KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: February 29, 2012

Today's headlines include reports on yesterday's GOP presidential primary elections and how health policy played a role in some of the rhetoric.

Kaiser Health News: Health On The Hill: House Republicans Pound Sebelius On Health Law
Mary Agnes Carey talks with Jackie Judd about HHS Secretary Kathleen Sebelius' appearance before the House Ways and Means Committee. She defended the health care law and the president's fiscal 2013 budget request. The hearing had all the hallmarks of a partisan political event (2/28). Read the transcript or listen to the interview.

Kaiser Health News: Medicare Spends Less Than Private Insurers On Knee Replacements
Kaiser Health News staff writer Julie Appleby reports: "The federal government spends 14 percent less than private insurers for knee replacement surgery and its related costs, even though Medicare patients are older and twice as likely to be readmitted to the hospital, a research paper released this week shows" (Appleby, 2/28).

Kaiser Health News: Main's Top Court Backs State Authority To Limit Health Plan’s Profits; More Americans Head To The ER For Dental Emergencies
Now on Kaiser Health News' blog, Julie Appleby reports: "In a case closely watched by the insurance industry, Maine’s top court Tuesday upheld state regulators' authority to hold down rate increases sought by Anthem Health Plans of Maine. In its ruling, the Supreme Judicial Court said that Maine's insurance superintendent had 'properly balanced the competing interests' in arriving at an approved rate increase of 5.2 percent" (Appleby, 2/28).

Also on the blog, Shefali S. Kulkarni writes: "Americans who turn up in the emergency room to get dental care aren't lost, they're probably just running out of options. According to a new report from the Pew Center on the States, more than 800,000 visits to the ER in 2009 were for toothaches and other avoidable dental ailments" (Kulkarni, 2/28). Check out what else is on the blog.

Politico: Who's Health Care's Key SCOTUS Vote?
Administration lawyers have peppered their briefs with citations to opinions written by Anthony Kennedy and Antonin Scalia, they've seized on the arguments made by one of Scalia's most beloved former clerks and their allies in legal circles have talked up how a decision upholding the Affordable Care Act would play into John Roberts's legacy as chief justice (Haberkorn, 2/28).

Los Angeles Times: States Should Study Spending Before Picking Benefits, Report Says
California and other states should consider the medical care used by the highest-cost patients who battle cancer and other chronic conditions when setting essential benefits under federal reform, according to a study. The report issued Tuesday by the IMS Institute for Healthcare Informatics found that the under-65 population, which will be affected the most by the federal healthcare overhaul, has very different medical spending patterns than Medicare beneficiaries that policymakers should take into account as they prepare to extend coverage to millions of the uninsured (Terhune, 2/28).

The Wall Street Journal: Insurer Battles Physician Group
A clash between health insurer Blue Shield of California and a doctor group that sold its operations to UnitedHealth Group Inc. highlights emerging tensions as lines blur between health insurers and medical providers (Mathews, 2/29).

The New York Times: Senate Nears Showdown On Contraception Policy
The Senate on Tuesday headed toward a showdown over President Obama's policy requiring health insurance coverage of contraceptives for women, even as Republicans appeared to be divided over the wisdom of pressing for a vote any time soon (Pear, 2/28).

The Wall Street Journal: Senate Set To Vote On Contraception
The heated battle over insurance coverage for contraception is shifting to Capitol Hill, with the Senate due to vote Thursday on a measure to let employers opt out of covering any health treatment they find morally objectionable (Bendavid, 2/29).

Los Angeles Times: Republicans Keep Up Birth Control Battle
Dissatisfied with the Obama administration's compromise on contraceptive coverage, congressional Republicans are fighting to do away with the requirement that insurers provide free birth control — a strategy that might rally their conservative base but risks alienating sought-after independent voters in this election year (Mascaro, 2/28).

Politico: Contraception Rule Could Lead To $100 Fines, Hill Report Says
So what, exactly, is the "or else" in the Obama administration’s contraception coverage mandate? House Republicans asked the Congressional Research Service to look into it, and now they're blasting out the answer they got. According to the research service, insurers and employers that do not comply with the contraception coverage rule could face federal fines of $100 per day per employee (Feder, 2/28).

The Wall Street Journal: Doctor Accused Of Big Medicare Scam
Federal agents on Tuesday arrested a Dallas-area doctor accused of bilking Medicare of $350 million over a five-year period, in what the government called the largest Medicare fraud scheme by dollar value linked to a single physician. According to documents filed by the Justice Department in Dallas federal court, 54-year-old Dr. Jacques Roy carried out the fraud with the help of his office manager and home health-care agencies (Zimmerman and Radnofsky, 2/29).

The Washington Post: Texas Doctor Charged in $375 Million Health-Care Scam, The Largest Of Its Kind
A Texas doctor and five owners of home health-care agencies were arrested Tuesday on charges that they fraudulently billed Medicare and Medicaid nearly $375 million in what authorities described as the largest case of its kind (Horwitz, 2/28).

Los Angeles Times: $375-Million Medicare Fraud: Dallas Doctor Accused In Record Case
Federal law enforcement officials announced what they called the largest healthcare fraud case in the nation’s history, indicting a Dallas-area physician for allegedly bilking Medicare for nearly $375 million in billings for nonexistent home healthcare services. Top Justice Department officials, working for several years to stem a rampant rise in healthcare fraud around the country, also revealed Tuesday that 78 home health agencies that were working with the physician, Dr. Jacques Roy, will be suspended from the Medicare program for up to 18 months (Serrano, 2/28).

The New York Times: Seven Charged In Health Care Fraud
The federal authorities in Dallas arrested a Texas doctor and six others Tuesday in a home health care scheme that the authorities said cheated the government out of nearly $375 million in Medicare and Medicaid fees. It was so brazen, they said, that it involved registering homeless people for home health care services they never received (Thomas, 2/28).

NPR: Texas Doctor Indicted In Record Medicare Fraud Case
A massive Medicare and Medicaid fraud scheme has been shut down by federal authorities. One doctor in Texas, Jacques Roy, was allegedly responsible for nearly $375 million in fraudulent billing (Goodwyn, 2/29).

The Washington Post: Michigan Voters Reveal Romney's Strengths And Weaknesses
But about 14 percent of voters said that abortion was their top concern — a larger proportion than in any of the other states that have held primaries. Of those voters, 77 percent backed Santorum, who has made social issues a centerpiece of his campaign. … Still, Spaniola said, his support of Romney was tenuous because of the health-care overhaul he backed in Massachusetts. "You have to send someone to Washington who knows how to run an economy, and Mitt’s the guy. But I hope he does what he says. I'm worried about him with this health-care stuff. It's scary" (Somashekhar and Henderson, 2/28).

Los Angeles Times: Santorum Puts Positive Spin On Second-Place Finish In Michigan Primary
Drawing cheers, Santorum pledged to repeal Obama's signature healthcare law, describing it as a broad and dangerous takeover of Americans' liberty. ... In his sole mention of Romney by name, Santorum linked the healthcare plan the former Massachusetts governor crafted while leading that state with Obama's federal plan, saying Americans needed "not Romneycare or Obamacare but a program that's based upon you, called 'Youcare,' because that's what we believe in America." Santorum, while calling for reducing federal debt and deficits, called for transferring all entitlement programs to the states, a statement that presumably would include programs such as Social Security, Medicaid and Medicare (Mehta, 2/28).

The Washington Post: Santorum's Scrappy Rhetoric A Campaign Staple
Santorum focused almost exclusively in his election-night remarks on promises to cut government spending, repeal Democratic health-care reform and revive the manufacturing sector. And for the first time, he stressed the role in his life of working women, including his mother, whom he said made more money than his father, a rarity in her generation (Helderman, 2/28).

The New York Times' The Caucus Blog: Santorum Pivots Ahead To Ohio
Mr. Obama, he said, had trampled on religious freedom through the administration's ruling that church-run institutions must offer contraception in health plans, even if it violates their beliefs. …. From an attack on the president, he pivoted to one on Mitt Romney, saying that because Mr. Romney's health care plan in Massachusetts was a model for Mr. Obama's plan, he would not be a credible opponent to Mr. Obama in the general election. "Here's the problem, folks," Mr. Santorum said. "We need to have a candidate who can take President Obama on in this biggest issue of the day, of government control of our lives" (Gabriel, 2/28).

The Associated Press/Washington Post: Maine GOP Sen. Snowe Announced She's Not Seeking Re-Election, Cites Polarization
While earning a reputation as an independent voice, Snowe became frustrated by the sharp partisanship and gridlock that has come to characterize the upper chamber recently. She was the only Republican who voted for a version of President Barack Obama’s health care overhaul, joining Democrats and casting a vote for the plan in the Senate Finance Committee (2/29).

The Associated Press/Washington Post: Troubled Kodak Moves To Drop Health Coverage For Medicare-Eligible, Post 1991-Retirees
Eastman Kodak Co., looking to whittle expenses as it reorganizes under bankruptcy protection, wants to end health care benefits for about 16,000 retirees who are over age 65 and thus eligible for Medicare (2/28).

The Wall Street Journal: Report: NJ Municipalities Overpay For Health Insurance
The New Jersey state comptroller said Tuesday that local and county governments are wasting more than $100 million a year by enrolling employees in private health-insurance plans — some of them politically connected — instead of the state health plan (Haddon, 2/28).

Los Angeles Times: California Bill Would Let Non-Doctors Do Some Abortions To Expand Access
A state lawmaker is proposing to allow nurse practitioners, physician assistants and nurse midwives to perform routine abortions in the first trimester of pregnancy as a way of expanding access to the procedure across California (Riccardi, 2/29).

The Washington Post: Virginia Senate Approves Contentious Ultrasound Bill
The Virginia Senate narrowly approved Tuesday a modified version of a contentious proposal that would require women to get an external ultrasound before an abortion (Kumar, 2/28).

The Associated Press/Washington Post: Virginia Senate Passes Bill Requiring Noninvasive Ultrasound Exams For Women Seeking Abortions
Virginia’s Senate passed legislation Tuesday that requires women seeking abortions to undergo noninvasive ultrasounds, days after amending the measure to eliminate a requirement that the exams be conducted through a vaginal procedure that had drawn the scorn of commentators and TV comedians (2/28).

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