Health Care Reform Around the Nation for the Week of May 4
Last week, the Florida House unanimously passed legislation that would increase licensing restrictions for certain health care service providers as a way to deter fraud in the Medicaid and Medicare programs, the Miami Herald reports.
Under the bill, people would have to live in the U.S. for at least five years before they could obtain a license to operate home health care agencies, medical equipment providers or health clinics unless they file a bond of no less than $500,000.
The bill would designate Miami-Dade County as a "health care fraud area of special concern."
The measure also would require that people applying for operators' licenses submit proof that they have the financial ability to operate or start such a company.
A one-year ban would be placed on new licenses in counties with higher numbers of home health care agencies. State regulators and industry groups say the rules would help prevent health care fraud in the region (Weaver/Gilpatrick, Miami Herald, 4/28).
Democratic lawmakers in Hawaii are planning to re-establish a state health insurance program for children by including $600,000 in various appropriations bills that were under consideration last week, rather than passing a single measure that could be vetoed by Gov. Linda Lingle (R), the AP/Baton Rouge Advocate reports.
Lingle eliminated the Keiki Care program in October 2008 a few months after it started accepting applicants. The program aimed to expand coverage to all uninsured children in the state.
Democrats say Keiki Care could offer coverage for 3,500 to 16,000 children. Funding for the program could be inserted into bills that fund support services, allocate federal stimulus money and lay out an overall state budget plan, the AP/Advocate reports.
Aides say Lingle would be able to cut funding for the program if it is presented as provisions in several other bills (Niesse, AP/Baton Rouge Advocate, 4/29).
On Tuesday, U.S. District Judge Justin Quackenbush of the East District of Washington County, Idaho, issued a temporary order blocking Medicaid hospital payment cuts scheduled to take effect May 1, the AP/Idaho Statesman reports.
The Idaho Department of Health and Welfare approved the cuts to meet budget reductions required by Gov. Butch Otter (R). The cuts would have reduced Medicaid reimbursements by as much as 55%.
The move was challenged in court by 16 Idaho residential rehabilitation agencies, which represent more than 50% of the state's residential rehab patients. The agencies said the payment cut would:
- Put them out of business;
- Diminish care for more than 2,000 beneficiaries; and
- Conflict with federal law and violate state law because the payment structure was not signed off on by the state Legislature.
The judge gave attorneys for each side three weeks to prepare briefs on how the case should proceed (Dvorak, AP/Idaho Statesman, 4/28).
Last week, the Minnesota House and Senate both approved bills that aim to slow health care spending as the state faces a $4.6 billion budget deficit, the Minneapolis Star Tribune reports.
Sen. Linda Berglin (D) said the Senate bill would lower projected spending by $625 million over the next two years -- nearly $200 million more than the House bill.
Much of the difference in savings is because the House bill pushed reductions into the next two-year biennium, Berglin said.
Gov. Tim Pawlenty (R) has proposed about $1.7 billion in reductions (Kaszuba, Minneapolis Star Tribune, 4/27).
The House bill would reduce by 3% payments to doctors, dentists and hospitals participating in health care programs for childless adults and low-income residents. The provision would save an estimated $82 million.
The Senate version includes a larger payment reduction for specialists, but primary care physicians are exempt from the payment cut under both bills.
Both the House and Senate bills would reduce dental services for MinnesotaCare beneficiaries, but neither bill would tighten eligibility for subsidized insurance programs, as Pawlenty has recommended.
The measures instead would expand coverage to 20,000 to 50,000 children (Dunbar, AP/St. Paul Pioneer Press, 4/28).
The redesigned West Virginia Mountain Health Choices Medicaid program has led to reduced coverage for thousands of state residents, according to a report by the Institute for Health Policy Research at West Virginia University, the Charleston Gazette reports.
Under the program, Medicaid beneficiaries who sign a pledge stating they will see their doctor regularly and take medications as directed, among other things, are enrolled in an "enhanced" benefits plan, which offers increased benefits from their previous Medicaid plan.
Those who do not sign the contract are automatically enrolled in a "basic" benefits plan, which includes less comprehensive benefits than their previous Medicaid plan.
The report found that 131,000 beneficiaries in the state are eligible for the enhanced plan, but only 19,000 are enrolled. According to the report, 10% of eligible adults and 13% of eligible children have enrolled.
The researchers concluded that the low enrollment numbers resulted from a lack of understanding among beneficiaries.The report recommends that officials consider whether certain beneficiaries, such as those with mental health problems, should be exempted from the program. It also recommends restoring benefits for the basic plan to traditional Medicaid levels (Charleston Gazette, 4/30). 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.