Clip files / Local news from the states
Clip files / Local news from the states
This column features selected short items about state health care policy digested from publications from around the country.
Georgia legislature approves independent HMO review, expands consumer choice
ATLANTA—Georgia legislators have approved a package of bills that will create an independent health care consumer advocate, allow patients to sue HMOs for improperly delaying or denying care, and expand a managed care patient’s choice of provider.
"This is the most sweeping health care reform that has been done by any state in this country," Gov. Roy Barnes said after Senate approval cleared the way for his proposals to become law.
Currently, patients in Georgia typically can sue only doctors for poor care. Gov. Barnes wants to let them seek compensatory, but not punitive, damages against insurers.
The consumer advocate will represent people who complain to the state Insurance Department that they were unfairly denied coverage or who have other complaints about an HMO or insurer.
The bill expanding doctor choice sets limits on the extra amount HMOs can charge patients who go outside their regular networks to get physician care.
"We were certainly more happy with the final result than what first came to us," said James Purcell, executive director of the Georgia Managed Care Association.
Legislators also approved the creation of a new superagency to oversee Medicaid, state employee health benefits, state health planning, tobacco settlement negotiations, and physician regulation as well as a new office devoted to women’s health. The state’s Division of Public Health may eventually be moved into the new Community Health Department as well.
—Atlanta Journal Constitution, March 21; Chattanooga Times and Free Press, March 25.
Guam wins approval to expand Medicaid with CHIP funds
WASHINGTON, DC—A proposal from the territory of Guam has won approval as the 51st plan to be approved in the federal Children’s Health Insurance Program (CHIP).
Up to $375,000 in new funds are available to Guam, which will use its CHIP allocation to expand its Medicaid program to children receiving services through a territory-funded program.
The local government will not expand income limits, but instead will expand the number of children served. The regular Medicaid benefits package will be provided, and there will be no cost to the families participating in the program.
—Health Care Financing Administration release, March 29.
Montana, Magellan agree on June 30 departure for behavioral health contractor
BALTIMORE—The rocky relationship between the state of Montana and Magellan Behavioral Health, its Medicaid managed health care contractor, will end officially on June 30.
Under an agreement announced in March, the state will assume financial risk for its Medicaid managed health care program beginning May 1, and Columbia, MD-based Magellan will provide care management and claims services through June 30.
The split cuts short Magellan’s five-year, $400 million contract to provide Medicaid managed behavioral health care to Montana residents. Legislators and other state officials are developing a bid process for a revamped regional system for such care. (See related story, State Health Watch, April 1999, p. 10.)
—Magellan release, March 27.
Smoking among Florida teens plummets, but cessation campaign faces budget cuts
ST. PETERSBURG, FL—Amid uncertainty over continued state funding for Florida’s smoking cessation efforts, the program reported the largest decline in teen smoking anywhere in the nation since 1980.
The declines represent "the most glorious success we’ve seen in 20 years," said Michael Eriksen, director of the Centers for Disease Control and Prevention’s Office on Smoking and Health. "Florida is kind of a national trend-setter right now. I don’t think it would be wise to change the program just for change’s sake."
The results even prompted former Surgeon General C. Everett Koop to pressure the Florida House of Representatives to preserve the program.
"This outstanding program serves as a model for other states to follow," Mr. Koop said.
From 1998 to 1999, smoking among middle school students dropped from 18.5% to 15.0%, the CDC reported. The decline among high school students was from 27.4% to 25.2%. The proportion of middle school students who smoked cigars and used smokeless tobacco products also decreased significantly.
—St. Petersburg Times, April 2; Morbidity and Mortality Weekly Report, April 2.
Chicago townships turn to Lloyd’s of London for protection against health claims
CHICAGO—Five townships in northern Cook County are protecting themselves against the cost of indigent health care with an insurance policy from Lloyd’s of London.
Under state law, townships must pay for the living costs and medical expenses of residents who need public assistance but don’t qualify for federal or state aid, or are waiting for applications to be approved. The insurance policy is designed to protect the townships’ limited budgets, which typically run about a few million dollars annually.
Tax caps passed by the General Assembly in 1991 and expanded in 1994 limit the ability of townships to raise taxes to meet expenses. Most taxing bodies in Chicago’s Cook County and the five surrounding counties may not raise annual property taxes by more than 5% or the annual increase of cost of living, whichever is lower, without voter approval.
The townships—Maine, Wheeling, Elk Grove, Schaumburg, and Northfield—together pay a premium of $15,000 per year. The deductible is $25,000 and coverage is for up to $1 million for each claim.
—Chicago Tribune, March 2.
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