Each month, this page features selected short items about state
health-care policy digested from newspapers around the country.
Clip File
Florida to publish reports on doctors who have lost malpractice suits or have been disciplined
TALLAHASSEE, FL—Early next year, Florida will start publishing quarterly reports on physicians who have had their state licenses revoked or suspended, who have been
disciplined, or who have lost or settled three malpractice lawsuits within five years.
In the future, if the legislature gives its approval, these reports may contain even more information. The Agency for Health Care Administration (AHCA), which assumed responsibility for regulating physicians last year, also has proposed including complaints against physicians earlier in the review process and making public medical mistakes reported to the state by hospitals in adverse incident reports, but now kept confidential. Hospitals will have to file adverse incident reports within three days or face stiffer fines.
Following a case in Florida, in which a self-insured physician failed to to make payments on several malpractice judgements against him, the AHCA also wants to be able to take away the licenses of physicians who self-insure for malpractice and file for bankruptcy. Physicians who do not carry insurance in Florida can self-insure by maintaining a $250,000 reserve fund.
Sun Sentinel, Fort Lauderdale, FL, Nov. 4, 1996
Tennessee counties and providers organize board to safeguard emergency psychiatric services
MEMPHIS, TN—County officials, providers and advocates in Shelby County, one of the poorest counties in Tennessee, are organizing a board to help safeguard emergency psychiatric services during the transition to managed mental health and substance abuse services for the Medicaid population. As of July 1, Tennessee began implementing its TennCare Partners program. The state has contracted with two behavioral health firms to
manage mental health and substance abuse for the whole state.
The group wants to become a formal state advisory council to provide oversight and ensure accountability on emergency
psychiatric services.
Meanwhile, five community mental health centers and two hospitals are trying to organize a nonprofit foundation, dubbed the Foundation for Mental Health Care, to provide patient services. Providers and others will receive invitations to join with a $5,000 contribution.
Commercial Appeal, Memphis, TN, Sept. 24, 1996
Federal judge rules California can drop prenatal care program for 70,000 undocumented women
SACRAMENTO, CA—A federal judge has ruled that California can make cuts in aid to illegal immigrants under the new federal welfare law, notwithstanding a 1994 court injunction on implementing Proposition 187. The judge’s ruling frees Gov. Pete Wilson to drop a prenatal care program for about 70,000 pregnant women who are undocumented immigrants.
The 1994 court injunction against Proposition 187 has presented a formidable obstacle to Gov.Wilson’s plans to implement the newly mandated federal bans.
The new ruling could open the way for the state to block illegal immigrants from dozens of state-funded programs, such as cancer-screening efforts and post-secondary education. Ironically, the judge’s ruling was prompted by immigrant advocates who went to court to block Gov. Pete Wilson’s plans to drop the prenatal care program for illegal immigrants.
Mark Rosenbaum, legal director of the American Civil Liberties Union of Southern California, predicted there would be other legal assaults such as a possible legal challenge of the ban on pregnancy under constitutional guarantees of equal protection. "Denying prenatal care to citizen children is an open question that could be litigated," he said.
The governor’s proposed regulations become effective Dec. 1, ending a program mandated by the legislature in 1988. The state program cost about $69 million last year.
The aid cutoff is expected to hit hardest in Los Angeles
County where county hospitals and clinics now provide prenatal care to about 20,000 illegal immigrants. County taxpayers will be left with the $9 million cost.
Los Angeles Times, Nov. 2, 1996
Tennessee mental health centers agree to halt joint contract negotiations under antitrust settlement
NASHVILLE, TN—A nine-month investigation into possible antitrust violations by Tennessee’s nonprofit community mental health centers has ended with a settlement in which the centers agreed to halt joint contract negotiations and pricing for
Medicaid business. Under the agreement reached by the attorney general, the Tennessee Association of Mental Health Organizations and the Tennessee Mental Health Center Corp., the mental health centers have agreed to pay the attorney general $150,000 to cover the costs of the investigation and to distribute $150,000 to its member health centers for "the benefit of the mentally ill in
Tennessee."
Executives of the Tennessee Association of Mental Health Organizations continued to maintain that their actions were not fraudulent and were "encouraged by the state in order to expedite the TennCare Partners program."
Commercial Appeal, Memphis, Tenn., Sept. 14, 1996
Conversion of Virginia’s Trigon Blues is approved
NORFOLK, VA—State regulators here have cleared the way for the state’s largest health insurer, Trigon Blue Cross Blue Shield, to convert from a nonprofit company to a for-profit.
The conversion was approved with several conditions
regarding the sale of stocks but consumer advocacy groups expressed disappointment that some of Trigon assets were not earmarked for public benefit.
The State Corporation Commission said in its approval that its examination was limited by a state law enacted earlier this year that restricts the distribution of Trigon’s assets to its policyholders. Under that law, the only test for evaluating Trigon’s application was whether it was fair and equitable to its policyholders. Trigon has agreed to pay the state treasury $175 million to compensate for tax breaks it has received in the past.
The Richmond-based insurer covers 1.8 million people and has said it must acquire other companies if it is to survive. Under the terms of the approval, the company’s officers and board are restricted from receiving any stock-based compensation or stock options until 90 days after a six-month "lockup" period. Another provision calls for Trigon to reduce an anti-takeover measure restricting the accumulation of Trigon stock from 60 months to 30 months.
Virginia-Pilot Ledger, Norfolk, VA, Oct. 29, 1996
Florida Medicaid officials to outline problems clients have with dental program
FORT LAUDERDALE, FL—Florida Medicaid officials are compiling problems that Medicaid recipients are having with dental care and plan to present the report to the legislature in February.
Adults who need root canals, crowns, extractions, fillings and other dental care find that they either have to live with their problems or get all their teeth removed and get fitted for dentures. Since 1970, the dental benefit under Florida Medicaid has not covered preventive or emergency dental care for adults, but will cover the removal of all the patient’s teeth and the cost of the dentures.
In the 12 months that ended June 30, Florida spent $16.3 million for the minimal dental services to the 653,000 adults in the program while it would take $30 million more to offer what basic private insurance covers, according to Bob Sharpe, chief of Medicaid program development for the Agency for Health Care Administration (AHCA).
In the past, the legislature has shot down several proposals to make changes in the Medicaid dental program.
Sun Sentinel, Fort Lauderdale, FL, Nov. 3, 1996
Each month, this page features selected short items about state
health-care policy digested from newspapers around the country.
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