- KFF Health News Original Stories 4
- After 3 Years Of Decline, Hospital Injury Rates Plateau, Report Finds
- Major Insurer Says It Will Offer Individual Life Insurance Coverage To People With HIV
- Aid-In-Dying Laws Only Accentuate Need For Palliative Care, Providers Say
- Sweet Name Of Kids' Clinic Gives Some People Heartburn
- Political Cartoon: 'Push Poll?'
- Capitol Watch 2
- Senate Scheduled To Vote This Week On Obamacare Repeal
- GOP Leader Indicates No Shutdown Expected On Planned Parenthood Funding
- Health Law 1
- Insurance Shoppers Beware: Experts Warn Against Picking Health Insurance Just On Premium Costs
- Marketplace 2
- Ever Wonder Why Rx Drugs Cost So Much In The U.S.?
- UnitedHealth Projects Revenue In 2016 Will Be Lower Than Analysts' Estimates
- State Watch 5
- Alabama Ends Legal Fight With Planned Parenthood; Judge Blocks Missouri Effort To Revoke Clinic License
- Connecticut Hospitals Ready Legal Action To Fight State Provider Tax
- Two Democratic Senators Question Iowa Gov.'s Plan To Move Ahead With Medicaid Privatization
- New York City To Announce Plans To Boost HIV Prevention And Health Care Funding
- State Highlights: D.C. Residents Embrace Paid Family Leave, But Don't Want To Pay For It, Poll Says; Judge Directs Ill. To Pay $13M In Insurance Costs For Home Health Workers
From KFF Health News - Latest Stories:
KFF Health News Original Stories
After 3 Years Of Decline, Hospital Injury Rates Plateau, Report Finds
The federal report estimates that 12 of every 100 hospital stays included an infection or other avoidable complication in 2014, about the same rate as 2013. Still, that was 17 lower than 2010. (Jordan Rau, 12/1)
Major Insurer Says It Will Offer Individual Life Insurance Coverage To People With HIV
The move signals growing recognition of HIV/AIDS’ transformation from a death sentence to a serious but manageable disease. (Barbara Feder Ostrov, 12/1)
Aid-In-Dying Laws Only Accentuate Need For Palliative Care, Providers Say
Doctors who minister to seriously ill patients say the flurry of aid-in-dying laws show just how afraid people are of a painful death, and how important it is to ease their suffering. (Anna Gorman, 12/1)
Sweet Name Of Kids' Clinic Gives Some People Heartburn
The Krispy Kreme Challenge Children's Specialty Clinic gets its name from a student-run charity race in Raleigh, N.C., that has already raised $1 million for kids. Still, some find the name unhealthy. (Michael Tomsic, WFAE, 12/1)
Political Cartoon: 'Push Poll?'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Push Poll?'" by Ron Morgan.
Here's today's health policy haiku:
GUESS WHAT THE SENATE IS UP TO
Just another week
On the Hill … And another
Health law repeal vote.
- 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.
WEB BRIEFING FOR MEDIA: On Wednesday Dec. 2 at 1 p.m. ET, KHN will host an interactive web briefing to help reporters explore new ways to cover caregiving issues. Interested? Register now.
Summaries Of The News:
Senate Scheduled To Vote This Week On Obamacare Repeal
The Senate legislation would delete large parts of the 2010 health law and will likely set up a veto fight with President Barack Obama. At the same time, Congress will attempt to move forward on key budget issues.
The Washington Post:
Senate To Vote On Obamacare Repeal This Week
Senate Republicans plan to vote this week on legislation that would repeal large parts of President Obama’s signature health care law, setting up a veto fight in the coming weeks. Leaders expect a final vote on a budget reconciliation bill targeting Obamacare as early as Thursday with debate beginning no later than Wednesday. The legislation would also cut off federal funding for Planned Parenthood, allowing Republicans a chance to force a veto confrontation with Obama over both issues before the end of the year. (Snell, 11/30)
Politico:
Obamacare Repeal May Finally Land On Obama's Desk
Republicans are closer than ever to putting a repeal of Obamacare on the president’s desk. After an all-out effort by emissaries and allies of Senate Majority Leader Mitch McConnell over the past two weeks to woo skeptical GOP senators, Senate Republicans are lining up behind a more aggressive plan to gut President Barack Obama's signature achievement through a majority-vote budget mechanism known as reconciliation. Obama, of course, would veto the proposal. But it would allow Republicans to finally say that Congress voted to overturn the health care law they've been railing against since it was signed into law nearly six years ago. Republicans have voted more than 50 times over the past five years to repeal Obamacare, with most of the attempts made in the House. (Everett and Haberkorn, 11/30)
The Wall Street Journal:
U.S. Bipartisan Talks Aimed At Making Tax Breaks Permanent
Republicans could win permanent extensions of the research and development tax credit, the deductibility of state sales taxes and a handful of other business tax breaks that expired at the end of 2014. The GOP would also get an extension, though perhaps not permanent, of bonus depreciation, a tax break for capital investment that’s been in place in some form since 2008. ... Democrats would get permanent extensions of tax credits for low-income families that are expiring at the end of 2017. They could also get an extension of the solar energy tax credit. The wind energy credit could also get extended and would be phased out, Hatch said. Delays of two pieces of Obamacare—the medical device tax and the Cadillac tax on high-cost health insurance—could also be included, [Sen. Orrin] Hatch said. Those taxes have bipartisan opposition. (Rubin, 11/30)
GOP Leader Indicates No Shutdown Expected On Planned Parenthood Funding
House Majority Leader Kevin McCarthy, R-Calif., signaled that Republicans are unlikely to force a government shutdown over federal funding for the reproductive health group. Meanwhile, U.S. senators from California are urging colleagues to "tone down" their rhetoric on the abortion issue after Friday's shooting at a Colorado Planned Parenthood clinic. However, other news outlets examine the dynamics in this heated debate and report on some of the most recent verbal salvos.
The New York Times:
No Shutdown Expected On Planned Parenthood
Days after a gunman killed three people at a Planned Parenthood clinic in Colorado, the House majority leader, Kevin McCarthy, said that Republicans were not planning to force a showdown with the White House over cutting federal financing to the group as many conservative lawmakers had been demanding just a few weeks ago. “I do not hear people shutting the government down over it right now, so that’s the bottom line,” Mr. McCarthy said at a news conference at the Capitol on Monday, where he was pressed about whether a measure cutting off Planned Parenthood’s funding would be attached to a must-pass spending measure later this month. (Herszenhorn, 11/30)
The Wall Street Journal:
National Security Will Be Focus In Year-End Spending Bill, GOP Leader Says
The California Republican’s comments suggested that party members won’t make defunding Planned Parenthood their primary focus in the negotiations over the spending bill. “Security is becoming the top issue I’m hearing [from lawmakers], especially in the last couple of weeks,” Mr. McCarthy said, when asked whether lawmakers were pushing to strip Planned Parenthood of federal funding. Mr. Ryan has been reluctant to rule out the possibility of a shutdown, saying that doing so would diminish Republicans’ bargaining power in negotiations over the bill. But Mr. McCarthy said he expects Congress would pass the spending bill by Dec. 11 or in the following week. (Peterson, 11/30)
The Associated Press:
Planned Parenthood Inquiry Defended
Republican congressional leader on Monday defended a House investigation of Planned Parenthood's provision of fetal tissue to researchers, offering no suggestion that last week's shooting deaths at one of the group's clinics will cause the GOP to retreat from that probe. House Majority Leader Kevin McCarthy (R., Calif.) also indicated that the Republican-run Congress will not risk a government shutdown fight with President Obama over GOP efforts to halt federal funding for the organization, which provides abortions and other health services to women. (Fram, 12/1)
Los Angeles Times:
California Senators Are Worried About Planned Parenthood Rhetoric
Friday's shooting deaths of three people at a Planned Parenthood in Colorado, and a series of arson incidents in recent months — including one in the Los Angeles area — have prompted California’s senators to urge colleagues to tone down partisan rhetoric on Planned Parenthood. “Doctors, nurses and patients shouldn’t be terrorized or threatened. The poisonous rhetoric must stop,” Sen. Dianne Feinstein (D-Calif.) tweeted Monday. (Wire, 11/30)
The Washington Post:
The Very Bitter Debate Over Planned Parenthood, In 6 Moments
The shootings at a Planned Parenthood facility in Colorado Springs, Colo., over the holiday have put the debate over the women's health services and abortion provider back in the news. And already, left and right are arguing in very heated terms over the shooter reportedly saying "no more baby parts" while discussing his motives. (Phillips, 11/30)
The Washington Post:
Ted Cruz Cites Reports That Planned Parenthood Shooter Could Be ‘Transgendered Leftist Activist.’ What?
Officially, the motive of alleged Planned Parenthood shooter Robert Lewis Dear remains unclear. ... But abortion rights advocates and opponents have quickly formed vastly different theories based on their own hand-picked media reports. On one side, Dear is basically what you’d imagine an abortion clinic attacker to be — an antiabortion activist. On the other, as Sen. Ted Cruz (R-Tex.) put it Sunday, Dear might be a "transgendered leftist activist." Cruz's campaign later said he was not making this allegation himself, but simply pointing out that there are conflicting reports — including some that Dear was registered to vote as a woman. (Borchers, 11/30)
And here's an update on the alleged shooter -
The Wall Street Journal:
Suspect In Colorado Planned Parenthood Shootings Makes First Court Appearance
The man accused of killing three people and wounding numerous others at a Planned Parenthood clinic in Colorado Springs, Colo., said little in his first court appearance Monday. Robert Lewis Dear, 57 years old, who allegedly opened fire at the clinic on Friday before surrendering to police after a lengthy standoff, appeared via a video feed in a courtroom in Colorado’s El Paso County. (Frosch, 11/30)
Insurance Shoppers Beware: Experts Warn Against Picking Health Insurance Just On Premium Costs
In other health law and insurance news, media outlets report on continued problems on Vermont's health insurance exchange, families struggle with growing long-term care costs and the Supreme Court is set to hear a case on states' efforts to collect health insurance claims in a database.
The Philadelphia Inquirer:
Don't Just Grab Lowest Premium
If you're in the individual market for health insurance and want to be covered by New Year's Day, you have until Dec. 15 to choose your plan on the Affordable Care Act exchange. Choosing a health plan is confusing, so it's understandable if you're tempted to just grab the lowest premium you can find. But don't do it. Depending on your family's income and health needs, you could come out ahead with a plan that has a higher monthly premium but that offers better coverage. (Calandra, 11/29)
Burlington Free Press:
Vermont Health Connect Promises Fixes
Although Gov. Peter Shumlin recently proclaimed the Vermont Health Connect a “totally different ballgame” in comparison to last year’s performance, a House committee on Monday heard of several unresolved problems affecting the insurance exchange. Cassandra Gekas, operations director for Vermont Health Connect, said staff members are working on a problem in which hundreds of people who paid their monthly premiums on time were canceled for nonpayment. Apparently, the cancellations were related to a five- to seven-day period it takes for the system to process end of the month payments. (Gram, 11/30)
The San Diego Union-Tribune:
Losing Your Life Savings To Long-Term Care
When he was growing up in Queens, N.Y., in the 1930s, Robert Raymond's family struggled with money. He remembers vowing that he wouldn't be in the same financial position when he got older. Like so many older Americans, the Raymonds have seen their life savings swallowed up by long-term care. It took the couple decades to turn their modest salaries into a $100,000 nest egg and just five years to completely deplete it after Claire moved into an assisted living facility. (Parente, 11/30)
Politico Pro:
Supreme Court To Hear Case On Claims Databases
The Supreme Court will hear oral arguments this week on a case that could upend states’ efforts to broadly collect health insurance claims in a database, a widely used tool aimed at improving transparency of health care costs. (Mershon, 11/30)
Ever Wonder Why Rx Drugs Cost So Much In The U.S.?
The Wall Street Journal examines the cost of prescription drugs in the U.S. compared with other developed nations while other news outlets report that Express Scripts will offer a lower-cost alternative to a $750-per-pill medication made by Turing Pharmaceuticals. In the background, STAT finds that public opinion supports government actions to hold down drug costs -- such as allowing Medicare to negotiate prices with drug companies.
The Wall Street Journal:
Why The U.S. Pays More Than Other Countries For Drugs
Norway, an oil producer with one of the world’s richest economies, is an expensive place to live. A Big Mac costs $5.65. A gallon of gasoline costs $6. But one thing is far cheaper than in the U.S.: prescription drugs. A vial of the cancer drug Rituxan cost Norway’s taxpayer-funded health system $1,527 in the third quarter of 2015, while the U.S. Medicare program paid $3,678. An injection of the asthma drug Xolair cost Norway $463, which was 46% less than Medicare paid for it. (Whalen, 11/30)
The Associated Press:
Express Scripts Offers Low-Cost Alternative To Turing Drug
Other drugmakers have also recently purchased the rights to old, cheap medicines that are the only treatment for serious diseases and then hiked prices. The practice has triggered government investigations, politicians' proposals to fight "price gouging," and heavy media scrutiny. The Express Scripts decision means that a cheaper alternative to Daraprim created by Imprimis Pharmaceuticals will now be available to about 25 million customers through its formulary. What those customers pay will depend on their insurance coverage. That could mean prescriptions that come with a co-payment as low as $10 or $20 for the whole bottle of pills. (12/1)
The New York Times:
Top Prescription Plan To Offer $1 Alternative To $750 Pill
Turing Pharmaceuticals’ effort to charge $750 a pill for a 62-year-old drug is facing a new headwind: The nation’s largest prescription drug manager plans to back an alternative that costs only $1 per pill. The prescription drug manager, Express Scripts, was expected to announce on Tuesday that it will promote use of a compounded medicine that contains the same active ingredient as the Turing drug, Daraprim. (Pollack, 12/1)
STAT:
STAT-Harvard Poll: Dismayed By Drug Prices, Public Supports Democrats' Ideas
Most Americans believe that the prices of brand-name prescription drugs have become unreasonable, and their dismay is leading to wide support for government action to keep costs down, including letting Medicare negotiate prices with drug companies, according to a new poll by STAT and the Harvard T.H. Chan School of Public Health. (Nather, 12/1)
UnitedHealth Projects Revenue In 2016 Will Be Lower Than Analysts' Estimates
Last month the insurer said that its participation in the health law exchanges would cut into profits. In other marketplace news, Arizona regulators found "deficiencies" during inspections of blood-testing startup Theranos' labs. And AppDynamics, a firm that helps customers find bugs in computer code, raises $158 million in funding.
The Wall Street Journal:
UnitedHealth Sees 2016 Revenue Slightly Below Estimates
UnitedHealth Group Inc., ahead of its investor day on Tuesday, projected revenue next year that falls just shy of analysts’ estimates, less than two weeks after it said weak performances on public health exchanges would cut into profit. UnitedHealth said it expects 2016 revenue of $180 billion to $181 billion, while analysts polled by Thomson Reuters had forecast $182.36 billion on average. ... The guidance comes shortly after UnitedHealth said it had suffered huge losses on its policies sold on the Affordable Care Act’s exchanges and would consider withdrawing from them, which stoked worries about the future of the marketplaces. (Becker, 11/30)
USA Today/The Arizona Republic:
Arizona Inspectors Find Theranos Lab Issues
Before the Silicon Valley lab-testing company Theranos suspended use of its finger-prick blood draws in September because of U.S. Food and Drug Administration concerns, the company tangled with Arizona lab regulators over testing instruments and lab practices. Theranos, which operates retail locations inside 40 Walgreens stores across metro Phoenix, did not always meet lab regulations before taking corrective steps, according to inspection reports reviewed by The Arizona Republic. (Alltucker, 11/30)
The New York Times' DealBook:
AppDynamics Expected To Announce Raising Of $158 Million
With customers as varied as large banks, Tesla and the Container Store, AppDynamics helps corporations find anomalies in computer code before they cause major problems, a sub-industry called “application performance management.” ... Among AppDynamics’ customers is Xerox Government Healthcare, which creates applications for Medicaid in multiple states. Gorkey Vemulapalli oversees the unit, which is responsible for seven million lines of code, and he said that before using AppDynamics, five people would spend a 40-hour workweek trying to pinpoint any issues. Now it takes minutes, he said. This business is growing rapidly but is filled with many heavy-hitting and deep-pocketed rivals. (Picker, 11/30)
Despite Voters' Drug Price Concerns, GOP Candidates Offer Few Options On The Issue
Politico examines how the Republican presidential candidates are dealing with consumers' unhappiness over rapidly rising drug costs. Also, STAT analyzes investments in health care companies by members of Congress.
Politico:
GOP Candidates Struggle To Address Public Ire Over Drug Costs
What the 2016 GOP presidential candidates don’t say is that Medicare should negotiate drug prices or that the government should limit drug maker’s profits, steps that might dramatically shake up the marketplace. For the most part, they’re not even making modest suggestions to stem rising costs, focusing instead on hammering a few headline-making companies that they portray as bad actors. Even as they try to address an issue that polls show is voters’ No. 1 health concern, the candidates are caught in the box of Republican free market orthodoxy — and also, of long-standing relationships with the pharmaceutical industry, a lobbying powerhouse on the Hill. (Demko and Karlin, 12/1)
STAT:
Investments Give Lawmakers Personal Stake in Biotech, Health Care
A STAT analysis of thousands of pages of congressional disclosure forms found that about 30 percent of senators and 20 percent of representatives held assets in biomedical and health-care companies, or in specialty funds set up to invest in those industries, during 2014. The most common investments in the House were Pfizer, Johnson & Johnson, Merck, and Abbott Laboratories. In the Senate, investors favored Johnson & Johnson, Pfizer, and Merck. (Kaplan and Swetlitz, 12/1)
First Sustained Drop Of New Diabetes Cases Reported In 25 Years, According To CDC
Researchers found that the rate of new diagnoses fell by about a fifth from 2008 to 2014. Experts don't know if the decline is due to diabetes prevention efforts taking hold or if the disease has peaked in the population. In other public health news, government officials reevaluate the influential health survey while scientists and ethicists hold a summit on gene editing.
The New York Times:
New Diabetes Cases, At Long Last, Begin To Fall In The United States
After decades of relentless rise, the number of new cases of diabetes in the United States has finally started to decline. The rate of new cases fell by about a fifth from 2008 to 2014, according to researchers at the Centers for Disease Control and Prevention, the first sustained decline since the disease started to explode in this country about 25 years ago. The drop has been gradual and for a number of years was not big enough to be statistically meaningful. But new data for 2014 released on Tuesday serves as a robust confirmation that the decline is real, officials said. There were 1.4 million new cases of diabetes in 2014, down from 1.7 million in 2008. (Tavernise, 12/1)
The Associated Press:
Officials Say Influential Health Survey Needs To Slim Down
When the government launched what would become most influential survey to monitor the nation’s public health, there were just 75 questions — and 95 percent of those asked agreed to sit for it. But that was nearly 60 years ago, and the National Health Interview Survey has mushroomed along with the government and its interests. There are now 1,200 potential questions, and the average family takes more than 90 minutes to complete the survey. (Stobbe, 11/30)
The Associated Press:
AP News Guide: Summit Opens Debate On Ethics Of Gene Editing
Hundreds of scientists and ethicists from around the world gather in Washington this week to debate the boundaries of human genome editing, sort of a biological cut-and-paste tool that allows researchers to spot a gene defect inside living cells and swap it out. It's all experimental so far, but the promise for new treatments is huge. The ethical quandary: Should it also be attempted in human embryos, altering a gene in not just one person but his or her descendants? Already, China has reported the first laboratory experiment with embryos to start learning how. (Neergaard, 12/1)
In addition, Florida investigators found no evidence that the Planned Parenthood clinics there purchased or sold human tissue.
Reuters:
Alabama Surrenders In Fight Against Planned Parenthood
Alabama called off a legal battle with Planned Parenthood on Monday after a federal judge last month blocked the state from defunding the reproductive health organization's clinics amid national controversy about its handling of aborted fetal tissue. In a joint court filing, both parties said that Alabama had resumed funding of Planned Parenthood clinics in Mobile and Birmingham, and the clinics were following state regulations. (11/30)
The Associated Press:
Alabama Ends Effort To Cut Off Funds To Planned Parenthood
Alabama on Monday gave up its effort to cut off Medicaid funds to Planned Parenthood clinics after the state lost an initial round in federal court. Lawyers for Gov. Robert Bentley’s administration and Planned Parenthood Southeast submitted a proposed settlement agreement to a federal judge to end the lawsuit brought by the health care provider against the state. Alabama lawyers said Planned Parenthood had been reinstated as a Medicaid provider. (Chandler, 11/30)
The Associated Press:
Judge Blocks Missouri From Pulling Clinic's Abortion License
A judge on Monday temporarily blocked Missouri's health department from revoking the abortion license held by a Planned Parenthood clinic in Columbia as its physician loses hospital privileges required under state law. The clinic stopped terminating pregnancies last week, but Planned Parenthood filed a federal lawsuit Monday in hopes of retaining its abortion facility license from the state Department of Health and Senior Services while its physician regains privileges or the clinic finds a new doctor. U.S. District Judge Nanette K. Laughrey issued her order at the end of a hearing by telephone conference call. (11/30)
The Associated Press:
Florida Investigators: Planned Parenthood Didn't Sell Organs
State investigators say there's no evidence Planned Parenthood in Florida purchased or sold human organs or tissue. Florida Department of Law Enforcement spokeswoman Gretl Plessinger confirmed in an email Monday that an inquiry into Planned Parenthood has closed and didn't move into a full investigation. (11/30)
In other news -
Reuters:
IUD Use Attracts New Opposition From Anti-Abortion Groups
A rapid increase in the number of U.S. women turning to intra-uterine devices to prevent pregnancy has prompted escalating attacks on the birth control method from groups that oppose abortion. The next battle will be at the U.S. Supreme Court, which has agreed to consider a new religious challenge to contraceptives coverage under President Barack Obama's healthcare law. Although the case deals broadly with whether religiously affiliated groups should be exempt from providing birth control coverage to their employees, some parties in the case have focused specifically on IUDs. (12/1)
Connecticut Hospitals Ready Legal Action To Fight State Provider Tax
Also in Connecticut, state regulators OK the sale of Johnson Memorial Hospital. Meanwhile, an estimated $6 million in equipment is missing from a Louisiana hospital.
The Associated Press:
Connecticut Hospitals Move Near Possible Lawsuit Over Tax
Hospitals took the first steps toward a possible legal battle with the state over a tax the medical centers claim is unconstitutional and is harming hospitals financially. The Connecticut Hospital Association filed letters Monday with the Departments of Social Services and Revenue Services, seeking declaratory rulings from the agencies on whether the so-called "provider tax" on hospitals is constitutional. Those letters were first obtained by The Associated Press. (Haigh, 11/30)
The Connecticut Mirror:
State Approves Johnson Memorial Hospital Sale
State regulators have approved plans for the parent company of St. Francis Hospital and Medical Center in Hartford to acquire the financially struggling Johnson Memorial Hospital. The $30 million purchase is expected to be finalized by the end of the year. (Levin Becker, 11/30)
The Associated Press:
$6M In Equipment Missing From State Hospitals, Audit Says
Nearly $6 million in state-owned hospital equipment can't be located, and millions more bought for the recently opened New Orleans public hospital hasn't been tracked properly, according to an audit released Monday. Legislative Auditor Daryl Purpera's Office looked at the LSU Health Care Services Division's financial reporting for the last budget year, which ended June 30. Most of LSU's hospitals were privatized several years ago by Gov. Bobby Jindal, with the facilities and equipment leased by private hospital managers. (11/30)
And in Pennsylvania -
The Associated Press:
Court Says UPMC Must Keep Cheaper Rates In Medicare Plans
Medicare Advantage plans won't have to pay comparatively higher rates in the coming years for services through the University of Pittsburgh Medical Center, the state Supreme Court ruled Monday. The court ruled 3-2 that about 180,000 people in Highmark's Medicare Advantage plans will continue to pay UPMC's "in-network" fees at least until June 2019, when a consent decree involving the two health providers is set to expire. (Scolforo, 11/30)
Two Democratic Senators Question Iowa Gov.'s Plan To Move Ahead With Medicaid Privatization
Gov. Terry Branstad remains committed to proceeding with the privatization plan, even after an administrative law judge recommended that one out of the four awarded contracts be dismissed.
The Des Moines Register:
Senators Question Moving Ahead With Medicaid Privatization
Two Democratic senators are questioning Republican Gov. Terry Branstad's plans to press forward with privatizing management of the state's Medicaid program after a judge's recommendation this week to throw out a contract awarded to one of four companies in line to manage the program. Iowa Administrative Law Judge Christie Scase on Wednesday recommended that Iowa throw out the contract awarded to WellCare, one of the for-profit companies hired to manage Iowa’s annual $4.2 billion Medicaid plan starting Jan. 1. Scase made the recommendation after reviewing and hearing the objections of three companies that are challenging the Iowa Department of Human Service’s competitive bidding process to award the contracts. The companies mounting the challenge — Aetna, Meridian and Iowa Total Care — say the selection process was unfair. (Clayworth, 11/28)
Iowa PublicRadio:
Despite Ruling, Branstad Says Medicaid Privatization Still Set for January 1st
Gov. Terry Branstad says the state will move forward as planned with the January 1st deadline for Medicaid privatization in Iowa. That’s despite last week’s recommendation from Administrative Law Judge Christie Scase that the state dismiss one of four contracts it awarded to for-profit companies to manage Iowa’s Medicaid programs. (Boden, 11/30)
Des Moines Register:
Branstad: No Reason To Delay Medicaid Privatization
Iowa Gov. Terry Branstad said Monday that an administrative law judge's recommendation to throw out one of the state's four managed care contracts is no reason to slow the move to Medicaid privatization. He said he has appointed Iowa Department of Administrative Services Director Janet Phipps to decide whether to follow the judge's recommendation or to move forward as planned. (Pfannenstiel, 11/30)
News outlets also report on Medicaid developments in Pennsylvania, Ohio and Virginia -
The Philadelphia Inquirer:
Pa. Medicaid Business Draws Limited National Interest
Nine companies have submitted bids to enter Pennsylvania's Medicaid market, which has grown substantially this year since Gov. Wolf expanded access to coverage. But only one of the new applicants seeking to offer managed care to lower-income Pennsylvanians beginning in 2017 is a national player. (Brubaker, 11/28)
The Columbus Dispatch:
Cost, Other Barriers Keep Some Hepatitis Patients From Treatment
Federal officials sent a notice this month to Medicaid directors nationwide that said state policies might unreasonably restrict access, even violate federal laws designed to ensure patients get care that is considered medically necessary. The Centers for Medicare and Medicaid Services’ notice pointed out that some states limit drug access to patients with severe disease and those who prove they aren’t using alcohol or drugs. At the same time, federal leaders also called for more information about pricing of the drugs from the pharmaceutical companies. (Crane, 11/30)
The Associated Press:
10 Individuals Convicted And Sentenced In Medicaid Fraud
Ten former employees of a counseling business have been convicted and sentenced for their roles in a scheme to defraud the Virginia Medicaid program. The Department of Justice tells media outlets the sentences of the 10 employees from Progressive Counseling Services, LLC range from 41 months to 108 months in prison. (12/1)
New York City To Announce Plans To Boost HIV Prevention And Health Care Funding
The announcement of an extra $23 million annually is scheduled for later today -- World AIDS Day. Meanwhile, The Pioneer Press reports that the number of cases in Minnesota isn't dropping.
The Associated Press:
NYC Proposes $23M More In HIV Health Care
New York Mayor Bill de Blasio and members of the City Council want to allocate an extra $23 million a year for AIDS prevention and health care programs. De Blasio plans to announce the plan on Tuesday, which is World AIDS Day. In 2014, about 2,700 New York City residents were newly diagnosed with HIV, a historical low. That's a 35 percent decrease from more than 4,100 new HIV diagnoses in 2004. (12/1)
The Pioneer Press:
New HIV Cases Aren't Dropping, Says Minnesota Health Commissioner
Tuesday is World AIDS Day, and Minnesota Department of Health officials say that the number of cases isn't dropping in the state. According to estimates, 35 million people are living with HIV worldwide with about 2 million becoming infected last year. In the U.S., estimates are that 50,000 people continue to be infected with HIV each year and that 1.2 million people are currently living with HIV. In Minnesota, over the last 10 years an average of 300 new infections have been diagnosed each year -- highlighting the fact that HIV/AIDS case numbers are not dropping. An estimated 7,988 people are reported to be living with HIV/AIDS in the state. (11/30)
Elsewhere, one of the nation’s largest life insurers plans to announce this week that it will offer traditional individual policies to people living with HIV --
Kaiser Health News:
Major Insurer Says It Will Offer Individual Life Insurance Coverage To People With HIV
Prudential Financial Inc., one of the nation’s largest life insurers, plans to announce this week that it will offer traditional individual policies to eligible people living with HIV, a condition that for decades has excluded most of them from any but the skimpiest of coverage, company officials said. It is the first such offering to be publicly announced by a major American insurer, and it signals a growing recognition that HIV/AIDS has evolved from a death sentence into a chronic but manageable disease, HIV advocates and insurance agents said. (Feder Ostrov, 12/1)
News outlets report on health care developments in the District of Columbia, Illinois, Virginia, New Jersey, California, Kentucky, North Carolina, Minnesota, Missouri and Florida.
The Washington Post:
D.C. Residents Love The Idea Of Paid Family Leave — Just Not Paying For It
An overwhelming majority of District residents support a proposal before the D.C. Council to give each worker in the city 16 weeks of paid time off to care for a newborn or for a dying family member, according to a Washington Post poll. There’s just one hitch: More than half of those polled also say they don’t want workers to have to pay for it themselves. (Davis and Clement, 11/30)
The Associated Press:
Judge Orders Illinois To Pay $13M Owed For Health Care Workers' Health Insurance
A judge has ordered Illinois to pay more than $13 million to cover the cost of health insurance for home health care workers. SEIU Healthcare Illinois took legal action against Gov. Bruce Rauner and Comptroller Leslie Munger earlier this month to force the payments. The union says nearly 5,000 health care assistants could lose insurance Dec. 31 if the state doesn't pay. (11/30)
The Washington Post:
McAuliffe Positive On Budget, Prepares For Showdown With GOP Legislature
Yet one area of major discord remains. McAuliffe’s goal of expanding Medicaid under the Affordable Care Act is a nonstarter in the House. “I don’t see Medicaid expansion happening,” Jones said in an interview. “If that’s put in the budget, that won’t stay in the budget.” But health care — as well as education and economic development dollars — will be debated in the upcoming session. (Portnoy, 11/30)
The Philadelphia Inquirer:
Officer Returns To Work After Settling Pregnancy Suit
After a pregnant patrol officer was ordered to stay home during most of her pregnancy and exhaust all of her accrued vacation and sick days, pickets appeared at the South Jersey police station and protested the decision made by Pemberton Township's administrator. The police union representing Shannon Sawyer also jumped in, filing a grievance that led the Township Council to vote in February in favor of having her return to work immediately. Still, Sawyer was forced to remain home until after her baby boy arrived in late June. By then, she was on unpaid leave, but she wanted to spend some time with her newborn. (Hefler, 11/29)
Kaiser Health News:
Aid-In-Dying Laws Only Accentuate Need For Palliative Care, Providers Say
More times than she can count, Dr. Carin van Zyl has heard terminally ill patients beg to die. They tell her they can’t handle the pain, that the nausea is unbearable and the anxiety overwhelming. If she were in the same situation, she too would want life-ending medication, even though she doubts she would ever take it. 'I would want an escape hatch,' she said. Earlier this month, California law became the fifth — and largest — state to allow physicians to prescribe lethal medications to certain patients who ask for it. (Gorman, 12/1)
The Messenger-Inquirer:
Registry Flags Adult Caregivers With Substantial Abuse Claims
A registry that was created [in Kentucky] to flag people applying for adult care jobs who have been found to have abused their charges in previous settings has been quietly building since it was created last year. The caregiver misconduct registry was created after Gov. Steve Beshear signed Senate Bill 98, which passed unanimously in the House and Senate. The registry includes the names of paid employees and volunteers at adult care facilities such as nursing homes who have had complaints of abuse or neglect substantiated against them by the Cabinet for Health and Family Services. (Mayse, 11/30)
Kaiser Health News:
Sweet Name Of Kids’ Clinic Gives Some People Heartburn
The name that UNC Health Care is giving its children’s clinic in North Carolina has been raising a lot of eyebrows. The facility is slated to be renamed the Krispy Kreme Challenge Children’s Specialty Clinic. But criticism from the medical community at the University of North Carolina and elsewhere is making the health care system rethink that choice. (Tomsic, 12/1)
Marketplace:
How Minnesota's Supporting People With Alzheimer's
With the annual number of new cases of Alzheimer’s and dementia-related diseases expected to double by mid-century, Paynesville is among a handful of Minnesota towns striving to be dementia-friendly for its aging population. Minnesota has a long tradition of taking the needs of the elderly seriously. In fact, Paynesville takes those needs so seriously, it greets visitors with a billboard announcing that it’s a dementia-friendly community. Programs offer shopping assistance at the local grocery store, education for first responders and training for local businesses. (Richert, 11/30)
Health News Florida:
New Grant Coming To Help Addicted Moms In Volusia
The Healthy Start Coalition of Volusia and Flagler Counties has gotten a $240,000 grant to help with addicted mothers. The grant will go toward housing, long-acting birth control, mental health care, peer support – a litany of wrap-around services to help addicted mothers get clean and get their children back. Opiate addiction during pregnancy is a growing problem in Florida. The rate of drug-addicted newborns in Florida has grown tenfold in the last two decades, triple the national increase. (Aboraya, 11/30)
The Kansas City Star:
Petition Drive Challenges Kansas E-Cigarette Restrictions
Yet another petition drive is underway in Kansas City, this time seeking to overturn restrictions on electronic cigarette use in enclosed public areas. The Kansas City Council voted Nov. 19 to support three ordinances restricting tobacco and e-cigarette use. Two ordinances were aimed at raising the legal age to purchase these products from 18 to 21. Those ordinances take effect Sunday. (11/30)
The Kansas City Star:
Syphilis Cases Rise Sharply In KC Area Amid Nationwide Increase In STDs
Reported cases of syphilis more than quadrupled in the Kansas City area from 2010 to 2014 — from 43 cases to 220 — according to recent data from the U.S. Centers for Disease Control and Prevention. The CDC data for 2014 reflected a dramatic national increase in sexually transmitted diseases, including chlamydia, gonorrhea and syphilis. The rates of chlamydia in 2014 were some of the highest ever recorded nationally, with 1.4 million cases reported in the United States. That’s the highest “number of annual cases of any condition ever reported to the CDC,” according to the November report. (Guiterrez, 11/30)
The Associated Press:
Private Company Canceling Prison Health Care Contract
The private company responsible for providing health care to most of Florida's prisons says it is terminating its contract. Corizon Health on Monday notified the Florida Department of Corrections that it wants to end a six-year $1.2 billion contract with the state. Corizon said in a letter it plans to end the contract by May 31 of next year. The Tennessee-based company is responsible for providing health care to inmates at prisons across a wide section of the state including those located in north and central Florida. (11/30)
The Philadelphia Inquirer:
For South Jersey Podiatrist, House Calls Are Part Of The Practice
On his first day on the job, David Carrozzino found a note on his desk to make a house call on his way home. More than two decades and thousands of visits later, Carrozzino, a podiatrist, still makes house calls to homebound patients in South Jersey. Carrozzino is among a rare breed in health care these days. A prevalent practice decades ago, home visits by physicians have declined drastically and are more often made today in rural areas. (Burney, 11/30)
NPR:
A Mother Asks If She's Selfless Enough To Care For A Son With Autism
Sophie Sartain had long worked in documentary filmmaking as a writer and editor. For her first film as a director, she turned the camera on her own family. Starting in 2009, she began filming her grandmother Mimi, then 92, who had cared for Sartain's aunt, Dona, for decades. Dona has an intellectual disability and "perhaps some undiagnosed autism," Sartain says. From there the film Mimi and Dona was born. It was released last week on PBS' Independent Lens. (Aliferis, 11/30)
Viewpoints: The Debate On Planned Parenthood Rhetoric; Bailing Out Insurers
A selection of opinions on health care from around the country.
Bloomberg:
Politics, Rhetoric And The Planned Parenthood Killings
Jim Pouillon was murdered in 2009 by a man who objected to the anti-abortion pamphlet he was distributing. Press coverage was scant, but some pro-choice groups, to their credit, denounced the murder. The New York Times didn't run articles suggesting that over-the-top pro-choice rhetoric -- likening pro-lifers to the Taliban, accusing them of seeking to oppress women, urging a crackdown on their ability to protest abortion -- had set the stage for the murder. Pro-lifers refrained from suggesting that pro-choice groups bore responsibility for the murder. (I'm not aware of any exceptions to this generalization.) That was to their credit: The suggestion would have been obscene. Pro-choicers have been less restrained in the wake of the recent murder of three people at a Planned Parenthood clinic in Colorado. (Ramesh Ponnuru, 11/30)
The Washington Post:
Antiabortion Rhetoric Unwittingly Unleashes The Unhinged
Though we do not know everything about Robert Lewis Dear, the alleged killer in the Colorado Planned Parenthood shooting, it’s probably safe to say he’s not a transgender liberal. Ted Cruz, however, isn’t so sure. “The media promptly wants to blame him on the pro-life movement when at this point there’s very little evidence to indicate that,” the Republican presidential candidate said in Iowa on Sunday afternoon. Um, but what about the law enforcement official telling The Washington Post and others that Dear (who distributed anti-Obama pamphlets, according to a neighbor) explained the shooting by saying “no more baby parts”? (Dana Milbank, 11/30)
The Washington Post's The Plum LIne:
Where Do GOP Investigations Of Planned Parenthood Go Now?
The shooting at a Planned Parenthood clinic in Colorado Springs on Friday was a vivid reminder that the organization isn’t just a political lightning rod for conservatives who oppose abortion rights. It’s also under constant threat of harassment and violence from radical anti-abortion advocates, ranging from hate mail and vandalism all the way up to arson, bombings, and in a few cases, the murder of clinic staff or patients. (Paul Waldman, 11/30)
Forbes:
Will There Be An Obamacare Bailout Of Insurers?
The Affordable Care Act (ACA) is not working out the way many insurance companies thought it would. Despite the individual mandate and massive new government subsidies delivered directly to insurers, many participating insurers, whose continued participation is essential to the ACA’s future, are losing substantial money. In order to assist those insurers, the administration is now seeking a taxpayer-financed bailout for them. Congress can block taxpayer funds from being used for this purpose by extending language contained in the 2015 government funding bill. Congress could also look to end the back-end subsidy that transfers money from people with workplace coverage to insurers selling ACA plans – plans that satisfy all of the new rules of the law. (Brian Blase, 11/30)
Bloomberg:
Good News: Medicare End-Of-Life Spending Declines With Age
A new CBO working paper has good news about Medicare: end-of-life health care spending declines as seniors grow older. Lest this appear intuitively obvious, let me remind you of another finding from the same study: Medicare spending per beneficiary rises dramatically with age. Average Medicare spending in 2012 was less than $3,000 per 65-year-old, steadily rising to a peak of nearly $14,000 for 97-year-olds. After that, it actually declines. (Chris Conover, 11/30)
Bloomberg:
Raise The Smoking Age To 21
Public health in the U.S. has come a long way from the 1960s, when almost half of adults were still smoking. Today that rate is 14.9 percent. The problem is, that's still far too high. Bolder steps to prevent and reduce tobacco addiction are needed -- like the one Hawaii took last summer when it raised the legal age for tobacco purchases to 21. (11/30)
The Philadelphia Inquirer:
Doing More To Fight Addiction
I have seen firsthand the destruction of addiction. Alcoholism has hit my family, close friends, and relatives, causing heartbreak and snatching away lives, relationships, and careers. My family and I aren't alone. An addiction epidemic is taking hold throughout Pennsylvania and the country as more people are turning from prescribed painkillers to the cheaper alternative of heroin. ... We need to fundamentally change our approach in dealing with this heroin epidemic - which means treating it as a health issue, not simply as a criminal justice issue. (Katie McGinty, 11/30)
The Philadelphia Inquirer:
More Resources Needed For Pediatric Mental Health Emergencies
All the perpetrators in the Columbine High school shooting in 1999, the Virginia Tech shooting in 2007, and the Newtown Sandy Hook Elementary School shooting in 2012 suffered from mental illness. Events similar to these have led to increased awareness of the disastrous consequences of untreated depression, suicidality, and aggression among adolescents and young adults. As a result, there has been a dramatic increase in youth presenting to the ED for psychiatric care. ... Unfortunately, most EDs which carry this burden are unprepared and unsupported to meet this demand. (Hazel Guinto-Ocampo, 11/30)