Health Care Reform News Around the Nation for the Week of April 13
Georgia Insurance Commissioner John Oxendine (R) has ordered 18 insurers that operate in Georgia to report how they establish reimbursement rates for out-of-network services, the Atlanta Journal-Constitution reports.
Oxendine said he also is seeking information about whether any of the insurers use the Ingenix database that has been at the center of a series of lawsuits alleging that data were manipulated to underpay out-of-network physicians. Ingenix is a unit of UnitedHealth Group (Miller, Atlanta Journal-Constitution, 4/2).
Louisiana Department of Health and Hospitals Secretary Alan Levine has asked interim HHS Secretary Charles Johnson to readjust calculations used to determine federal contributions to the state's Medicaid program, saying the current method is skewed, the Baton Rouge Advocate reports.
In a letter to Johnson, Levine said that the federal formula, which includes a three-year average of per capita income, has become "artificially skewed by the infusion" of hurricane recovery dollars into per capita income numbers.
According to Levine, the formula means that the state would have to pay $700 million more each year for its Medicaid program, and its share of funding for Medicaid would rise from 28% to 36.9% by fiscal year 2011 (Baton Rouge Advocate, 4/7).
Employers, state residents and the Massachusetts government are paying the same, proportionately, for health coverage as they did the year before the implementation of the Massachusetts health insurance law in 2006, according to a study the Center for Health Law and Economics at the University of Massachusetts Medical School released last week, the Boston Globe reports.
Researchers determined that overall spending on health care coverage increased by $4.7 billion, or 23%, to $25.5 billion in 2007, compared with nearly $21 billion in 2005.
In addition, researchers found that in 2007 employers accounted for 48% of the overall spending on coverage in Massachusetts, with individuals accounting for about one-quarter of spending and the government -- split between the state and federal governments -- contributed about 27%.
According to the report, health care inflation unrelated to the law caused 60% of the spending increase, and 31% was associated with new enrollment in existing health coverage options, such as employer-sponsored health coverage or Medicaid.
The 2006 law requires that all state residents obtain insurance and that all employers offer insurance to their workers.
According to the report, residents paid approximately $16 million in penalties for not complying with the requirement, while employers paid $7.7 million (Lazar, Boston Globe, 4/7).
Mississippi state lawmakers last week rejected efforts to repeal a state rule requiring Medicaid beneficiaries to show up in person to renew their enrollment each year, the AP/Miami Herald reports.
The rule was approved with the intention of deterring fraud, and Gov. Haley Barbour (R) -- a leading proponent of the rule's development -- said that it has been effective.
Census data show that the number of uninsured children in the state has increased by 146,000, or 72%, since the policy was implemented in 2005.
According to advocates, children are being denied coverage under the rule because their parents do not have transportation or are unable to take time off of work to renew coverage.
State House Medicaid Committee Chair Dirk Dedeaux (D) said the bill will be revived when lawmakers return in May or June.
Barbour is expected to fight such an effort (Byrd, AP/Miami Herald, 4/2).
Gov. Jon Corzine (D) has put forward a budget proposal that would limit adult enrollment in the state's FamilyCare program but seek to expand coverage of low-income children, the Philadelphia Inquirer reports.
Corzine is seeking to save $9.7 million by lowering the maximum income for parents applying for new enrollment in FamilyCare from 200% of the federal poverty level to 150%.
The program added 45,000 adults last year after the income cap was increased from 133% of the poverty level to 200%, and the program's costs are expected to increase from $339 million last year to $595 million this year if the cap is maintained.
The governor's budget plan also would eliminate a $19 monthly premium for children in families with incomes between 151% and 200% of the poverty level. The plan includes new copayments for HIV/AIDS treatments andÂ medications Medicaid beneficiaries purchase, and a provision seeking to purchase drugs more efficiently (Tamari, Philadelphia Inquirer, 4/6).
Earlier this month, the South Carolina House voted to approve legislation that would raise the state's cigarette tax from seven cents per pack to 57 cents per pack to help fund health care for low-income workers, the Charleston Post and Courier reports.Of the $147 million the measure is expected to generate, about $139 million would be used to establish a fund to cover 75% of health plan premiums for workers with annual incomes of up to $21,600 (Behre, Charleston Post and Courier, 4/3). 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.