Health Care Reform Around the Nation: July 30
A shortage of primary care physicians in Massachusetts has led many doctors to stop accepting new patients, according to a report released Tuesday by the Massachusetts Medical Society, the Wall Street Journal reports.
According to the Journal, the lack of physicians could undermine the Massachusetts health insurance law, which took effect July 1 and requires all state residents to obtain coverage or face tax penalties.
The study found that:
- 49% of internists in the state are not accepting new patients;
- 95% of the 270 general practice physicians at Boston's top three teaching hospitals have stopped accepting new patients; and
- The average wait time for Massachusetts residents who make an appointment with their PCP is more than seven weeks, a 57% increase over last year (Seward, Wall Street Journal, 7/25).
North Carolina could save nearly $16 million by shifting billing services for its version of the State Children's Health Insurance Program from the state employee health plan office to the state Department of Health and Human Services, according to a report released on Tuesday by the Office of the State Auditor, the Raleigh News & Observer reports.
The savings would allow the state to enroll an additional 10,000 children in the program, according to the News & Observer.
The employee health plan office currently processes claims through Blue Cross and Blue Shield of North Carolina for $4.88 per claim, whereas DHSS uses Electronic Data Systems to process Medicaid claims at 41 cents each (Bonner, Raleigh News & Observer, 7/25).
Gov. Ed Rendell (R) recently signed into law a bill that will loosen restrictions on the types of care certified nurse practitioners can provide, the Philadelphia Inquirer reports. The law also eases some restrictions on dental hygienists, certified midwives and physician assistants.
The legislation is part of Rendell's "Prescription for Pennsylvania" health care reform plan and is intended to reduce health care costs and boost access to care by easing doctors' workloads.
The law will allow certified nurse practitioners to perform duties such as:
- Ordering medical equipment;
- Treating chronically ill patients at home; and
- Referring patients to specialists (Roarty, Philadelphia Inquirer, 7/20).
A decision by the South Dakota Legislature to grant a 3% inflation increase in reimbursement rates to hospitals and nursing homes contradicts a state Department of Social Services payment plan submitted to CMS that is based on the consumer price index, the Sioux Falls Argus Leader reports.
DSS Secretary Deb Bowman said the Legislature has "been out of compliance for several years ... on legislative audit findings."
DSS has submitted an amendment to CMS to clarify the 3% increase, according to Larry Iversen, assistant administrator of the Office of Medicaid Services in DSS (Woster, Sioux Falls Argus Leader, 7/23).
Virginia-based Maximus on Monday agreed to pay $30.5 million to end a Department of Justice investigation into whether the company falsified tens of millions of dollars in Medicaid claims while working for the District of Columbia government, the Washington Times reports.
Jeffrey Taylor, U.S. attorney for the district, said Maximus admitted its responsibility for causing "Medicaid dollars to be spent for undocumented services that likely were never provided to some of the neediest residents" in the district (McElhatton, Washington Times, 7/24).
Few eligible West Virginia residents have enrolled in a state Medicaid program designed to encourage healthy lifestyles, the AP/Idaho Statesman reports. The Mountain Health Choices program aims to improve state residents' overall health and reduce the long-term costs of Medicaid.
Under the program, which is available in three counties, beneficiaries are eligible to receive enhanced benefits in exchange for signing contracts that pledge healthy behavior, such as regular physician visits and use of necessary medications.
According to the state Medicaid agency, out of 2,236 eligible residents, 64 adults and 216 children have enrolled in the program from February to July 18 (Breen, AP/Idaho Statesman, 7/21).