Health Care Reform News Around the Nation for the Week of March 23
Maine Gov. John Baldacci (D) on Tuesday signed an executive order allowing the state to use $45 million in federal stimulus money to pay part of the $163 million the state owes to hospitals for treating MaineCare beneficiaries, the AP/Portland Press Herald reports.
MaineCare is the state's Medicaid program.
In 2006, the governor and the Maine Hospital Association made a commitment to repay the debt over four years.
Baldacci proposed that next year the state make a payment of an additional $57 million, which would draw down federal matching funds to provide hospitals with a total of $211 million in 2010 (AP/Portland Press Herald, 3/17).
Massachusetts' health insurance law will not be sustainable over the next five to 10 years unless the state takes significant steps to reduce health care spending growth, government and industry officials say, the New York Times reports.
Architects of the 2006 law said that it would not have been feasible to include heavy cost control measures in the legislation.
Spending on health insurance programs in the state is expected to increase by 42%, or $595 million, this year, compared with 2006, and nearly 60% of the newly insured are covered by public health insurance programs.
Since the law took effect, about 432,000 people have obtained coverage, leaving about 2.6% of the state's population uninsured -- about one-sixth the national average.
Gov. Deval Patrick (D) and a state commission are considering a new payment method for physicians and hospitals that would reward prevention and effective control of chronic diseases, rather than the current fee-for-service model. Changes being considered include reimbursing providers for episodes of care rather than for each visit and bundling payments to groups of providers who would collectively be responsible for a patient's health.
The commission is expected to recommend such payment changes to the state Legislature this spring (Sack, New York Times, 3/16).
Minnesota Democratic-Farmer-Labor lawmakers released a number of legislative proposals last week that are intended to overhaul the state's health care system, the Minneapolis Star Tribune reports (Kaszuba, Minneapolis Star Tribune, 3/16).
The proposals include:
- Eliminating payment for hospital errors or duplicative laboratory work;
- Discouraging caesarean sections forÂ pregnant women enrolled in state-sponsored health insurance programs;
- Offering tiered health benefits based on an assessment of an individual's health (Hoppin, St. Paul Pioneer Press, 3/17);
- Establishing 24-hour emergency dental clinics and birthing centers; and
- Directing government and private providers to buy medical supplies in bulk.
DFL leaders said the long-term savings of such proposals could amount to hundreds of millions of dollars. However, they said some of the proposals initially would cost money, which is "a likely source of conflict in a session focused on erasing" the state's budget deficit, according to the Star Tribune (Minneapolis Star Tribune, 3/16).
Earlier this month, the Oklahoma House voted 97-2 to approve a bill that would authorize the state's insurance commissioner to allow health insurance companies to offer low-cost, mandate-free coverage to residents younger than age 40, the AP/Journal Record reports.
Bill author state Rep. Doug Cox (R) said about 60% of the state's 600,000 uninsured residents are between ages 18 and 40 and the measure is designed to provide them with an affordable health coverage option.
Oklahoma currently requires insurance companies to cover 36 services, including children's immunizations and prostate cancer screening, which some lawmakers say contribute to the high cost of health insurance (AP/Journal Record, 3/13).
Last week, the Texas Health and Human Services Commission announced that it will terminate its contract with UnitedHealth's Evercare program effective May 31, the Dallas Morning News reports.
The program sought to improve medical care for more than 74,000 elderly and disabled Medicaid beneficiaries in North Texas by coordinating preventive care services (Jones, Dallas Morning News, 3/17).
However, many beneficiaries complained that Evercare has failed to provide adequate access to care.
From February 2008 to December 2008, the commission filed more than 1,300 complaints about Evercare. The state has fined Evercare more than $1 million in the last year, ordering it to increase the size of its staff and fix other problems (California Healthline, 1/12).
Evercare's North Texas beneficiaries' plans will roll over into traditional fee-for-service Medicaid plans and the Star Medicaid program, an HMO model, on June 1, according to commission spokesperson Stephanie Goodman (AP/El Paso Times, 3/17).
The Utah Legislature recently approved a bill (HB 178) that would add new, local provisionsÂ to allowÂ laid off Utah workers to enroll in COBRA, the Salt Lake City Deseret News reports (Thalman, Salt Lake City Deseret News, 3/18).
Under the federal economic stimulus package, workers involuntarily terminated between Sept. 1, 2008, and Dec. 31, 2009, whose annual incomes do not exceed $125,000 for individuals or $250,000 for families qualify for subsidies to cover 65% of the cost of health insurance premiums under COBRA for as long as nine months (American Health Line, 3/2).
The Utah bill addresses COBRA coverage for Utah workers at companies with up to 19 workers who were laid off between Sept. 1, 2008, and Feb. 17 and did not enroll in a COBRA plan (Salt Lake City Deseret News, 3/18).
In addition, Gov. John Huntsman (R) earlier this month signed into law four bills intended to serve as the state's basis for overhauling its health care system, the Deseret News reports (Thalman, Salt Lake City Deseret News, 3/12). Summaries of the four bills appear below.
- HB 165: The legislation changes the way hospitals and health care providers send information and billing to patients and creates a health care delivery and payment pilot project. The measure also moves the state toward standardized swipe card technology for insurance cards that will allow patients and providers to access information about deductibles, copayments and insurance status.
- HB 188: The bill creates a new health plan, called NetCare, that insurers will be able to offer at one-half to one-third the cost of the average large-group health insurance premium. The plan will be exempted from certain state coverage mandates and will include wellness incentives, higher deductibles and caps on preventive care. The measure also allows small employers to give workers the choice of enrolling in an employer-sponsored health plan or using an employer contribution to purchase coverage on their own. Insurance companies would be required to cover workers regardless of pre-existing health conditions, and the Utah Health Re-Insurance Pool would provide assistance to insurers who experience a spike in costly claims. In addition, the legislation allows employers to offer NetCare rather than COBRA as an option for state residents transitioning from group coverage to individual health plans.
- HB 331: The legislation requires all general contractors who contract with certain state departments and public transit districts for construction projects worth $1.5 million or more, as well as subcontractors for projects worth $750,000 or more, to give employees a basic level of insurance.
- SB 79: The bill increases the level of evidence plaintiffs must show for emergency department-related medical malpractice claims. In addition, the bill strengthens Utah's licensing laws to increase oversight of out-of-state medical expert witnesses (Rosetta, Salt Lake Tribune, 3/12).