Latest California Healthline Stories
Obama Unveils $100M Initiative Focused on Veterans’ Mental Health
During a speech on Saturday, President Obama announced a $100 million initiative that would guide mental health research to help treat veterans with brain injuries and mental health conditions. He also highlighted progress in the government’s efforts to reduce the backlog of veterans’ disability claims. Washington Post et al.
CMS Takes Steps To Suspend Medicare Payments to Nevada Mental Health Facility
In a letter sent to Nevada health officials on Friday, CMS said it is “initiating a process which could result in termination of [a] Medicare provider agreement” with Rawson-Neal Psychiatric Hospital, which bused patients with mental illnesses to California and other states. According to CMS, recent surveys of the facility found that it is not in compliance with certain conditions required to receive payment for treating Medicare beneficiaries. The letter said that the hospital could retain its Medicare funding if administrators can prove that problems have been corrected. However, CMS said, “[m]ere plans of future correction or evidence of progress toward correction will not be sufficient.” Sacramento Bee.
Calif. Looks to Multicultural Providers To Help Solve Doctor Shortage
California’s growing physician shortage has created an opportunity for the state to recruit more multicultural health care providers to help fill care gaps, according to experts. Research shows that patients are more likely to accept and adopt treatment from a provider who shares their background. Sacramento Bee.
Brown Administration Reaches Tentative Contract Deal With Health and Social Services Workers Union
Gov. Brown and AFSCME Local 2620 — the union representing state health and social services workers — have reached a tentative labor agreement that covers three fiscal years ending July 2016. The deal includes an 8% raise for two job classifications, a 3% increase for all other workers and assurance that the state will consider additional pay hikes for certain jobs. Union members and the Legislature must sign off on the contract before it would retroactively take effect to July 1. Sacramento Bee‘s “The State Worker.”
At the request of Gov. Brown and Bay Area Rapid Transit management, a San Francisco Superior Court judge on Sunday ordered BART workers — who were threatening to strike Monday morning — to continue to work for the next 60 days. BART’s labor unions have said they will strike if an agreement on pay raises and health care and pension contributions is not reached by Oct. 11. Contra Costa Times.
Brown Asks Supreme Court To Reject Federal Prisoner Release Order
Lawyers for Gov. Brown have filed an appeal with the U.S. Supreme Court over a federal court-order to reduce the state’s prison population by nearly 10,000 inmates. The appeal argues that the state already has released 46,000 inmates and improved the prison health care system. Los Angeles Times‘ “PolitiCal” et al.
Covered Calif. Will Not Post Health Insurers’ Quality Ratings in 2014
Covered California has announced that it will not post quality ratings for insurers during the first year of the marketplace because currently available data are outdated and inaccurate for plans offered through the exchange. The exchange instead is focusing on strategies for quickly collecting performance data during the first year and creating its own ratings. Los Angeles Times.
More Providers, Patients Accepting Group Appointments
The number of providers offering shared medical appointments has more than doubled in recent years — from 6% in 2005 to 13% in 2010 — as providers and patients increasingly find group visits to be more cost-effective and informative than one-on-one appointments. Patients participating in group visits typically receive physical exams individually before joining a group to talk about the results and other relevant information. Time‘s “Healthland.”
CMS To Help Insurers Comply With Data-Sharing Rules
CMS is collaborating with an anonymous health care provider and a health IT consultant to develop a strategy that would help some insurers comply with federal requirements for sharing electronic data with physicians. The new collaboration was driven by Stanley Nachimson, a Baltimore area health IT consultant, who contacted CMS in May on behalf of an unnamed health care provider client that was not receiving all the information from a certain health insurer as required under regulations that took effect in July 2012 and January 2013. Modern Healthcare.
HHS To Unveil Grant Distribution for Navigator Program Next Week
HHS is preparing to announce next week how it will distribute $54 million in grants through the Affordable Care Act’s insurance exchange “navigator” program, Modern Healthcare reports (Lee, Modern Healthcare, 8/8). According to the Wall Street Journal, the announcement is expected on Aug. 15, which leaves “just 32 business days” for officials in nearly three dozen states to hire and train thousands of workers (Schatz, Wall Street Journal, 8/7).
Background on Navigator Program
Under the ACA, exchanges that will be operated solely by or in partnership with the federal government are required to have at least two certified navigator entities, one of which must be a not-for-profit. HHS has allocated $54 million in funding grants to train and pay navigators in the 37 states with federally run exchanges.
Navigator workers must provide “fair, impartial and accurate information that assists consumers with submitting the eligibility application, clarifying distinctions among [qualified health plans] and helping qualified individuals make informed decisions during the health plan selection process.” They also must provide additional assistance to:
- Consumers with disabilities, limited proficiency in English; or
- Consumers who are unfamiliar with health insurance.
Lawmakers in recent months have raised concerns about the workers’ level of training and access to consumers’ personal and potentially sensitive data. In particular, some GOP leaders have stepped up their scrutiny of the navigator program and a separate “in-person assisters” program in states that will operate their own exchanges. The ACA prohibits federal funding for the assisters program because it does not have to meet the same criteria as the navigators program (California Healthline, 7/15).
Training Issues
According to the Journal, the government earlier this month announced that it would reduce the required number of training hours from 30 to 20 to accommodate the tightened schedule (Wall Street Journal, 8/7). However, HHS has said the Journal report was not accurate, Modern Healthcare reports.
An HHS spokesperson said the workers would need to complete about 20 hours of initial training between Aug. 15 and the Oct. 1 start of the exchanges’ open enrollment period, followed by mandatory “refresher” training through the six-month open enrollment period. In an email to Modern Healthcare, the spokesperson added, “We view training as an ongoing process” (Modern Healthcare, 8/8).
Meanwhile, many of the remaining states that are operating their own exchanges have already launched their in-person assisters training programs and a few of them have also established additional requirements for certification, the Journal reports (Wall Street Journal, 8/7).
Insurance Industry, Advocates Clash Over Navigator Program Oversight
Insurance agents and brokers — concerned that the navigator and in-person assisters programs could encroach on their business — have waged a three-year effort to enact laws regulating state oversight of the program, the Center for Public Integrity/Kaiser Health News reports.
However, consumer advocates and some health policy experts have countered that such laws could hinder the program and impede consumers’ access to insurance. While HHS will have regulatory oversight of the programs in states with federal exchanges, several of the states that are running their own marketplaces have enacted regulations for their in-person assisters program. The regulations require states to conduct background checks on their in-person assisters and prohibit them from recommending specific insurance plans (Kusnetz, Center for Public Integrity/Kaiser Health News, 8/9).