Health Reform News Around the Nation: Nov. 5, 2007
Alabama Medicaid Commissioner Carol Hermann-Steckel on Wednesday told state lawmakers she has not determined the amount of additional funds that the Alabama Medicaid Agency will require to address an expected budget deficit in fiscal year 2008-2009, the Huntsville Times reports (Lowry, Huntsville Times, 11/1).
Hermann-Steckel, who previously said that the agency would require an additional $199 million, said that she does not "know the number because we haven't calculated" the effect of an expected decrease in federal Medicaid matching funds in FY 2008-2009.
The state had received additional federal Medicaid matching funds for 11 counties affected by Hurricane Katrina, but those additional funds will end in FY 2008-2009, a change that will reduce the amount of funds that the state receives by about $135 million. Hermann-Steckel said that the agency has entered discussions with the federal government about the loss of Medicaid matching funds (Lyman, Mobile Press-Register, 11/1).
The amount of claims paid by the state Medical Care Availability and Reduction of Error, or MCARE, fund will decrease for a fourth consecutive year to $191 million, about a 50% decrease from 2003, Gov. Ed Rendell (D) said last week, the Pittsburgh Tribune-Review reports.
The fund helps cover the cost of malpractice claims that exceed $500,000 in primary coverage, which all physicians in the state must obtain. Rendell said legislative, judicial and administrative reforms in the state have made Pennsylvania "a success story when it comes to medical malpractice" (Pittsburgh Tribune-Review, 10/26).
A state malpractice law enacted last year prevents public disclosure of reports of medical errors by individual hospitals, according to a legal opinion sent last week by the state Office of the Attorney General to the state Department of Health, the Seattle Times reports.
The department has collected and made public reports of certain "adverse events or incidents" by individual hospitals since 2000. However, the Washington State Hospital Association recently asked the department to end public disclosure of the reports on the grounds that the law prohibited the practice.
The department agreed to the request, provided that the office concurred in a legal opinion of the association (Ostrom, Seattle Times, 10/30).
Gov. Charlie Crist (R) on Oct. 26 signed legislation enacting a fiscal year 2008 budget that includes $1.1 billion in spending reductions, the AP/Orlando Sentinel reports.
The cuts include $233.8 million from Medicaid and $164.5 million from nursing homes that care for low-income residents. The cuts were made to address a budget shortfall caused by weak home sales and a sagging economy, according to the Sentinel (AP/Orlando Sentinel, 10/28).
In other Florida news, a report from the Florida Health Insurance Advisory found one in four Florida residents younger than age 65 is uninsured, and the number of uninsured Florida residents of all ages increased by 38% over the past eight years.
According to the report, based on U.S. Census data, there are about 3.8 million uninsured residents in Florida. The report also found that the number of people enrolled in private insurance plans increased from 2005 to 2006 (Fineout, Miami Herald, 11/1).
State officials on Tuesday announced that residents can now apply for Medicaid online, the Capitol News/Baton Rouge Advocate reports.
The state also has posted on the Department of Health and Hospital's Web site applications for:
- LaCHIP, Lousiana's version of the State Children's Health Insurance Program;
- LaMOMS, a program that provides coverage for pregnant women;
- The Medicaid Purchase Plan, for workers with disabilities;
- The Medicare Savings Program, a premium subsidy program for Medicare beneficiaries; and
- TAKE CHARGE, family planning services for women.
State lawmakers in Maryland on Thursday presented an additional $440 million in cuts from the state budget proposed by Gov. Martin O'Malley (D), including $32 million in cuts from Medicaid spending, the Washington Times reports.
To address the estimated $1.7 billion budget shortfall for FY 2009, the House lawmakers' plan would make cuts to Medicaid, stem cell research, teacher retirement payments for educators and higher education funding. Lawmakers are participating in a special session convened by O'Malley to consider his budget proposals, according to the Times (LoBianco, Washington Times, 11/2).
O'Malley's health care plan would increase subsidies to small businesses providing coverage to workers and raise the eligibility for Medicaid to include parents with incomes less than 116% of the federal poverty level. The same eligibility requirements could apply to childless adults (Smitherman, Baltimore Sun, 11/2).
The Massachusetts Medical Society has asked state lawmakers to pass a bill sponsored by state Sen. Robert O'Leary (D) under which plaintiffs could not use statements of guilt or admissions of error by physicians as evidence in malpractice lawsuits, the Boston Globe reports.
In addition to that bill, state Sen. Richard Moore (D) has introduced legislation that would create a "Health Apology Pilot Program." Under the program, plaintiffs could not use statements of guilt by physicians and hospitals as evidence in malpractice lawsuits, provided that they make admissions of error and apologize, as well as agree to negotiate "fair settlements."
The state Senate last month held a hearing on the Moore bill but has not scheduled a hearing on the O'Leary bill (Kowalczyk, Boston Globe, 10/31).
State lawmakers on Wednesday approved a $9.7 billion FY 2008 state budget that would increase Medicaid spending by $154 million, the Detroit Free Press reports. Along with federal aid, Medicaid funding would increase by $373 million for the fiscal year (Christoff, Detroit Free Press, 10/31).
The overall Community Health budget would increase from $11.4 billion in FY 2007 to $12.04 billion in FY 2008, the Detroit News reports. To prevent Medicaid cuts, doctors and hospitals agreed to pay an additional $60 million for a hospital quality assurance program that draws matching money from the federal government (Hornbeck/Heinlein, Detroit News, 10/31).
New Jersey Gov. Jon Corzine (D) on Wednesday signed into law a bill that requires hospitals to file quarterly reports with the state on patient infection rates, types of infections and plans to control infections, the AP/Philadelphia Inquirer reports. The information will be posted publicly on a state Web site (Hester, AP/Philadelphia Inquirer, 11/1).
The statistics eventually will allow the public to compare infection rates at hospitals, although the site will not be finalized for two years, Health Commissioner Fred Jacobs said. The law requires the disclosure of:
- Surgical infections:
- Urinary tract infections related to catheters:
- Pneumonia related to ventilators; and
- Blood infections related to catheters.
Presidential candidate New Mexico Gov. Bill Richardson (D) on Thursday announced a health care proposal that aims to increase the number of insured state residents, the Santa Fe New Mexican reports (Terrell [1], Santa Fe New Mexican, 10/26).
Under the proposal, the state would phase in a requirement that people obtain private health coverage, enroll in a state-subsidized program or provide documentation showing they have sufficient financial resources to afford health care expenses out of pocket. Some residents, primarily those who are able to afford coverage, would be required to start showing proof of coverage beginning in 2010, such as when they renew a driver's license.
In addition, the proposal would require employers with six or more workers to pay into a state-run fund, with the payments offset by the amount that an employer contributes to coverage for its employees.
The proposal would create the New Mexico Health Care Coverage Authority, which would administer most of the health care mandates and oversee decisions on benefits and eligibility. Richardson's proposal also would increase the use of electronic claims and health records to improve quality of care, control costs and reduce errors (Terrell [2], Santa Fe New Mexican, 10/26).
Gov. Eliot Spitzer (D) last week proposed an increase in Medicaid physician reimbursement rates for FY 2008-2009, the AP/Albany Times Union reports.
A recent report by Public Citizen found New York's Medicaid program ranks second-to-last in the nation for the amount it reimburses physicians for services, despite the fact that the program spends more per beneficiary than in most other states. According to the report, the state's Medicaid program spends $7,500 per beneficiary (Bauman, AP/Albany Times Union, 10/29).