data available through the Centers for Disease Control and Prevention. The data come from 2014, but the CDC continues to use the estimate for blood lead levels in children today. According to the CDC, about 500,000 children in the United States aged 1 to 5 years old have blood lead levels above 5 micrograms of lead per deciliter of blood. CDC considers this amount of lead a level of potential public health concern. (Kessler and Ye Hee Lee, 3/6)
Meanwhile, advocacy groups are calling out Sanders for "ableism," saying he belittled mental health patients with his joke about the Republican debates —
The Washington Post:
Mental Health Patients To Bernie Sanders: Don’t Compare Us To The GOP Candidates
Mental health was mentioned twice during Sunday’s Democratic presidential debate. First, in connection to mass shootings. “I don’t want to hear anything about tougher laws for mental health or criminal backgrounds, because that doesn’t work,” Gene Knopf, the father of 14-year-old shooting victim Abigail Knopf, asked in a question to former secretary of state Hillary Clinton and Sen. Bernie Sanders (Vt.), both of whom responded with calls for gun control. Second, in a jab at the Republican presidential candidates. “You know, we are, if elected president, going to invest a lot of money into mental health,” Sanders said. “And when you watch these Republican debates, you know why we need to invest in that.” (Wang, 3/7)
GOP Health Policy Experts Despair Over Trump Plan, See Chance Of Reshaping Landscape Slipping Away
Republicans experts are lobbing insults at Donald Trump's health care plan, which he released last week. “I think it really makes you want to scratch your head and possibly bounce it off a table once or twice,” said Paul Howard, director of health policy at the Manhattan Institute.
STAT:
Republican Health Care Experts Dismiss 'Buffoon' Trump's Ideas
The rise of Donald Trump has been disappointing for establishment Republicans — and downright excruciating for conservatives involved in health care policy. Even after the release of his health care plan Wednesday, Trump strikes many of them as barely familiar with the most basic conservative health care ideas in their life’s work. In interviews, some of the most influential Republican experts on the issue told STAT they’re dismayed by what they consider the GOP front-runner’s lack of understanding of health care, his inconsistent statements about what he really believes, and his embrace of populist ideas for lowering drug prices that are straight out of the Democratic playbook. (Nather, 3/4)
Kaiser Health News:
TrumpCare Takes It On The Chin
There may finally be one thing Republicans hate more than ObamaCare: TrumpCare. The GOP front-runner, after weeks of talking in vague terms about his plans for the health care system, put out a seven-point proposal Wednesday night. But within hours, Republican opinion leaders in health care were already piling on. “It has the look and feel of something that a 22-year-old congressional staffer would write for a backbencher based on a cursory review of Wikipedia,” wrote Avik Roy, the opinion editor at Forbes who has advised several GOP presidential candidates on health policy, including Mitt Romney in 2012. (Rovner, 3/4)
Forbes:
Trump's Health Plan Does To Medicaid What Obama's Waivers Already Do
Republican presidential candidate Donald Trump, who issued a few more details to his healthcare reform plan, would give states “block grants” to manage health insurance for poor Americans because “state governments know their people best,” his proposal updated this week says. But giving states flexibility to administer Medicaid isn’t a new idea because administrations from Obama through both Bushes to Reagan have granted waivers of all kinds. And an unprecedented number of states are also handing off administration of benefits to private health insurers like Aetna, Centene, Anthem, Molina and UnitedHealth Group as a way to save money or bring private technology and claims administration to a government program. (Japsen, 3/4)
Health Law Plans Will Be Rated On Provider Network Size
New rules, scheduled for publication Tuesday, will allow insurers to sell health plans with narrow provider networks, but it will rate plans so that consumers know what they are getting. News outlets also report on how the health law is not erasing unpaid hospital expenses and, as a result of the Affordable Care Act, some states are giving physician assistants more autonomy.
The New York Times:
Health Law Insurance Plans To Be Rated By Network Size
The Obama administration, responding to consumer complaints, says it will begin rating health insurance plans based on how many doctors and hospitals they include in their networks. At the same time, the maximum out-of-pocket costs for consumers under the Affordable Care Act will increase next year to $7,150 for an individual and $14,300 for a family, the administration said. Consumer advocates said those costs could be a significant burden for middle-income people who need a substantial amount of care. (Pear, 3/6)
Modern Healthcare:
The Affordable Care Act Isn't Wiping Out Unpaid Hospital Bills
The promise of the Affordable Care Act for hospitals was that bad debt—a figure that reflects bills a hospital can't collect—would shrink substantially under the law's coverage expansions. The reality, so far, is less uniformly dramatic, even though 20 million fewer Americans are uninsured. Even in states that agreed to expand Medicaid, the popularity of high-deductible plans in those insurance exchanges has added to hospitals' mounting concerns over how patients can pay those bills, if at all. In Wyoming and other states that did not expand Medicaid, hospitals are seeing little relief from patients who can't pay their bills or need financial aid. (Evans, 3/5)
Forbes:
States Remove Barriers To Physician Assistants
An increasing number of states are granting physician assistants more autonomy to increase access to patients amid a shortage of doctors and an influx of patients with health insurance under the Affordable Care Act. (Japsen, 3/6)
Also in the news, how the health law is playing this campaign season —
Modern Healthcare:
Onslaught Of Pro-, Anti-Obamacare Spots Is Waiting In The Wings
Unlike the last few election cycles, paid political advertising that features healthcare issues hasn't played a starring role in the early primaries. But once the Democratic and Republican nominees are selected, watch out. The Affordable Care Act and other healthcare issues are going to get plenty of screen time, according to experts who track campaign advertising. (Meyer, 3/5)
Talks On Troubled Tribal Hospital May Propel S.D. Medicaid Expansion Plans
Federal officials are in discussions with the Rosebud Sioux Tribe over a reservation hospital, the Sioux Falls Argus Leader reports. In Missouri, where Medicaid expansion is a political issue, PolitiFact looks at a Democratic candidate's comments.
Sioux Falls (S.D.) Argus Leader:
With Tribal Hospital In Spotlight, Medicaid Expansion Talk Could Be Imminent
As federal agencies come to the table with the Rosebud Sioux Tribe to discuss ways to improve health care at an embroiled reservation hospital, Medicaid expansion supporters say the dialogue could propel efforts to grow the health care program for needy people. With a spotlight shining on the Rosebud hospital, the stage could be set for a broader conversation about improving Indian Health Service (IHS) in the South Dakota. Gov. Dennis Daugaard has been working for months to strike a deal with federal agencies and private health care providers that would save South Dakota taxpayers millions of dollars that could be used to expand Medicaid in the state to tens of thousands of low income residents. (Ferguson, 3/6)
PolitiFact:
Koster Doesn't Exaggerate Income Threshold To Qualify For Medicaid
Medicaid expansion in Missouri continues to be a major item of partisan contention within the state legislature, and now, candidates for governor have begun weighing in on the issue. Missouri Attorney General Chris Koster, a Democratic gubernatorial candidate, recently tweeted: "A single mother of two can’t qualify for basic healthcare through Medicaid if she makes more than $3,504 dollars a year." Koster’s statistic seemed pretty low, and we decided to take a closer look at the state’s Medicaid eligibility requirements. ... Our Ruling: Koster may be off by a little more than $100 when it comes to the maximum income a single mother of two can have and still qualify for Medicaid. But his point that Missouri’s maximum yearly income for parents on Medicaid is one of the lowest in the nation is on target. (Moeller, 3/6)
High Court Temporarily Blocks Louisiana Abortion Law Focused On Doctors' Admitting Privileges
The Supreme Court said the decision was "consistent with" one last June that blocked a Texas law.
The New York Times:
Supreme Court Blocks Louisiana Abortion Law
The Supreme Court on Friday temporarily blocked a Louisiana law that its opponents say would leave the state with only one abortion clinic. The court gave no reasons, though it did say that its order was “consistent with” one last June that blocked part of a Texas abortion law. The move came two days after the Supreme Court heard arguments in the Texas case, and abortion rights groups said they hoped that the development Friday was a sign that they had secured five votes to strike down the Texas law. (Liptak, 3/4)
The Wall Street Journal:
Supreme Court Temporarily Blocks Louisiana Abortion Law
The Supreme Court blocked a Louisiana abortion regulation Friday, temporarily stopping the state from requiring doctors to hold admitting privileges at local hospitals while litigation over the issue continues. ... The high court said it was granting the Louisiana stay “consistent with the court’s action” in the Texas litigation. The Supreme Court last summer prevented parts of the Texas law from going into effect while that case continued, so Friday’s move may have been made to maintain the status quo until the court announces the Texas ruling. Both laws were blocked by federal judges who found they were a “substantial obstacle” for women seeking abortions. The Fifth U.S. Circuit Court of Appeals in New Orleans, which oversees Louisiana, Mississippi and Texas, overrode those decisions, prompting abortion providers to appeal to the Supreme Court. (Bravin, 3/4)
Los Angeles Times:
Supreme Court Majority Blocks Louisiana Law Restricting Abortion Providers
The Supreme Court handed abortion rights advocates a victory Friday by blocking a Louisiana law they said would leave the state with only one doctor licensed to perform the procedure. The court, with only Justice Clarence Thomas dissenting, issued a brief order that restores an earlier judicial ban on enforcing the 2014 state law. The ruling is a good sign for abortion rights groups in Louisiana and nationwide. Coming shortly after the justices debated a similar Texas law, the order indicates a majority of the high court is unwilling to permit conservative states to enforce stringent regulations, at least for now. (Savage, 3/4)
In other abortion news, the Utah Senate moves on an anesthesia law —
The Associated Press:
Utah Senate Gives Initial OK To Abortion Anesthesia Bill
Utah's Senate gave initial approval Friday to a proposal requiring doctors to administer anesthesia prior to an abortion performed after 20 weeks gestation, based on the disputed premise that a fetus can feel pain at that point. State law currently gives women the choice to have anesthesia for the fetus to reduce potential pain during abortion. Anesthesia would be mandatory under the legislation sponsored by Sen. Curt Bramble, R-Provo. (Price, 3/4)
Hybrid Long-Term Care Insurance Gaining Interest
The New York Times examines the increasing popularity of this type of insurance policy. Also, the Times looks at how much retirees should save for medical costs. And The Denver Post explores the importance of end-of-life discussions.
The New York Times:
Hybrid Long-Term Care Policies Provide Cash And Leave Some Behind
There’s a good reason to have long-term care coverage in your wealth management plan. If you need to go to a nursing home, it can cost more than $90,000 a year for a private room, according to a survey by Genworth Financial, an insurance company. The costs, especially for longer stays because of Alzheimer’s disease, can deplete your estate. The financial impact of prolonged long-term care expenses concerned Brian Cassell, 55, a veterinarian in Denver, and his wife, Linda. Although they had looked at several stand-alone policies for long-term care, they didn’t like them because they were expensive and the premiums could rise. They wanted something more flexible. Working with financial planners, the Cassells looked at a relatively new option, hybrid policies that package coverage for long-term care with a universal life insurance policy or a fixed annuity. (Wasik, 3/4)
The New York Times:
On Eve Of Retirement, Savings For Medical Costs Can Fall Short
William Seavey, 69, does not fret about paying future medical expenses. He and his wife, Eleanor, are healthy. And they both have Medicare and Medigap policies, which can help pay many health costs. So they have not put any money aside in a medical savings account. If they do need cash, said Mr. Seavey, they can sell one of their three homes. Or they can go to Mexico for cheaper medical treatment. Various studies show that people in or nearing retirement have not saved nearly enough for medical expenses, which rise substantially with age. (Gustke, 3/4)
The Denver Post:
As Older Adult Population Rises, End-Of-Life Discussions Gain Traction
Four years ago, when her husband collapsed and died after his daily swimming regimen, Jean Oksner slowly emerged from her shock and grief to realize that circumstances had spared her something she long had feared — that she would be ill-equipped to manage his medical care during a life-threatening illness. Mickey, healthy until his unexpected death at 79, stubbornly had refused to talk about end-of-life issues. But Jean resolved to make her own desires known, as a gift to her three adult sons. (Simpson, 3/6)
Initiative Makes Getting Veterans Cutting-Edge Cancer Technology Top Priority
Long ago, the Department of Veterans Affairs got left behind on cancer research, but now a new push is aiming to bring veterans back into clinical trials. In other news, Vietnam veterans search ships' logs in their continued push to get compensation for possible Agent Orange exposure.
STAT:
Shut Out For Decades, Veterans Slowly Gaining Access To Innovative Cancer Treatments
Veterans have less access to cutting-edge cancer treatments today than at any point in recent history, but a new initiative aims to change that. A major cancer research group is seeking to enroll veterans in clinical trials of experimental therapies. The initiative is in its early stages, and so far only patients with lung cancer can participate. (Tedeschi, 3/4)
ProPublica:
Ailing Vietnam Vets Hunt Through Ships' Logs To Prove They Should Get Benefits
During the Vietnam War, hundreds of U.S. Navy ships crossed into Vietnam’s rivers or sent crew members ashore, possibly exposing their sailors to the toxic herbicide Agent Orange. But more than 40 years after the war’s end, the U.S. government doesn’t have a full accounting of which ships traveled where, adding hurdles and delays for sick Navy veterans seeking compensation. The Navy could find out where each of its ships operated during the war, but it hasn’t. The U.S. Department of Veteran’s Affairs says it won’t either, instead choosing to research ship locations on a case-by-case basis, an extra step that veterans say can add months — even years — to an already cumbersome claims process. Bills that would have forced the Navy to create a comprehensive list have failed in Congress. (Ornstein and Parris, 3/4)
Heroin Crisis Invading Public Places As Epidemic Gains Momentum Across Country
More and more users are overdosing in cars, fast food restaurants, public bathrooms and on mass transit.
The New York Times:
Heroin Epidemic Increasingly Seeps Into Public View
With heroin cheap and widely available on city streets throughout the country, users are making their buys and shooting up as soon as they can, often in public places. Police officers are routinely finding drug users — unconscious or dead — in cars, in the bathrooms of fast-food restaurants, on mass transit and in parks, hospitals and libraries. Nationally, 125 people a day die from overdosing on heroin and painkillers, and many more are revived, brought back from the brink of death — often in full public view. (Seelye, 3/6)
In other news, how a life-changing injection can dramatically change opioid recovery —
The Great Falls (Mont.) Tribune:
How A Shot Could Change A Drug Addict's Life
Late last August, Ryan Haman was ordered to spend a week in a cell at the Cascade County Detention Center. As an opioid addict, it definitely wasn't his first time in jail, but hopefully it would be his last. Haman would walk out of the jail clean after detoxing, as always. "I couldn't stay sober for more than a week." But this time, instead of relying on sheer force of will to keep his urges to inject himself with drugs like oxycodone or heroin at bay, Haman had an appointment to receive a shot that had the potential to change his life. (Fisher, 3/4)
With No End In Sight, Flint Residents Defeated, Demoralized
Even as aid floods in, there has been no promise that the water problem will be fixed any time soon, and residents are getting tired. “I think we need to stop talking about fixing the water, and get moving. I’m not a politician. I’m not a scientist. All I know is this water is still poison," said the Rev. Alfred Harris, the pastor of Saints of God Church. Meanwhile, would a different vote on a referendum have changed the fate of the city?
The New York Times:
As Aid Floods Into Flint, A Fix Remains Far Off
For months, almost no one would listen to residents’ fears about their odd-looking drinking water. Now, it seems, everyone is listening — and sending truckloads of bottled water, water filters and baby wipes, and cash donations and television news crews that set up along Saginaw Street downtown. ... But five months after state authorities announced that it was unsafe to drink unfiltered water because of high lead levels caused by government errors over the past two years, federal officials said here last week that the water still was not safe, and, as testing goes on, offered no promise for when it would be. (Davey, 3/6)
The Associated Press:
Crews Start Replacing Troublesome Lead Water Pipes In Flint
Crews in Flint are starting to dig up old lead pipes connecting water mains to homes as part of efforts to allay the city’s contaminated water crisis. Mayor Karen Weaver says work starting Friday will target lead service lines at homes in neighborhoods with the highest number of children under 6 years old, senior citizens, pregnant women, people with compromised immune systems and homes where water tests indicate high levels of lead at the tap. (3/4)
ProPublica:
The Referendum That Might Have Headed Off Flint’s Water Crisis
The tragic lead poisoning of the Flint water supply in Michigan is a study in bureaucratic bungling, racial inequity and national media inattention. But the fallout from the crisis has obscured another lesson: There are consequences when those in power are able simply to circumvent the public will. For two decades, Michigan has used emergency managers to supplant local elected officials and bring order to its most financially troubled cities. Flint has been overseen since 2011 by a succession of these state appointees, who have power to cut spending and sell off assets to raise money. (MacGillis, 3/4)
Potential Weapon On The Zika Battlefront: Genetically Engineered Mosquitoes
The owner of the company testing the new technology -- modifying male mosquitoes to pass on a gene to make their offspring self-destruct -- says the approach could save millions of people from being infected with the virus. In other outbreak news, drugmakers race to find a vaccine, and researchers are finding that the effects of Zika go beyond microcephaly.
The New York Times:
A Biotech Evangelist Seeks A Zika Dividend
In the expanding realm ruled by Randal J. Kirk, sliced apples don’t brown. Salmon grow twice as fast without swimming upriver to spawn. Beloved cats are reborn. And male mosquitoes are unleashed with the sole mission to mate, pass on a gene that kills their offspring, and die. A few decades ago, the foods and creatures nurtured by Mr. Kirk would have been found only in dystopian fantasies like those written by Margaret Atwood. But Mr. Kirk’s company, Intrexon, is fast becoming one of the world’s most diverse biotechnology companies, with ventures ranging from unloved genetically engineered creatures to potential cancer cures and gene therapies, gasoline substitutes, cloned kittens and even glow-in-the-dark Dino Pet toys made from microbes. (Pollack, 3/5)
The Wall Street Journal:
Drugmakers Scramble To Find Zika Vaccine
International health officials vowed after West Africa’s Ebola crisis to be better armed for the next epidemic with vaccines, drugs and diagnostic tests. Now the next one—Zika—is here and in an echo of Ebola, researchers are scrambling to develop medical tools to fight the virus. About 15 companies are working on Zika vaccines, most in the initial stages, according to the World Health Organization. (McKay and Loftus, 3/6)
The Wall Street Journal:
Zika Vaccines Would Pose Special Risks To Pregnant Women
Researchers are debating whether vaccines and drugs developed for Zika would be offered to pregnant women. They are the group most at risk from infection, because the virus is linked to serious birth defects. But medical products to be offered to pregnant women would have to go through extra, potentially lengthy regulatory hurdles to evaluate the potential risk to the unborn baby. “That’s going to slow you down quite a bit,” said Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston and president of the Sabin Vaccine Institute. (Loftus and McKay, 3/6)
The Associated Press:
Evidence Of Zika's Risk To Pregnant Women Continues To Grow
Researchers report that the Zika virus may be linked to a wider variety of "grave outcomes" for developing babies than previously reported — threats that can come at any stage of pregnancy. The findings released Friday are preliminary results from the first study tracking pregnant women in Brazil from the time they were infected, and do not prove that Zika is to blame. But they come as separate laboratory research released Friday strengthens the case that Zika causes a serious birth defect called microcephaly — babies born with abnormally small heads — by targeting embryonic brain cells. (3/5)
Hospice Fraud Is Costing Medicare Millions Of Dollars
Federal officials prosecuted more than 60 cases just last year. Also, news outlets report on fraud cases in Illinois, Texas, Florida and Indiana.
Pittsburgh Post-Gazette:
Hospice Fraud Becoming A Costly Problem For Medicare
Theft has been called a crime of opportunity, which would make cheating Medicare’s hospice benefit a bag of Skittles left open on the coffee table. No one knows how big the problem of hospice fraud is — all types of improper Medicare payments are estimated at $65 billion for 2010 — but federal investigators prosecuted more than 60 cases in the last year alone, involving hundred of millions of dollars nationwide. The system that was built to help dying patients live out their remaining days with dignity and comfort has few quality metrics to meet, no minimum requirements for how often care is provided, and low barriers to getting into the business. Critics say that can make end-of-life care seem ripe for abuse. (Mamula, 3/6)
The Chicago Tribune:
Doctor Known As 'King Of Nursing Homes' Convicted In Kickback Scheme
A federal jury on Friday convicted a doctor known as the "king of nursing homes" for routinely referring elderly patients to a financially struggling hospital on Chicago's West Side as part of a kickback scheme. Dr. Venkateswara Kuchipudi became the fifth physician and 10th defendant overall to be convicted for taking part in the massive Medicare and Medicaid fraud scheme at the now-shuttered Sacred Heart Hospital for 12 years. Doctors referred patients to the hospital in exchange for hundreds of thousands of dollars in kickbacks disguised as office rent, teaching fees and other bogus payments, prosecutors charged. (Eltagouri, 3/4)
Reuters:
Texas Doctor Found Guilty Of Bilking Insurers, Government Of $10 Million
A Texas doctor has been found guilty of bilking $10 million from health insurance companies and the U.S. government through fraud, including being paid for attending surgeries while he was actually on his private jet, U.S. prosecutors said on Friday. Anesthesiologist Richard Toussaint Jr., 58, was convicted by a federal jury in Dallas on seven counts of fraud for submitting false claims for payments in 2009 and 2010 from Blue Cross Blue Shield of Texas, United Healthcare, Aetna, Cigna the Federal Employees Health Benefits Program and others, they said. (Richter and Herskovitz, 3/4)
NPR:
Florida Doctor Says False Diagnoses Inflate Bills, Could Harm Patients
Insurance giant Humana Inc., which operates some of the nation's largest private Medicare health plans, knew for years of billing fraud at some South Florida clinics but did little to curb the practice even though it could harm patients, a doctor alleges in a newly unsealed whistleblower lawsuit. The suit was filed by South Florida physician Mario M. Baez. It accuses Humana and Baez's former business partner, Dr. Isaac K. Thompson, of engaging in a lucrative billing fraud scheme that lasted for years. The suit also names three other Palm Beach County doctors, two medical clinics and a doctors' practice group as defendants. The suit was filed in October 2012 but remained under a federal court seal until Feb. 26. (Shulte, 3/4)
The Associated Press:
Indiana Man Gets 2 Years For Bilking $1M From Medicare
A northern Indiana man has been sentenced to two years in prison for conspiracy to commit health care fraud. Forty-two-year-old Anthony Bitterling of Winamac also was sentenced Thursday to 400 hours of community service and two years of supervised release. He was ordered to pay more than $1 million in restitution. (3/4)
N.M. Faces $417 Million Medicaid Shortfall In Current Budget Crunch
Officials are looking at possible cuts in reimbursements for doctors and hospitals. News outlets also report on Medicaid issues in Kansas, Georgia, North Carolina and Alaska.
Albuquerque Journal:
NM Faces $417M Medicaid Shortfall
New Mexico’s budget crunch has left the state facing a $417 million Medicaid shortfall over the next 16 months, a daunting figure that could mean reduced reimbursement rates for providers and hospitals and, down the road, new mandatory payments for some patients. The belt-tightening measures, some of which will probably take effect in July, come at a time when the state’s Medicaid enrollment is skyrocketing – roughly 850,000 New Mexicans are on the state’s rolls, and that number is expected to rise. State funding is not expected to keep up, and without that match, New Mexico loses hundreds of millions of federal dollars. (Boyd, 3/5)
The Kansas Health Institute News Service:
Brownback Administration Hears From Nursing Homes On Medicaid Problems
Judy Kregar is not a member of the Rotary Club in Greensburg, but she decided to go when she heard Gov. Sam Brownback would be at the club’s recent meeting. Kregar, the administrator of a small nursing home in nearby Bucklin, wanted to tell Brownback in person about the struggles some of her residents are having getting their Medicaid applications and annual renewals processed. (Marso, 3/4)
Georgia Health News:
Nursing Home Firm Penalized Again As Feds Cut Funds At 4th Georgia Facility
Federal health officials, citing potential harm to patients, is stopping Medicare and Medicaid payments to a fourth Georgia nursing home operated by a Tennessee-based company. Three of those Georgia facilities run by New Beginnings Care have closed, with state officials helping to relocate more than 200 patients. The fourth facility, in Abbeville, south of Macon, is having federal payments cut off this month, according to a CMS letter. (Miller, 3/4)
Winston-Salem Journal:
Medicaid Reform In NC Has Health Care Systems Juggling Best Path For Services
The state’s largest health care systems have been caught in a logistical tug-of-war after legislators proposed a hybrid strategy for handling the biggest piece of Medicaid reform.
Do the systems pursue a statewide Medicaid coverage role, whether individually or collaboratively, which carries both revenue opportunities and risk, or do they focus on serving their own markets? (Craver, 3/6)
Alaska Public Radio/KTOO:
Alaska Senate Weighing A Bill To Overhaul Medicaid
The Senate Finance Committee has been weighing a wide-ranging bill to overhaul Medicaid in Alaska. One provision is aimed at curbing the abuse of opioid drugs. Senate Bill 74 would require doctors to check a database before prescribing opioids. The sponsors want to make sure patients aren’t going from doctor to doctor seeking pills. The bill also requires pharmacists to check the Alaska Prescription Database Monitoring Program. (Kitchenman, 3/4)
West Virginia Bill Would Shield Hospitals From State, Federal Anti-Trust Regs
The proposal is drawing increasing scrutiny as some are concerned it would draw large hospital monopolies to the state. News outlets also report hospital-related developments in Wisconsin, North Carolina, Illinois and Louisiana.
Marketplace:
West Virginia Hospital Deal In National Spotlight
There’s a big healthcare battle brewing in West Virginia that could have national implications. A vote could come Friday on a bill that would protect certain hospitals from federal and state anti-trust regulation. Put it another way, if this legislation passes, its possible West Virginia could become home to massive hospital monopolies. (Gorenstein, 3/4)
The Milwaukee Journal-Sentinel:
Hospitals Continue To Make Progress In Reducing Infections, But Work Remains
On average, almost three people die each day in Wisconsin from sepsis, a complication from infections. The infections often occur in hospitals and other health care settings. And new strains of bacteria are increasingly resistant to antibiotics. The potential risks were shown last week when the state Department of Health Services announced that bacteria causing sepsis had been linked to 18 deaths and 44 cases of infection in southern Wisconsin since late December. (Boulton, 3/5)
North Carolina Health News:
Rural Hospitals Embrace Population Health In Quest For Relevance
There are some 2,000 rural hospitals in the U.S. today, and, one could argue, those hospitals face nearly as many challenges to their viability. North Carolina’s rural hospital administrators find themselves grappling to gain footing in a shifting economic and health care landscape, pursuing paths they trust will lead to solutions to fit the communities they serve. (Sisk, 3/4)
The Chicago Sun-Times:
Late Jump In Flu Cases Has Chicago Hospitals Limiting Visits
An unusual jump in late-winter flu cases has prompted hospitals in the Chicago area to restrict visitors to protect very ill patients from picking up the flu. The Illinois Department of Public Health says officials statewide are seeing a flu increase. The Chicago-area flu season usually lasts from October to May and peaks in early January. Health professionals say this year’s late-season increase might be due in part to milder temperatures. (3/5)
The Associated Press:
Accident Or Crime? VA Worker Faces Trial In Patient's Death
Hospital officials called it an accident when a 70-year-old psychiatric patient was fatally injured in an altercation with a nursing assistant at a Department of Veterans Affairs medical center in central Louisiana three years ago. But the case became fodder for the VA's congressional critics after local prosecutors charged the employee, 54-year-old Fredrick Kevin Harris, with manslaughter in the death of Air Force veteran Charles Lee Johnson. (Kunzelman, 3/3)
News outlets report on health issues in Florida, Connecticut, Colorado, Illinois, Washington, North Carolina and Minnesota.
The Miami Herald:
Late Changes May Doom Florida Proposal To Protect Patients From Surprise Medical Bills
A proposal led by Miami-Dade lawmakers to protect patients from receiving unexpected medical bills for out-of-network care — a goal that doctors, hospitals and health insurers all say they support — is in trouble in the Florida Legislature this week after a last-minute change that consumer advocates worry is undermining support for the legislation. The coalition of political support behind the bill is a “delicate agreement,” said Laura Brennaman, director of Florida Community Health Action Information Network, or CHAIN. An amendment to the bill tacked on in the Senate, a week before the end of the legislative session, could be “an effort to scuttle the bill altogether without any real validity,” she said. (Chang, 3/7)
The Connecticut Mirror:
Malloy Holds Back Community Health Center Funds
Gov. Dannel P. Malloy’s administration is withholding $3.89 million in payments for community health centers, a response to projections that show a ballooning budget deficit. The move is similar to one the administration made in suspending $140 million in payments to hospitals, and led health center officials to warn that it could cost jobs and set back services for poor patients. (Levin Becker, 3/4)
The Connecticut Mirror:
Prospect Of Detox, Psychiatric Bed Cuts Worries Hospital Officials
As they try to cut more than $34 million from their budget, officials at the Department of Mental Health and Addiction Services say they anticipate reducing the number of treatment beds available – a prospect that worries hospital officials and mental health professionals. (Levin Becker, 3/4)
The Wall Street Journal:
Colorado Looks To Broaden Therapists’ Power To Prevent School Shootings
In a state that has been battered by mass shootings, Colorado lawmakers are trying a new, focused approach to stopping bloodshed in schools. A proposed bill would broaden the circumstances under which mental-health professionals can report a student that they believe poses a threat, an issue that has drawn increasing attention around the country. Colorado law requires mental-health workers to alert authorities if a patient expresses a specific, imminent threat, and mandates that they warn those being threatened. The proposal would permit therapists to alert school administrators about a potentially dangerous student even if that danger isn’t immediate. (Frosch, 3/6)
The Chicago Tribune:
Consumers Could Be Losers As Insurers Cut Brokers' Commissions
When Blue Cross and Blue Shield of Illinois canceled his family's health plan last year, Tony Schor could have gone online to Get Covered Illinois, the state's insurance shopping mall, to buy a new policy. But Schor, a small-business owner who lives in Highland Park, turned to his insurance broker. (Sachdev, 3/4)
The Denver Post:
No Changes For Health Center At Downtown Auraria Campus, For Now
Plans to change the health care center operations at Metropolitan State University of Denver have been tabled, officials say. Catherine Lucas, a spokeswoman for the school, said the Board of Trustees had to prioritize a list of 27 projects at a meeting last month. Finding a new operator for the health center through a request for proposals, as was planned, ended up among 10 projects deemed a low priority. (Robles, 3/4)
The Seattle Times:
Antibiotics Instead Of Appendectomy? UW Study May Be 'Game Changer'
Nick Fedewa endured three days of stomach pain last October before he realized he had appendicitis. “It was enough that you just wanted to curl up into a ball,” he recalled. By the time the 27-year-old Seattle medical-data worker had a friend take him to the emergency room, he’d mentally prepared himself for surgery. (Aleccia, 3/4)
The Orlando Sentinel:
Pathways To Care Offers Rare Healing Oasis For Homeless
Donald Testa had just had three surgeries, part of one foot amputated and a fresh diagnosis of Type 2 diabetes when an Orlando hospital discharge planner announced he was well enough to go home. There was just one problem: Testa had no home. The 49-year-old had been living out of a motel and working day-labor jobs when blisters from a new pair of boots led to a nasty infection. An initial trip to the emergency room turned into repeated hospital stays and, at discharge, he was in a wheelchair, on intravenous antibiotics and taking 10 prescription medications plus insulin, which had to be refrigerated. The hospital found him a bed at Pathways to Care — a rare place of respite for the homeless. (Santich, 3/6)
The Seattle Times:
High School Kids Need Chickenpox Shots By Fall, New Rules Say
Washington state health officials are reminding parents of a new state requirement that adds high-school students to the list of those required to be vaccinated against chickenpox starting this fall. In the 2016-2017 school year, all students in public and private school grades kindergarten through 12 must show proof of two doses of chickenpox vaccine, proof of previous disease or a blood test showing immunity to chickenpox or herpes zoster, a related infection. Or, they can provide an approved exemption. (Aleccia, 3/5)
North Carolina Health News:
Distant Echoes Of Slavery Affect Breast-feeding Attitudes Of Black Women
As certified nurse-midwife Stephanie Devane-Johnson works with her patients in Greensboro, she talks to them about a lot of health issues. But for her pregnant clients, one of the biggest topics is breast-feeding. “I’m asking about whether they’re going to breast-feed or bottle-feed,” Devane-Johnson said. “If they say they’re going to bottle feed, I say, “What about breast-feeding?’’ But to her frustration, for many black women breast-feeding their babies isn’t the first option. (Hoban, 3/4)
The StarTribune:
Delta Dental Pays Almost $5M For Naming Rights To New Clinic At HCMC
Naming rights aren't just for pro sports teams and stadiums. Delta Dental of Minnesota Foundation is giving $4.6 million to Hennepin County Medical Center (HCMC) for a part of the county's $220 million ambulatory clinic under construction between 8th and 9th streets and Chicago and Park avenues in downtown Minneapolis. (Olson, 3/4)
A selection of opinions from around the country.
Los Angeles Times:
The Supreme Court Just Made Healthcare Comparison Shopping Much Harder
Go figure. Just when you thought the Supreme Court's new lineup might turn it more consumer-friendly, the eight-member court went and blew a hole in one of the most promising new approaches to healthcare cost transparency. The issue in Gobeille vs. Liberty Mutual, which was decided Tuesday, was whether Vermont could require all payers for healthcare, including insurers and self-insuring employers, to report to a state-run database what they pay to every hospital or doctor for every claim. The court answered no. (Michael Hiltzik, 3/4)
Fayetteville (N.C.) Observer:
No More Reason To Evade Medicaid Expansion
As of the end of December, the governor announced in a press release last month, Medicaid was $181 million under budget. Yes, under budget by the same kind of numbers that it once exceeded its budget. ... And our repaired Medicaid system is getting even more attention, being revamped from a program that pays medical costs for the sick to one that pays to keep people healthy. There's good reason to expect even more savings. ... With that accomplished, McCrory's only good objection to Medicaid expansion is gone. (3/7)
Al.com:
The Case For Medicaid Expansion In Alabama
Over the past several years, arguments for Medicaid expansion in Alabama have been made using sound economic, budgetary and public health rationales. They have collapsed, however, under the reflexive antipathy toward the Affordable Care Act of conservatives in the state legislature. The result: Tens of thousands of Alabama's workers go without health insurance compared to states that expanded Medicaid, according to a study by Families USA. Expansion states, on average, saw a 25 percent decline in their rate of uninsured workers, compared to just 12 percent for Alabama – a difference of more than 2 to 1. It shouldn't be this way. (Ron Pollack, 3/4)
Los Angeles Times:
Tell Me Again How Obamacare Is A 'Disaster'
Conservative attacks on the Affordable Care Act long ago took on the qualities of reflexive, empty rhetoric, of the "say it enough and people will believe it" variety. As it happens, a couple of statistical releases from the U.S. government give the lie to the most persistent attacks. ... As the Department of Health and Human Services reported Thursday, "20 million uninsured adults have gained health insurance because of the Affordable Care Act as of early 2016." The figure includes 17.7 million who gained coverage via the insurance exchanges or Medicaid, and 2.3 million young adults age 19 to 25 who were able to remain on a parent's plan up to age 26. The overall uninsured rate has been cut by nearly half, from 20.3% in 2012 to 11.5% now. The trend includes every ethnic group and both genders; for whites and non-Hispanic blacks, the reduction in the uninsured rate exceeds 50%, and for Hispanics the rate has come down from 41.8% to 30.5%. (Michael Hiltzik, 3/4)
The New York Times:
Paying Employees To Lose Weight
If your employer offered you $550 to lose weight, an amount that would be deducted from your health insurance premiums next year, would that provide the motivation to help you finally shed those pounds? Roughly four out of five large employers in the United States now offer some sort of financial incentive to employees to improve their health. The Affordable Care Act has encouraged the creation of such programs by significantly increasing the amount of money, in the form of a percentage of insurance premiums, that employers can reward (or take away) to improve factors such as body mass index, blood pressure and cholesterol, as well as for ending tobacco use. These programs make intuitive sense. But do they work? (Mitesh S. Patel, David A. Asch and Kevin G. Volpp, 3/4)
The New York Times:
The Return Of The D.I.Y. Abortion
During oral arguments last week before the Supreme Court in Whole Woman’s Health v. Hellerstedt, Justice Elena Kagan noted that she was struck by the clear relationship between abortion restrictions in Texas and the closing of abortion clinics. “It’s almost like the perfect controlled experiment as to the effect of the law, isn’t it?” she said. “It’s like you put the law into effect, 12 clinics closed. You take the law out of effect, they reopen.” How women respond to these closings, however, is another story. (Seth Stephens-Davidowitz, 3/5)
The Washington Post:
My Grandmother Died Because Of An Illegal Abortion
This testimony in State of New York v. Regina Michele was heard in the New York City 6th District Court of Brooklyn on Nov. 10, 1921. Michele, accused of providing an abortion, denied knowing or ever seeing my grandmother. The case was dismissed. Maria died at age 36. She had already given birth to seven children, then ranging in age from 11 months to 10 years. An immigrant from Santa Paolina, Italy, an hour east of Naples, she spoke no English and depended on her husband, Francesco, to negotiate the world outside their Brooklyn flat. Maria, a talented seamstress, helped the family eke by, taking in clothing to repair and alter. Her oldest child, Biaggio, would lug piles of garments in need of her handiwork back and forth to tailor shops. (Christine Dinsmore, 2/4)
The New York Times:
Republicans’ Baseless Abortion Investigation
With its hidden-camera videos that took aim at Planned Parenthood, the Center for Medical Progress tried to stir up opposition to abortion rights by concocting a controversy over fetal tissue research. Now Republicans in the House are doing much the same thing. Initially convened in response to the videos, the Select Investigative Panel on Infant Lives, a part of the House Energy and Commerce Committee, pledges to “get the facts about medical practices of abortion service providers and the business practices of the procurement organizations who sell baby body parts.” (3/7)
Detroit Free Press:
The EPA Needs To Look At Where It Went Wrong In Flint
It's not that no one was paying attention. That's one of the hardest things to understand about the Flint water crisis in which the city's roughly 100,000 residents were exposed to lead-contaminated drinking water for nearly two years, after the city failed to properly treat the water it pumped from the Flint River. (Nancy Kaffer, 3/5)
Los Angeles Times:
Dirty Water Isn't Just A Flint Problem
Two days before primary voters go to the polls in Michigan, Democrats will bring the Bernie Sanders-Hillary Clinton debate road show to the put-upon city of Flint on Sunday, where they will doubtlessly discuss the city's well-publicized water crisis. Sanders and Clinton can take turns blaming Republican state officials for their sluggishness in protecting residents from the dangerous levels of lead that leached into their tap water, the result of a temporary cost-saving switch from a tried-and-true lake supply to more corrosive river water. (3/6)
The Washington Post:
I Have Parkinson’s — And My Wife Is Its Invisible Victim
Probably the only good thing I can say about having Parkinson’s disease is that it has introduced me to the unexpected helpfulness of others. Any time I venture out with my sturdy cane, people go out of their way to open doors, offer a helping hand or instruct their kids to stand aside as I shuffle past. Some teenagers will even extract themselves from their smartphones to offer assistance. Yet people seldom offer to help the woman who struggles to hoist me from the car seat, push my chair up to the restaurant table or quietly cope with my unseen, round-the-clock needs and demands. (Don Riggenbach, 3/4)
news@JAMA:
JAMA Forum: Cultural Influences Reflected In Divergent US Vs UK Human Embryo Research Policies
In a first, the Human Fertilisation and Embryology Authority (HFEA) of the United Kingdom recently approved a research application to use a gene-editing tool on early human embryos. The applicant, Kathy K. Niakan, PhD, a developmental biologist with the Francis Crick Institute in London, England, is seeking to define the molecular program of the earliest stages of human development. (Eli Y. Adashi, 3/3)
Tampa Bay Times:
Florida's Smart Investment In Mental Health
The Florida Legislature is making a smart call by adding money to the state budget to hire more mental health workers. For too long, Florida has starved state-run mental health hospitals of appropriate funding, leading to severely understaffed institutions that have become havens for violence and mayhem. Adding more workers is an important step in the right direction. (3/4)
The Washington Post:
Five Myths About Heroin
America’s epidemic of heroin and prescription-pain-reliever addiction has become a major issue in the 2016 elections. It’s worse than ever: Deaths from overdoses of opioids (the drug category that includes heroin and prescription analgesics such as Vicodin) reached an all-time high in 2014, rising 14 percent in a single year. But because drug policy has long been a political and cultural football, myths about opioid addiction abound. Here are some of the most dangerous — and how they do harm. (Maia Szalavitz, 3/4)
The Denver Post:
Michael Marshall Was A Candidate For Pre-Arrest Diversion Programs
Last November, 50-year-old Michael Marshall suffered an acute psychotic episode — symptomatic of his chronic schizophrenia — while in custody at the Denver jail. Multiple deputies forcibly restrained the 130-pound, 5-foot-3 man for 13 minutes, during which time he choked on his own vomit. Marshall died 10 days later when his family made the heartbreaking decision to discontinue life support. However, the district attorney determined that the deputies involved should not face prosecution. (Art Way, 3/4)
The New York Times:
Raise The Legal Age For Cigarette Sales To 21
California could soon raise the legal age for buying cigarettes and other tobacco products to 21, from 18. That change could help prevent many young people from becoming addicted and reduce premature deaths from lung cancer and other tobacco-related diseases. ... The biggest reason to raise the legal age to 21 is to reduce young people’s access to tobacco when they are more likely to become addicted and when their brains are still developing. Studies have found that nicotine, the main addictive ingredient in cigarettes, can impair cognition among young people. About 90 percent of adult smokers first use cigarettes before turning 19, and almost all smokers start before age 26, according to an Institute of Medicine study published last year. (3/5)