KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

State Roundup: Ill. To Scrutinize Medicaid Eligibility

A selection of health policy news from Florida, Illinois, Connecticut, Texas, California, Oregon and Georgia.

Health News Florida: 1/5 Of Nursing Homes On "State Watch List"
[Fort Pierce resident Cathi] Odom recently learned that her mother's nursing home is one of 140 on the state's "Watch List."  Families for Better Care, a citizen advocacy organization, found that one in five facilities in Florida are on that list for not meeting state standards, or for not making corrections quickly enough. Twelve of the homes have been on the watch list for more than 100 days. Brian Lee, executive director for Families for Better Care, says that is unacceptable (Pusateri, 1/2).

The Associated Press: Vendor Begins Checks Of Medicaid Eligibility
Illinois officials have announced the launch of an effort ... to verify annually the income levels and residency of the state's 2.7 million Medicaid clients...Illinois Department of Healthcare and Family Services Director Julie Hamos says annual verification can determine whether people's circumstances have changed and they're no longer eligible (1/3).

Texas Tribune (Video): Valley Physicians Push For Medicaid HMO Reforms
[W]e've traveled across the state to find out what voters hope their lawmakers will fight for on their behalf during the 83rd Legislature. ... Put in place 10 months ago to save the state $385 million, many doctors in the Rio Grande Valley say Health Maintenance Organizations, HMOs, are limiting patients' access to care. The Texas Medical Association is among those hoping the 83rd Legislature can find ways to streamline the current system (Rocha, 1/2).

The CT Mirror: Report: Mental Health Care System Fragmented, Inadequate
There are too few hospital beds and psychiatrists for people seeking mental health and substance abuse treatment in Connecticut. There are too many barriers to getting services that could prevent crises. There's too much pushback from insurers over covering inpatient care even after a patient attempts suicide. And people with private health insurance often face some of the biggest challenges to getting treatment, according to a report issued Wednesday by the state Office of the Healthcare Advocate (Levin Becker, 1/2). 

The CT Mirror: After Newtown: A Rethinking Of Connecticut Law On Outpatient Commitment
The first time Jeanne Maillet's family called the police on her mentally ill relative, they thought he would finally get to a doctor, get treatment and get better. "We were so naïve," she said. Instead, it was only one step in what Maillet calls five years of hell, trying to get him help in Connecticut's mental health system. ... He doesn't think he's ill. And Maillet wishes there was a way to require he get treatment -- something she thinks would be possible in nearly every other state (Levin Becker, 1/2). 

The Lund Report: Regence Regains Its Lead While Losing Individual Members
Regence BlueCross BlueShield took back its spot as Oregon's top provider of health insurance, though its ongoing battle for market dominance remains a near-tie with previous leader Kaiser Permanente. Oregon’s health reform efforts played a major role pulling Kaiser down from the top position. Coordinated care organizations began insuring the majority of the state’s Medicaid members in the third quarter, removing 13,503 people from Kaiser's official Oregon rolls. In all, 650,000 people on Medicaid are in CCOs (Sherwood, 1/2). 

San Francisco Chronicle: Retirees Can Sue Livermore Lab Over Health Care
A state appeals court has revived a lawsuit by retired employees of the University of California's Lawrence Livermore National Laboratory over UC's decision in 2008 to switch their health insurance to a private plan that covered less and cost more. The four retirees presented evidence that the university had promised them lifetime health coverage and can try to prove that the shift to a lesser plan was a breach of contract, the First District Court of San Francisco ruled Monday (Egelko, 1/2).

Medscape: Prompt-Pay Reform In Georgia Blocked By Judge Temporarily
In a case pitting physicians against health insurers, a federal judge on Monday temporarily blocked an amendment to Georgia's prompt-pay law that would require companies cutting checks on behalf of self-funded employer health plans to pay errorless electronic claims within 15 working days or suffer a 12 percent penalty. The law originally applied only to traditional health insurers, not third-party administrators (TPAs) of self-funded plans (Lowes, 1/2). 

Atlanta Journal-Constitution: DeKalb Doctor Indicted On Medicaid Fraud Charge Over Abortions
A DeKalb County physician has been indicted for alleged Medicaid fraud for taking federal funds to perform elective abortions. Andre Damian Williams was indicted on Dec. 20 on one count of Medicaid fraud for allegedly accepting $205,003 in Medicaid funds for services not rendered and for services associated with the performance of elective abortions, according to Lauren Kane, a spokeswoman for the Georgia Attorney General's office (Jeffries, 1/2).

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