- KFF Health News Original Stories 3
- 2016 PPO Plans Remove Out-Of-Network Cost Limits, A Costly Trap For Consumers
- NIH Isn’t Ensuring That Clinical Trials Account For Different Outcomes By Sex
- Who Are America’s Caregivers? Nearly A Quarter Are Millennials
- Political Cartoon: 'Heart Of The Matter'
- Capitol Watch 3
- Senate Set To Vote On GOP Measure To Unravel Health Law
- Negotiations On Spending Bill Threatened By Policy Riders, National Security Issues
- Speaker Ryan To Push Work Requirements For Safety Net Programs
- State Watch 3
- Kentucky Republican Senators Don't Plan To Block $250M Allocated For Medicaid Funding
- Protests, Hate Mail And Stalkings Are Part Of Daily Life For Abortion Providers
- State Highlights: Quarantine Questions Continue; Californians Split On Whether People In U.S. Illegally Should Get Subsidized Health Care, Poll Finds
From KFF Health News - Latest Stories:
KFF Health News Original Stories
2016 PPO Plans Remove Out-Of-Network Cost Limits, A Costly Trap For Consumers
A trend among this year’s marketplace plans leaves some consumers responsible for potentially unlimited out-of-network health care bills, even though they chose plans in which they thought they had some financial protections. (Julie Appleby, 12/3)
NIH Isn’t Ensuring That Clinical Trials Account For Different Outcomes By Sex
Clinical trials should look at whether men and women are affected differently, but the NIH isn’t holding researchers accountable, a new report says. (Julie Rovner, 12/3)
Who Are America’s Caregivers? Nearly A Quarter Are Millennials
About 40 million Americans considered themselves caregivers in 2013, according to an AARP report. (Shefali Luthra, 12/3)
Political Cartoon: 'Heart Of The Matter'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Heart Of The Matter'" by Ron Morgan.
Here's today's health policy haiku:
CONSUMERS: WHEN IT COMES TO COVERAGE, READ THE FINE PRINT
Changes in health plans...
Higher out-of-network caps...
Caveat emptor!
- 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:
Senate Set To Vote On GOP Measure To Unravel Health Law
The measure, which is likely to land on President Barack Obama's desk and be greeted by a veto, would eliminate the health law's individual and employer mandates, medical device tax and so-called Cadillac tax. It also would cut off federal funding for Planned Parenthood.
The Associated Press:
Senate Set To OK Republican Bill Unraveling Health Care Law
Republicans are pushing toward Senate approval of legislation demolishing President Barack Obama's signature health care law and halting Planned Parenthood's federal money, setting up a veto fight the GOP knows it will lose but thinks will delight conservative voters. The White House promised a veto Wednesday, saying the bill would "take away critical benefits and health care coverage" from families. With Republicans lacking the two-thirds House and Senate majorities needed for a successful override, the measure became a political messaging battlefield as both parties looked toward the 2016 presidential and congressional elections. (Fram, 12/3)
Politico:
McConnell Boxes In Cruz, Rubio On Obamacare Repeal
Mitch McConnell is close to pulling off a feat that at first seemed impossible: Coax Ted Cruz and antagonistic conservative groups to back his strategy to repeal Obamacare. For weeks, Cruz, a 2016 GOP presidential candidate and chief McConnell nemesis, and conservative Sens. Mike Lee and Marco Rubio threatened to vote against a House-passed bill dismantling the health care law, insisting that it didn’t go far enough in the Republican quest to finally send a sweeping Obamacare repeal to the White House. (Kim, Everett and Haberkorn, 12/3)
The New York Times:
Senate Set To OK Republican Bill Unraveling Health Care Law
GOP lawmakers suggested the bill could serve as a bridge to a new Republican health care law. Though Obama's overhaul was enacted five years ago and gets tepid support in public opinion polls, GOP members of Congress have yet to produce a detailed proposal to replace it. Democrats say repeal would destroy a program that has reduced the number of uninsured Americans by around 16 million, let families' policies cover children until age 26 and guarantees coverage for people with pre-existing illnesses. (12/3)
Los Angeles Times:
After Many Failures, GOP Poised To Pass Affordable Care Act Repeal Bill
Republicans understand that Obama will veto any measure to undo his signature domestic policy accomplishment. But that doesn’t matter. As the party in charge, Republicans believe they owe it to the constituents who put them in office to force the issue. But yanking millions of Americans off health insurance may be easier as a campaign slogan than a policy initiative, and Thursday’s vote to pass a repeal bill from the Senate was proving difficult until the final gavel. (Mascaro, 12/3)
CBS News:
Senate Begins Debate On Obamacare Repeal Bill
The Senate is expected to vote on the bill Thursday, which the White House said President Obama would veto. The legislation would eliminate Obamacare's individual and employer mandates, the medical device tax and the so-called Cadillac tax. It would also cut off funding to Planned Parenthood for one year after an anti-abortion group released videos over the summer showing officials discussing the transfer of fetal tissue. (Shabad, 12/2)
Negotiations On Spending Bill Threatened By Policy Riders, National Security Issues
Congressional leaders have only 10 days to reach an agreement to avert a government shutdown.
The Washington Post:
Policy Fights Heat Up In Spending Negotiations
Democrats on Wednesday rejected a proposed spending bill deal from Republicans due to concerns over policy riders GOP lawmakers want to attach to the must-pass legislation, leaving congressional leaders with fewer than 10 days to reach an agreement to avert a government shutdown on Dec. 11. ... Democratic lawmakers and aides said the problematic policy riders in the Republican offer include proposals to ... Give health care providers the right to object to providing certain services that go against their religion, better known as a “conscience clause;” ... Strip family planning funding from organizations like Planned Parenthood; ... If any of those provisions appear in the final omnibus, they would be deal breakers, according to Democratic aides. (Snell and Demirjian, 12/2)
The Wall Street Journal:
Congressional Spending Bill Gets Entangled In Syria Refugee Measure
The GOP emphasis on national security has, for now, supplanted Republicans’ focus earlier this year on stripping federal funding for Planned Parenthood Federation of America in the spending bill, likely avoiding a standoff with Democrats over the women’s health organization. ... On the spending bill, House Republicans planned to confer Thursday morning over their strategy. Although the latest GOP proposal didn’t include language defunding Planned Parenthood, some conservatives are expected to mount a campaign to do so, or to include other antiabortion measures. But with many of those lawmakers expected ultimately to vote against the spending bill, GOP leaders have tried to use other methods to target Planned Parenthood. On Thursday, the Senate is expected to pass a bill tied to the budget process that defunds Planned Parenthood and repeals much of the 2010 health law, but would be vetoed by the president. (Peterson and Lee, 12/2)
The Hill:
Dems, Obama Battle Over Health Law's 'Cadillac' Tax
Democrats are growing more confident that they’ll win their battle with the White House over whether to include the repeal of ObamaCare’s “Cadillac” tax on high-cost insurance plans in a package of tax extensions both parties want to approve before the end of the year. Unions have long wanted to kill off the tax, and they have new leverage with Democrats readying for next year’s election, when labor’s support will be crucial for the party. (Jagoda and Ferris, 12/3)
Speaker Ryan To Push Work Requirements For Safety Net Programs
Elsewhere, Senate Minority Leader Harry Reid intends to force a vote on an amendment to keep guns away from people convicted of violating a law meant to ensure access to abortion clinics.
The Associated Press:
Speaker Ryan Calls For ‘Bold, Pro-Growth Agenda’
New House Speaker Paul Ryan is calling for tough work requirements and cuts to safety net programs as he sketches a vision for congressional Republicans for 2017 and beyond. In a speech Thursday that his staff is billing as his first major address, the Wisconsin Republican who took over the House gavel just over a month ago says Republicans must go beyond trying to undo President Barack Obama’s agenda, “as if we could time-travel back to 2009.” (Werner, 12/3)
Politico:
Harry Reid To Force Vote On Gun Amendment
Senate Democrats plan to force a vote on keeping guns out of the hands of people convicted of violating laws protecting the entrances of health care clinics. Senate Minority Leader Harry Reid has introduced the amendment, which would ban gun ownership by people who have been convicted of misdemeanors under the Freedom of Access to Clinic Entrances Act, a 1994 law meant to prevent violence and harassment at abortion clinics. (Haberkorn, 12/2)
Also, 9/11 first responders fight to keep their federal health care help, and some mental health care advocates reaffirm their opposition to proposed legislation in Congress --
The Associated Press:
9/11 First Responders Fight For Extension Of Health Care
A day after undergoing chemotherapy, 9/11 first responder Robert Digiovanni stood angrily outside Senate Majority Leader Mitch McConnell's office, railing about politics interfering with life-or-death issues. (12/3)
North Carolina Health News:
Advocates Reaffirm Opposition To Mental Health Bill
Advocates for people living with mental health and substance use issues reaffirmed their opposition to the federal “Helping Families in Mental Health Crisis Act.”
The legislation is more commonly known as the “Murphy bill” for its sponsor, Rep. Tim Murphy (R-PA), a psychologist. Opponents object to provisions in the bill they believe would restrict the privacy of people with mental health issues and their freedom to determine their own future. They also believe the bill would deprive people of care that advances recovery. A primary point of contention in the Murphy bill is the funding of incentives for states to implement assisted outpatient treatment initiatives, which allow a court official to order outpatient services as an alternative to institutionalization. (Sisk, 11/30)
Obamacare, Expensive New Drugs Drive Up 2014 U.S. Health Spending
Health spending last year grew by 5.3 percent to more than $3 trillion, which is the biggest jump since 2007.
The New York Times:
Health Spending In U.S. Topped $3 Trillion Last Year
Health spending in the United States last year topped $3 trillion — an average of $9,500 a person — as five years of exceptionally slow growth gave way to the Affordable Care Act’s expansion of Medicaid and private insurance coverage, and as prescription drug prices resumed their sharp climbs, the government said Wednesday. Health spending grew faster than the economy in 2014, and the federal share of health spending grew even faster, as major provisions of the Affordable Care Act took effect. Total spending on health care increased 5.3 percent last year, the biggest jump since 2007. (Pear, 12/2)
The Wall Street Journal:
Growth In U.S. Health-Care Spending Picks Up
The return to more robust growth after a slowdown in spending had been anticipated by economists. Still, it is likely to add to criticism that the 2010 health law isn’t doing enough to rein in costs. The report, based on 2014 government numbers and published in the journal Health Affairs, follows five consecutive years where average spending growth was less than 4% annually. The rate of growth is closely watched because the Obama administration has initiated changes in health-care delivery to help restrain spending. The administration said the faster pace of growth is still below levels before the law, a sign the ACA is working. (Armour, 12/2)
The Associated Press:
2014 US Health Spending Grew At Fastest Rate Of Obama Years
For the Obama administration, it may signal the end of an unusually long lull in health care inflation that yielded political dividends. While the president's health care law has increased coverage, the cost problem doesn't appear solved. Even now, the Republican-led Congress is preparing to send a repeal bill to his desk. "From the political point of view, it's absolutely significant," said Robert Blendon, who follows public opinion on health care at the Harvard T.H. Chan School of Public Health. Critics will point to the report as authoritative evidence the health law is starting to raise costs. (Alonso-Zaldivar, 12/2)
Los Angeles Times:
U.S. Health Spending Hits $3 Trillion As Obamacare And Rising Drug Costs Kick In
Experts aren't predicting a return to double-digit increases in medical spending. But the latest trend underscores how difficult it will be for policymakers, employers and insurers to control healthcare costs going forward. The upswing could further squeeze American workers. Health insurance premiums and deductibles keep taking a bigger bite of their paychecks, as employers shift more healthcare costs to employees. (Terhune, 12/2)
NBC News:
Obamacare, Pricey New Drugs Send Up US Health Spending
The new CMS report sees a large increase in the growth in spending by private health insurance, which covered just under 190 million Americans in 2014, up from 187.7 million the year before. "Total private health insurance spending growth accelerated from 1.6 percent in 2013 to 4.4 percent in 2014, driven in part by the expansion of health insurance coverage under the Affordable Care Act," the report reads. Private health insurance companies spent $991 billion on patients in 2014, accounting for one-third of total national health care expenditures. (Fox, 12/2)
The Washington Post's Wonkblog:
Obamacare And Drug Prices Push Health Spending To $3 Trillion
Another major driver of the increases was prescription drug spending, which grew more than 12 percent to $297.7 billion -- its largest annual increase in more than a decade. Anne Martin, an economist in the office of the actuary at CMS attributed the growth in part to a new generation of pricey hepatitis C drugs. Price hikes on brand name drugs also contributed, along with fewer savings on drugs whose patents expired. (Johnson, 12/2)
The Huffington Post:
National Health Care Spending Is Up For A Really Obvious Reason
President Barack Obama and Democrats in Congress designed the Affordable Care Act to spend a lot of money to give more people health insurance so they could access medical care. The law seems to have succeeded on all three counts, and the results are showing up on America's national health care tab. (Young, 12/2)
Insured By A PPO? Beware Of Costly Trap As Insurers Remove Out-Of-Network Limits
A trend among this year’s marketplace plans leaves some consumers responsible for potentially unlimited bills when they thought they had some financial protections. And in other Obamacare news, The Texas Tribune reports on a rise in health insurance scams.
Kaiser Health News:
2016 PPO Plans Remove Out-Of-Network Cost Limits, A Costly Trap For Consumers
Citing the flexibility they offer, many consumers choose health plans that provide some coverage outside the insurer’s network. Traditionally, such plans not only paid a portion of the bill, but also set an annual cap on how much policy holders paid toward out-of-network care. Not anymore. (Appleby, 12/3)
The Texas Tribune:
Rise Seen in Health Insurance Scammers
It might be a sign directing callers to an 800 number where they can get help choosing an Affordable Care Act plan — for a fee. Or it might be a cardboard poster attached to a telephone pole offering “Real insurance. Not Obamacare.” In any case, advocates for the uninsured warn, if it asks for money, it's probably a scam to prey on low-income Texans seeking mandated insurance coverage under President Barack Obama’s signature health law. Nonprofit workers in the Rio Grande Valley say they’ve seen an increase this year in sales tactics — including the examples cited above — that are at best unethical and at worst illegal, charging low-income Texans fees for assistance they are entitled to receive for free. (Walters, 12/2)
Elsewhere, other health law developments are reported from Georgia and Virginia -
Georgia Health News:
Ga. Exchange Enrollment Already Past 100,000
More than 100,000 Georgians have signed up for coverage in the insurance exchange as of Nov. 28, federal officials announced Wednesday. The state’s total of 105,299 trailed only Florida, Texas and North Carolina among the 38 states that use the federally run marketplace, created under the Affordable Care Act. It’s the first state-by-state enrollment breakdown since open enrollment began Nov. 1. (Miller, 12/2)
The Associated Press:
Nearly 87,000 Virginians Enroll In Health Insurance
Federal officials say nearly 87,000 Virginians have chosen health plans in the insurance marketplace created by President Barack Obama’s health care law since an open enrollment period began on Nov. 1. The U.S. Department of Health and Human Services released the 2016 enrollment figures Wednesday. (12/3)
High Court Hears Oral Arguments On Vermont Health Care Data Law
Some of the state insurers argued that federal law bars states from requiring insurers to supply data on the costs and outcomes of their services. But some policymakers counter that these databases are important in the effort to improve quality of care and control costs.
The Associated Press:
High Court Skeptical Of State Power To Gather Health Data
The Supreme Court on Wednesday appeared skeptical that state officials have the power to require health insurers to turn over reams of data revealing how much they pay for medical claims. Most of the justices seemed to agree during a one-hour argument that efforts by Vermont and other states to collect and publicize the data conflict with federal law governing certain health plans. (Hananel, 12/2)
The Wall Street Journal:
Vermont’s Effort To Gather Data On Health-Care Costs Faces Supreme Court Test
Vermont’s Green Mountain Care Board requires insurers to provide information on payments made to medical providers, hoping that by knowing what is paid for health care it can find ways to keep costs in check and improve efficiency and quality of care. At least 18 other states already have or are setting up similar databases, but Vermont has the boldest experiment in mind: eventually building a single-payer plan that would aim for universal coverage akin to programs in Canada and some European countries. ... Vermont’s solicitor general, Bridget Asay, told the Supreme Court on Wednesday that Congress intended to encourage states to collect data that could provide insight into improving care or reducing expenses. She said the 2010 Affordable Care Act, which amended the 1974 law, “contemplated a robust federal-state partnership in health experimentation.” (Bravin and Radnofsky, 12/2)
Reuters:
U.S. Justices Cast Doubt On Scope Of Vermont Healthcare Data Law
Members of the U.S. Supreme Court on Wednesday indicated that Vermont and 17 other states could be prevented from collecting healthcare information from certain employee health plan administrators. The nine justices heard a one-hour oral argument over whether a 2005 Vermont data collection law aimed at improving the quality of healthcare applies to self-funded insurance plans, which are most commonly used by large companies. (12/2)
California Healthline:
Supreme Court To Hear Case Deciding Fate of All-Payers Claims Databases
Some legislators and policymakers consider the databases important tools to improve care and reduce costs. (Gorn, 12/2)
Super PACs Spend Campaign Cash -- Even If Candidates Don't Want It
Even for presidential candidates like Donald Trump and Bernie Sanders who have denounced the political groups, the super PACs are planning big spends on their behalf. In more campaign news, after questioning other candidates but not releasing his own medical records, Trump says he will do so.
The Associated Press:
Super PACs Dole Out Cash, Whether Candidates Like It Or Not
Unlike formal campaigns for president, super PACs are allowed by law to accept donations of any size. That fact makes them a juicy political target for populist candidates such as Trump and Sanders. Yet already, a super PAC allied with a nurses' union that endorsed Sanders over Democratic front-runner Hillary Clinton in August has put more than $600,000 into pro-Sanders digital and print ads in the important early primary states of Iowa, New Hampshire, South Carolina and Nevada. Billboards put up by the super PAC, National Nurses United for Patient Protection, proclaim: "Politics As Usual Won't Guarantee Healthcare For All. Bernie Will." (12/2)
CNN:
Donald Trump To Release Medical Report
Donald Trump said Thursday he will release a doctor's report of his health within two weeks and it will show "perfection." ... Earlier in the morning Trump touted his health after a Politico report Thursday morning pointed out that he had called on other candidates to release their medical reports but had not released his own. (LoBianco, 12/3)
Politico:
Trump Relents After Withholding Medical Records
Donald Trump says he is in good health, but voters up to now have had to take his word for it. Trump once said that all presidential candidates should release their medical records. But so far in the 2016 race, he had declined to release his, and a campaign spokeswoman had not responded to multiple requests for comment about the candidate’s health records stretching back to October. (Schreckinger, 12/3)
Kentucky Republican Senators Don't Plan To Block $250M Allocated For Medicaid Funding
Though Republican lawmakers fought expansion of the low-income health program, it now covers over 400,000 Kentucky residents. State Senate leaders say they will wait for the new Medicaid plan of incoming Republican governor, Matt Bevin, who has said he wants to roll it back. Elsewhere, Arkansas Republican Gov. Asa Hutchinson stops an unfinished Medicaid enrollment system. And the Centers for Medicare and Medicaid Services is allowing states asking for Medicaid waivers to use money to provide housing for some who are ill and homeless.
The Associated Press:
Kentucky GOP Senators Don't Plan To Block Medicaid Spending
Republican leaders of Kentucky's state Senate said Wednesday they will not block about $250 million in state spending needed to pay for the health insurance of more than 400,000 people on the state's expanded Medicaid program. Outgoing Democratic Gov. Steve Beshear used an executive order to expand Kentucky's Medicaid program under the federal Affordable Care Act. Because the federal government paid for 100 percent of the first three years of the expansion, Beshear did not need to ask the state legislature for money to pay for it. But Senate Republicans, fearful of the eventual cost of the program, tried and failed at the time to prevent Beshear's actions. (Beam, 12/2)
ArkansasOnline:
Governor Halts Project To Check Medicaid Rolls
Gov. Asa Hutchinson has directed the state Department of Human Services to hold off on adding to a Medicaid eligibility and enrollment system that already has doubled its expected cost. The unfinished system also has been blamed for delays in processing applications and reviewing the eligibility of those already enrolled. (Davis, 12/3)
Stateline:
States Freed To Use Medicaid Money For Housing
Communities with big homeless populations are increasingly turning to a strategy known as housing first. The idea: Helping chronically homeless people to find a permanent home, and stay in it, is the best way to help them lead stable, healthy lives. Urban Ministries Center's leaders took a desolate area beyond Charlotte's Uptown and turned it into a supportive apartment community for people transitioning from homelessness. The approach has been used in cities like Chicago and Cleveland, as well as in several states, such as Massachusetts, Minnesota and Washington, as local nonprofits have worked to provide both housing and health care to homeless people. And it got an important endorsement in June, when the Centers for Medicare & Medicaid Services (CMS) told state Medicaid offices around the country that Medicaid dollars, usually reserved for clinical services and medications, could be used to help chronically homeless people and others with long-term disabilities to find and maintain permanent housing. (Ollove, 12/2)
Protests, Hate Mail And Stalkings Are Part Of Daily Life For Abortion Providers
ProPublica talks with an author who interviewed 87 clinic owners, doctors and employees about their experiences. In related news, following the shooting at a Colorado Planned Parenthood, regional reproductive rights groups are asking the state legislature to classify attacks on abortion facilities as domestic terrorism.
ProPublica:
For Abortion Providers, A Constant Barrage Of Personalized Harrassment
Since 1993, 11 people have been killed in abortion-related attacks — doctors, clinic staff, and last week, a police officer and two visitors in the line of fire at a Planned Parenthood clinic in Colorado Springs. While the investigation continues into the shooter’s background and motives, David Cohen, a law professor at Drexel University, says that stalking and harassment pose a much more common threat to abortion providers and their families. For their May 2015 book “Living in the Crosshairs: The Untold Stories of Anti-Abortion Terrorism,” Cohen and co-author Krysten Connon interviewed 87 providers in 34 states — clinic owners, doctors, and other employees. ProPublica spoke with Cohen about their findings; the interview was edited for clarity and length. (Martin, 12/2)
The Denver Post:
ProgressNow, NARAL Pro-Choice, Blame Republicans In Planned Parenthood Attacks
The liberal group ProgressNow Colorado assembled Planned Parenthood supporters on the state Capitol steps Tuesday to characterize the rhetoric of anti-abortion Republicans as the match that lit the fuse in last Friday's mass shooting in Colorado Springs. "No one should have to fear for their lives when they're just out just being in their communities, when they're going to the grocery store, when they're going to the doctor, accessing health care," ProgressNow Colorado's executive director Amy Runyan-Harms said at a the press conference. (Bunch, 12/1)
News outlets report on health care developments in California, New Mexico, Georgia, Colorado, Minnesota, Connecticut, New Jersey, Wisconsin, Massachusetts and Washington, D.C.
The New York Times:
Ebola Crisis Passes, But Questions On Quarantines Persist
The Ebola epidemic has subsided, but in the United States the fallout over how health care workers and their families were treated during the crisis continues. Throughout the months of fear and uncertainty, the federal Centers for Disease Control and Prevention recommended monitoring people entering the United States from Ebola-affected countries, not confining them, because research showed that people with Ebola are not contagious before they show symptoms. But states, which have the legal authority to impose quarantines, often exceeded those guidelines, restricting the movements of returning health workers and others. (Fink, 12/2)
Los Angeles Times:
Californians Split On Health Coverage For Those In The U.S. Illegally
A new statewide poll found a noticeable split among Californians when it comes to offering government subsidized healthcare regardless of immigration status. The split is between Californians who vote and those who don’t. (Myers, 12/2)
The Sacramento Bee:
Gavin Newsom Picks Up California Nurses Endorsement
The California Nurses Association, whose support helped Gov. Jerry Brown defeat Republican Meg Whitman in 2010, on Wednesday endorsed Lt. Gov. Gavin Newsom to succeed him. The endorsement, though not unexpected, comes unusually early – three years before the 2018 election. It is an indication of Newsom’s appeal to organized labor, and also a challenge facing one of his main rivals, former Los Angeles Mayor Antonio Villaraigosa. (SIders and Cadelago, 12/2)
The Associated Press:
Feds Want New Mexico To Repay $16M In Bonus Payments
Investigators recommended Tuesday that New Mexico repay the federal government nearly $16 million they say the state should not have received under a health insurance program for low-income children. The U.S. Health and Human Services' Office of Inspector General made the recommendation following a review of enrollment over a five-year period beginning in fiscal year 2009. According to the findings, New Mexico overstated the number of children in the program when compared to enrollment data maintained by the Centers for Medicare and Medicaid Services. (Bryan, 12/1)
The Atlanta Journal-Constitution:
Georgia Authorities Shut Down 12 Care Homes For Elderly, Arrest 8 People
A team of state and local authorities shut down a dozen Georgia unlicensed care homes for the elderly and disabled on Wednesday, freeing as many as 30 people living in unsafe conditions. The daylong "Operation Mercury" arrested eight people who were running the homes in Gwinnett County operators who at times left their residents unattended and forced them to fork over food stamps and Social Security benefits as rent, police said. Metro Atlanta officials have struggled and largely failed to stop the proliferation of unlicensed personal care homes. Wednesday's operation reflected a new strategy of combining agencies when descending on these places. (Stevens, 12/8)
Los Angeles Times:
Prudential To Offer Life Insurance For People Living With HIV
Prudential Financial Inc. said it will make life insurance coverage available to people living with HIV, becoming the first major insurer to do so, according to California Insurance Commissioner Dave Jones. People with HIV will be eligible for 10- and 15-year individual convertible term life insurance products. The policies will be available to those who meet the underwriting qualifications, the Newark, N.J.-based company said. (Masunaga, 12/2)
The Denver Post:
Evergreen Fee-For-Emergency Response Unsuccessful At Bringing In Funds
Evergreen Fire Rescue's new fee charging out-of-district residents for response to their at-fault accidents has not brought in as much revenue as hoped. The district is now exploring the possibility of asking voters for a mill levy increase, as well as a bond to fund improvements to one of its stations. "The majority of our accidents that occurred in our area that had an injury involved drivers who live in our district," said Stacee Martin, public information officer for Evergreen Fire Protection District. Fee-for-service "was not the revenue stream we thought it may be, based on past years." (Klemaier, 12/3)
Minnesota Public Radio:
Minnesota OKs Using Medical Pot For Pain
The Minnesota Health Department says it will expand the legal use of medical marijuana to cover people with intractable pain. The department's top leaders announced their decision Wednesday after several meetings around the state to gather public input. (12/2)
The Connecticut Mirror:
Lembo Helps Dems In D.C. Sharpen Attack On High Drug Costs
Connecticut Comptroller Kevin Lembo has joined a growing Democratic attack on high drug prices, an issue expected to be at the center of many Democratic election campaigns next year. He was supposed to be there in person, but fog and rain grounded his plane and kept him from testifying at a Capitol Hill hearing on drug pricing Wednesday. Lembo submitted written testimony instead. (Radelat, 12/2)
The Associated Press:
Man Allegedly Used Genetic Testing Scheme To Cheat Medicare
Federal prosecutors say a New Jersey man defrauded Medicare by convincing hundreds of senior citizens to submit to unnecessary genetic testing. Seth Rehfuss was arrested Wednesday and charged with health care fraud. The 41-year-old Somerset man was due to make his initial court appearance later in the day. Since July 2014, prosecutors say Rehfuss and others used a nonprofit agency known as The Good Samaritans of America to gain access to low-income senior housing complexes. (12/2)
The Associated Press:
Wisconsin Lab Settles Medicare Fraud Allegations
A laboratory company in western Wisconsin and its owners have agreed to pay the federal government $8.5 million to settle claims it submitted false billing information to Medicare. Federal prosecutors say the settlement resolves allegations that Pharmasan Labs, of Osceola, and its billing company, NeuroScience, also violated Medicare rules on services referred by practitioners who weren't doctors. (12/2)
The Associated Press:
Doctor Prescribed Opioids To Suspected Heroin Users
A western Massachusetts doctor has been indicted on dozens of charges including unlawfully prescribing oxycodone and other drugs and making false Medicaid claims. Dr. Fernando Jayma was indicted Monday by state Attorney General Maura Healey on charges including illegally prescribing controlled substances, false Medicaid claims and larceny. Authorities say Jayma was prescribing medications to patients who had tested positive for heroin and other non-prescription drugs. They say he also had other doctors see his patients, then billed MassHealth as if he had treated them. (12/2)
The Washington Post:
Judge Says Paramedic Not Negligent For Ambulance Running Out Of Gas At White House
The summer of 2013 delivered one public relations punch after another to the D.C. fire department. Top officials admitted they didn’t know how many vehicles they had. Ambulances were catching fire idling at emergency calls. Delays getting patients to hospitals seemed routine. (Hermann, 12/2)
Viewpoints: GOP's 'Doomed Quest' On Health Law; Insurers And Drug Prices; HIV Therapy
A selection of opinions on health care from around the country.
The Washington Post:
The GOP’s Latest Doomed Quests To Kill Obamacare
Nearly six years have elapsed since Obamacare became law. The Supreme Court has upheld the foundations of the law — twice. Lawmakers tried dozens of times to repeal the law — and failed every time. President Obama was reelected after a campaign that focused in large part on the Affordable Care Act. More than 17 million people gained health-care coverage. But, like Captain Ahab and the white whale, congressional Republicans continue their quest to repeal the law. (Dana Milbank, 12/2)
Los Angeles Times:
A New Obamacare Myth Is Born: Hordes Of Americans Are 'Gaming' The System
With the traditional attack points on the Affordable Care Act having faded away--most enrollees were already insured (wrong), millions of people lost their coverage and couldn't replace it (wrong), etc.--Obamacare's critics have been looking for new ones. An up-and-coming star of this firmament is the notion that Americans are "gaming" the system by waiting until they're sick to enroll in an individual policy, then dropping it as soon as they're cured. (Michael Hiltzik, 12/2)
The Wall Street Journal's Washington Wire:
What’s The Political Power Of Those Newly Insured Under Obamacare?
An estimated 17 million uninsured have been covered by the Affordable Care Act. As that number grows in the coming years, it could have political implications: How will the newly insured behave at the ballot box? Will they vote? Will they become a Democratic constituency? The ACA may be an issue in the 2016 elections, but the newly insured are unlikely to become an important electoral factor themselves. (Drew Altman, 12/3)
Modern Healthcare:
Drugmakers Make Valid Point About Insurers' Role In High Drug Costs
Drugmakers are facing a torrent of criticism from healthcare providers, patient advocates, politicians, and insurers over the high prices of their prescription drug products. ... But largely overlooked in the legitimate uproar over high drug prices is the pharmaceutical industry's valid counterattack against insurers. The industry says policymakers should focus their scrutiny on insurers that are designing benefit plans with high deductibles for prescription drug coverage. (Harris Meyer, 12/3)
The Washington Post:
Premature Finger-Pointing After The Planned Parenthood Shooting
Predictably, the killing rampage at a Colorado Springs Planned Parenthood facility has prompted a political scrimmage of the usual sort. From the pro-choice front, we hear that pro-lifers and Republican rhetoric made the killer do it. Or, at least, they created an environment in which a deranged person might become unhinged. From the pro-life trenches, we hear, There they go again, blaming the messenger. (Kathleen Parker, 12/1)
The Baltimore Sun:
Maryland's Addiction Problem
A task force appointed by Gov. Larry Hogan to look into how Maryland can reduce the number of heroin overdose deaths released a wide-ranging series of recommendations yesterday that included both expanded access to treatment for addicts and tougher law enforcement measures against drug dealers and gangs. The 11 members of the panel, chaired by Lt. Gov. Boyd Rutherford, acknowledged that there are no quick or easy solutions to overdose deaths and that a coordinated, multifaceted approach is needed to address them. But their final report offered few specifics regarding how large an effort will be needed to make a dent in the problem or how much it would cost. (12/2)
The Baltimore Sun:
Doctors Need More Training To Address Obesity
Chances are someone close to you is obese or overweight; just look at the statistics. Worldwide, obesity has nearly doubled since 1980. Worldwide, more than 1.4 billion adults 20 and older are overweight, and of those, 500 million are obese. In the United States, more than two-thirds of adults and one-third of children ages 6 to 19 are overweight or obese. And obesity rates are higher in Baltimore than the national average: According to the Centers for Disease Control, almost 40 percent of Baltimoreans are overweight and almost 30 percent are obese. (Bruce Y. Lee, 12/2)
news@JAMA:
A Pulse Check On Primary Care Transformation
Transforming primary care was encoded into the Affordable Care Act as a central part of reforming how health care is delivered. Major investments supported enhanced reimbursement for primary care, community health center expansion, and multipayer partnerships for practice transformation. ... An Agency for Healthcare Research and Quality synthesis report of 14 grants to study primary care transformation revealed few overarching “pearls.” Instead, the success of transformation depended on context. (Dave A. Chokshi, 12/1)
The New England Journal of Medicine:
Applying Public Health Principles to the HIV Epidemic — How Are We Doing?
Over the past decade, U.S. health departments, community organizations, and health care providers have expanded HIV screening and targeted testing, and as a result a greater proportion of HIV-infected people are now aware of their infection; the number of reported new diagnoses of HIV infection has decreased; and people with HIV infection are living longer. ... Despite this progress, most people living with HIV infection in the United States are not receiving antiretroviral treatment (ART); notification of partners of infected people remains the exception rather than the norm; and several high-risk behaviors have become more common. ... Although surveillance has improved, data-driven targeted interventions are not being rapidly and effectively implemented in most geographic areas. Much more progress is possible through further application of public health principles by public health departments and the health care system and, most important, through closer integration of health care and public health action. (Thomas R. Frieden, Kathryn E. Foti and Jonathan Mermin, 12/3)
The New England Journal of Medicine:
Ending The HIV–AIDS Pandemic — Follow The Science
[B]etween 2000 and 2014, the rollout of ART saved an estimated 7.8 million lives worldwide. Despite this success, the timing of ART initiation has remained the subject of intense debate. As with any therapy, clinicians and their patients weighed ART's benefits against its risks, and the results of that calculus seemed to depend on the patient's stage of illness. ... Today, a series of well-designed efficacy studies conducted over a period of more than a decade has fundamentally changed this discussion. (Anthony S. Fauci and Hilary D. Marston, 12/3)