Health Care Reform Around the Nation for the Week of Feb. 9
Last month, Florida Gov. Charlie Crist (R) signed into law legislation (SB 8A) that will place a 5% tax on nursing homes' net revenues as a way to increase the matching federal funds they receive through Medicaid, Florida Health News reports.
The tax is expected to draw down 55 cents in federal Medicaid funds for every 45 cents it generates. The tax assessment would generate an additional $3.79 a day paid to the nursing homes by Medicaid, Florida Health News reports.
Nursing homes will begin collecting the money on April 1 under the assumption that CMS will approve a Medicaid waiver that will allow the matching funds to be allocated.
Thirty-two states use similar assessments on health care facilities to draw down federal money (Jordan Sexton, Florida Health News, 2/3).
In other news, last week, WellCare announced that it will end its participation in Florida's Medicaid pilot program in Duval and Broward counties, effective May 1, the Florida Times-Union reports (Larrabee, Florida Times-Union, 2/5).
Under the pilot program, the state pays private insurers a set amount for covering a specific number of residents and the companies determine what benefits and coverage network they will offer.
The initiative covers most Medicaid beneficiaries in five Florida counties (Kennedy, AP/Miami Herald, 2/4).
In a statement, WellCare said its decision to leave the pilot program in Broward and Duval counties "is a result of recent state budget cuts that make it economically unfeasible to continue offering members sufficient access to quality health services in those programs" (Caputo, Miami Herald, 2/5).
The action will affect more than 78,000 beneficiaries in the two counties, where WellCare has a market share of about 41% through its HealthEase and Staywell plans (Jordan Sexton/Gentry, Florida Health News, 2/4).
A bill sponsored by Indiana state Sen. Patricia Miller (R) aims to increase government oversight of and set new standards for retail health clinics in the state, the Indianapolis Star reports. There are about 300 retail health clinics in the state.
Under Miller's proposal, the clinics would have to:
- Install entrances that are separate from the store entrance;
- Train all staff in cardiopulmonary resuscitation;
- Display fees outside of the examination rooms; and
- Provide a detailed report of patients' visits to their primary care physicians, among other measures.
Currently, the Indiana State Department of Health does not license retail clinics but regulates them under the license of the physician affiliated with the clinic (Rudavsky, Indianapolis Star, 2/2).
New York's "most powerful health care interests are mounting a multimillion-dollar media campaign" beginning Monday that criticizes Gov. David Paterson's (D) plan to cut funding for hospitals and other health care facilities by $3.5 billion over the next 14 months, the New York Times reports.
Paterson is making the cuts in order to address a $15 billion budget deficit.
The media campaign will run for at least four weeks and includes television spots, radio commercials, newspaper advertisements, direct mailings and phone banks that criticize Paterson's decision to make the cuts to health care.
The television and radio ads will cost at least $1 million weekly, according to the Times. Organizers hope to reach up to two million voters across the state.
The 1199 Service Employees International Union United Healthcare Workers East and the Greater New York Hospital Association paid for the campaign (Peters, New York Times, 2/2).
The ability of patients to pay and the lack of dentists have negatively affected access to dental care in North Carolina, and the problem likely will get worse, the Raleigh News & Observer reports.
The ratio of dentists to residents in North Carolina declined by 0.7% in 2007. The ratio already was below the national average of six dentists for every 10,000 residents.
Now more than half of the state's counties have fewer than three dentists for every 10,000 residents.
According to a report by the Cecil G. Sheps Center at the University of North Carolina, four of the state's 100 counties have no dentists; dentists in five counties have reached retirement age; and 39 mostly rural counties experienced a decrease in dentists between 1997 and 2007 (Avery, Raleigh News & Observer, 2/1).
More than one million Pennsylvania residents, or 8.2% of the state population, are uninsured, compared with 7.5% in 2004, according to a survey the Pennsylvania Insurance Department released last month, the AP/Pittsburgh Tribune-Review reports (AP/Pittsburgh Tribune-Review, 1/29).
The survey, conducted between September 2007 and May 2008, was based on information on 50,000 state residents and has a margin of sampling error of plus or minus 0.7 percentage points.
According to the survey, 880,000 of uninsured state residents are adults -- up 17% from 2004 -- and 140,000 are children -- up 5% from 2004 (Worden, Philadelphia Inquirer, 1/30).
The survey found that more than 50% of the uninsured have been without coverage for a year or less but that almost 18% have been without coverage for more than five years (AP/Pittsburgh Tribune-Review, 1/29).
Of the adults who lack insurance, 62% are employed, but either do not have access to health coverage or cannot afford the coverage being offered (Philadelphia Inquirer, 1/30).
The survey found that 62% of Pennsylvania residents have some form of private health insurance, 4% fewer than in 2004, while 18%, or 2.2 million, are covered through state-sponsored programs such as Medicaid, SCHIP or adultBasic, which offers basic coverage to adults who have been without insurance for at least three months.
According to state Insurance Commissioner Joel Ario, there are 183,000 people on the adultBasic waiting list, which "is projected to grow to 282,000 by the end of June" (Twedt, Pittsburgh Post-Gazette, 1/30).
Last week, the Rhode Island House approved legislation that would require the governor to obtain approval from the General Assembly for nearly every change to the Medicaid program through 2013, the Providence Journal reports.
The legislation is intended to provide oversight of changes the state will implement under the "global Medicaid waiver" that Gov. Don Carcieri (R) negotiated with CMS last year (Peoples, Providence Journal, 2/4).
Under the agreement, the state will limit Medicaid spending to $12.4 billion through 2013. In exchange for capping spending, the state will receive broad authority to change services, such as nursing home care, subsidized transportation for the elderly and beneficiaries with disabilities, health insurance for low-income children and parents, and prescription drug coverage for seniors (California Healthline, 1/26).
The bill approved on Tuesday also would create a task force to oversee implementation of the waiver (Providence Journal, 2/4).
Enrollment in Wisconsin's health insurance programs, such as BadgerCare Plus, has increased by 35%, or 238,000 beneficiaries, since 2003 and is expected to rise as the national economic recession continues, the Milwaukee Journal Sentinel reports.
Medicaid programs currently provide some level of care to about one in six state residents, and enrollment reached 926,600 last month, the Journal Sentinel reports.
Officials at the state Department of Health Services said the increases in enrollment can be attributed to:
- Fewer employers offering health insurance benefits;
- A simplified enrollment process for BadgerCare Plus and other programs; and
- Higher enrollment in smaller programs, such as the prescription drug program SeniorCare.
The state's Medicaid program, which costs $5 billion annually, faces a deficit of about $1.4 billion through the next two-year budget (Forster, Milwaukee Journal Sentinel, 1/29).
Last month, the Wyoming Senate approved two bills (S 95 and S 62) that aim to close loopholes that health insurance companies use to deny coverage, the Wyoming Tribune Eagle reports.
Under current law, insurance companies can deny coverage for any reason and decide whether a procedure is medically necessary, and the details of insurers' contracts are not regulated.
The bill S 95 would define when a treatment qualifies as medically necessary and create an external review process for patients who are denied coverage for a procedure.S 62 would prohibit insurance companies from adding discretionary clauses to insurance policies that allow them to easily deny coverage of procedures. The bills now move to the state House for consideration (Dynesdr, Wyoming Tribune Eagle, 1/31). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.