Health Care Reform News Around the Nation for Feb. 2, 2009
Florida
Gov. Charlie Crist (R) rejected $90 million in budget cuts included in a $2.6 billion state deficit-reduction package recently passed by the Legislature and reinstated funds for some health care programs, the Orlando Sentinel reports.
Crist restored $22.8 million in health care services for about 31,000 people with disabilities, medical treatment for about 900 "special needs" children and programs for mental health and drug use treatment (Deslatte, Orlando Sentinel, 1/28).
In other news, the Florida Agency for Health Care Administration will alert some Medicaid beneficiaries about their rights to disenroll from their HMOs if their physicians are not in the network of the managed care organization or if their care is poor, denied or unreasonably delayed, among other reasons, Florida Health News reports.
AHCA promised to give patients the information as part of a settlement of a class-action lawsuit in November 2008.
The settlement also requires Medicaid HMOs to include "good-cause disenrollment" information in member handbooks and hotline operators to have information on patient rights. In December 2008, AHCA adopted a definition of what constitutes a "good cause" reason for beneficiaries to leave their HMO (Jordan Sexton, Florida Health News, 1/22).
Maine
On Tuesday, the state Legislature approved a $166 million supplemental budget that includes $34 million in cuts to health care programs, the Capital News Service/Bangor Daily News reports.
Under the supplemental spending plan, payments to physicians working in hospitals will be cut by $1.7 million.
The budget also includes a provision that prioritizes settlement payments to Maine hospitals for bills they are owed when expected federal Medicaid funds in the economic stimulus bill are distributed (Leary, Capital News Service/Bangor Daily News, 1/28).
Maryland
On Wednesday, the Maryland Board of Public Works approved a three-year, $6.8 million contract with insurer Doral Dental Services to reimburse dentists for treating Medicaid beneficiaries, the Washington Post reports.
According to health officials, the contract will improve access to dental care for about 435,000 low-income children and pregnant women in the state. The General Assembly approved millions of dollars to improve dental care for low-income children.
Most of the funds were used to increase Medicaid reimbursement rates for dental care because many dentists had declined to treat child Medicaid beneficiaries (Rein, Washington Post, 1/29).
Also in Maryland, district court officials plan to give new legal aid to defendants in debt collection lawsuits with hospitals and change the way settlement conferences are handled, the Baltimore Sun reports.
The courts are responding to a Sun investigation in December 2008 and a University of Maryland School of Law study in November 2008 that found defendants are confused by the court process, do not understand that they might have legitimate defenses and assume that they must accept the terms hospital lawyers dictate in settlement conferences, according to the Sun.
The first changes will begin in February when defendants assigned to "rocket docket" receive new notices explaining their rights. A rocket docket is a weekly session where plaintiffs' attorneys try to work out agreements with several defendants in quick succession without a judge present (Drew, Baltimore Sun, 1/26).
Massachusetts
On Wednesday, Gov. Deval Patrick (D) released a $28 billion state budget proposal for fiscal year 2010 that freezes Medicaid reimbursement rates for physicians and hospitals and cuts funding to several public health programs, the Boston Globe reports.
The budget would eliminate a $3.5 million program that helps uninsured residents enroll in health coverage.
The budget proposal also would place new levies on alcohol, candy and sweetened beverages to generate an estimated $121.5 million for public health initiatives, according to the administration (Lazar/Smith, Boston Globe, 1/29).
Pennsylvania
Pennsylvania has spent millions of dollars annually on Medicaid payments for residents who no longer qualify for the program, according to a state audit released on Wednesday, the Philadelphia Inquirer reports.
According to the audit, the state Department of Public Welfare failed to properly determine eligibility for more than 1,600 Medicaid applicants between January 2005 and March 2008. Auditors believe that many of the improper eligibility determinations were caused by the failure of DPW to consistently review changes in a beneficiaries' income, age, disability, family status and other factors.
According to the audit, errors occurred in 14% of the 11,700 randomly sampled Medicaid cases examined (Couloumbis, Philadelphia Inquirer, 1/29).
Texas
A work group appointed by Texas legislators has proposed a standard for defining and calculating the cost of charity care provided by not-for-profit hospitals in the state in order to determine the actual value of such care, the Fort Worth Star-Telegram reports.
The proposal does not call for the hospitals to increase the amount of charity care they provide, but seeks to clarify how state and federal indigent care funding is spent.
The Star-Telegram received a copy of the group's report, which states that available funding sources appear to offset most charity care and bad debt costs. However, the group found that it is difficult to understand how well the system is working and seeks to increase transparency and accountability for hospitals.
Texas hospitals report as many as six different calculations for the amount of charity care they provide, some of which include inflated charges used by hospitals, rather than market rates, the Star-Telegram reports (Barbee, Fort Worth Star-Telegram, 1/26).
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.