Clip files / Local news from the states
Clip files / Local news from the states
Congress moves to override Oregon’s physician-assisted suicide law
WASHINGTON, DC—The U.S. House of Representatives in late October overwhelmingly approved a measure that would override Oregon’s groundbreaking law allowing physician-assisted suicide.
The bill, which passed 271 to 156 sets new national standards for palliative care and provides $5 million in grants to medical schools and hospices to develop training programs for doctors on easing pain among the terminally ill.
The Clinton administration is generally in favor of the bill, but Assistant Attorney General Robert Raben told Congress he was concerned about the "harsh, mandatory penalties" for doctors convicted of assisting with suicide.
—Miami Herald, Oct. 28
Innovations in Medicaid payment strategies analyzed by NASHP
PORTLAND, ME—Payment strategies to increase the performance of Medicaid contractors is the topic of a recent publication from the National Academy for State Health Policy (NASHP).
NASHP surveys activities in 28 states and highlights three that have the most experience with performance-based Medicaid contracting — Iowa, Massachusetts, and Rhode Island. The report, Innovations in Payment Strategies to Improve Plan Performance, is the fourth volume of NASHP’s Medicaid Managed Care — A Guide for States. It is available by calling (207) 874-6524.
—NASHP release, Oct. 29
Organized crime increasing its presence in health care industry, says GAO
WASHINGTON, DC—The shadow of organized crime in health care is growing, according to a General Accounting Office report issued Nov. 4.
GAO auditors described seven groups that set up, between 1992 and 1998, a total of 160 sham clinics, labs, and equipment supply companies in Florida, North Carolina, and Illinois. The criminal groups received payment for fraudulent claims to Medicare, Medicaid, and private insurers ranging from $72,000 to $32 million.
—AP/NewsEdge Corp., Nov. 4
Advocates blast new requirements for reporting EPSDT data
WASHINGTON, DC—"Immensely disappointing" is how advocates at the National Health Law Program (NHeLP) view new federal reporting requirements for Medicaid Early and Periodic Screening, Detection, and Treatment services. Revisions in the Health Care Financing Administration (HCFA) Form-416 will "reduce the ability to track trends in preventive services for children," says a recent report by Jane Perkins and Kristi Olson of the program’s Child Health Law and Policy Project.
The report is a response to a July letter describing the changes from HCFA to state Medicaid directors. Rather than "assist HCFA and states to capture more reliable EPSDT data in both fee-for-service and managed care settings" as suggested by HCFA, the new forms will "render comparisons across time and across states virtually impossible and could result in overinflated results," says NHeLP.
The report requests a series of stop-gap measures and a review of their concerns before implementation of the changes.
—National Health Law Program, Oct. 18
The bottom line on Washington state’s health and health care system: A mixed bag
SEATTLE—Rising costs and declining enrollment of employment-based health insurance are among the trends that "bear watching" in Washington state’s annual snapshot of health and health services. The Pulse Indicators: Taking the Pulse of Washington’s Health System also noted that insurers in Washington state collectively incurred increasing net losses since 1995.
On the bright side, the study by the University of Washington Health Policy Analysis Program reported that the proportion of state residents with employer-sponsored insurance — 65%, and the proportion of residents who are uninsured — 9.5%, both compare favorably with national average.
—The Pulse Indicators: Taking the Pulse of Washington’s Health System, October 1999
Tennessee’s governor would require employers to offer health insurance
NASHVILLE, TN—Tennessee employers would have to offer health insurance to their employees under legislation filed in early November by Gov. Don Sundquist. The legislation would become effective Jan. 1, 2000, for employers with 200 or more employees in Tennessee; on Jan. 1, 2001, for companies with 100 or more workers; and on Jan. 1, 2002, for companies with 25 or more workers.
The proposal also would impose a 1% premium tax on Tennessee health insurance companies and plans that do not participate in TennCare. The levy would not be applied to an insurance company medical service plan, hospital service corporation, or hospital and medical service corporations if at least 25% of its clients are TennCare recipients or if it covers at least 2,000 TennCare enrollees.
—Nashville Tennessean, Nov. 5
Smoking rate among adults virtually unchanged’ in the 90s, says CDC
ATLANTA—Public health efforts are likely to fall short of the national goal reducing smoking to no more than 15% of the population by the year 2000, the Centers for Disease Control and Prevention reported in early November.
While the per capita consumption of cigarettes dropped by 50% between 1963 and 1998, the smoking rates among adults — calculated at 24.7% in 1997 — is "virtually unchanged" during the 90s, says the Nov. 5 issue of Morbidity and Mortality Weekly Report. A climb in smoking during the 1990s among 18 to 24 year olds, though not statistically significant, concerned CDC researchers and prompted a call for increased smoking cessation efforts among this age group.
—MMWR, Nov. 5
DHHS proposes greater patient protections for children covered under CHIP
WASHINGTON, DC—Access to health care specialists, access to emergency services, an assurance that doctors and patients can openly discuss treatment options, and access to an appeals process are among the Children’s Health Insurance Program (CHIP) protections proposed Nov. 1 by Department of Health and Human Service (DHHS) Secretary Donna Shalala.
The proposed regulation would codify policies and procedures already worked out between DHHS and the states during implementation of CHIP. They have a 60-day comment period.
—DHHS release, Nov. 1
Midwest states come to consensus on interstate sharing of organs
MILWAUKEE—Transplant surgeons representing five Midwestern states agreed in early November on a system for sharing livers across state lines.
Programs in Illinois, Wisconsin, Minnesota, North Dakota, and South Dakota were under orders from the Richmond, VA-based United Network for Organ Sharing to resolve disputes regarding the sharing of livers, particularly concerns that busy Chicago programs would drain resources in other states.
The agreement, which applies only to the sickest "Status 1" patients, calls for a cap of four livers that any state would send to another before the recipient had to start repaying the transfer. In a major concession by Wisconsin and Minnesota, states with relatively high rates of organ donation, the surgeons agreed to forgive the "debt" at the end of a year.
—Milwaukee Journal Sentinel, Nov. 4
Washington managed care plans agree to offer independent review
OLYMPIA, WA—Washington state managed care plans covering about 3.8 million people have agreed to implement a binding, independent review process for their enrollees by March 31, 2000.
The review process will be available after an enrollee has exhausted a plan’s internal grievance procedures and its cost of the review will be borne by the plan.
The plans agreeing to the voluntary review are the one associate and nine full members of the Association of Washington Healthcare Plans (AWHP).
"There’s been a lot of recent discussion in Congress about patient protections. Our plans believe independent review is the best possible patient protection initiative," said Margaret Lane, chair of the AWHP board.
—Business Wire, Nov. 3
Healthy Florida Hospital to close obstetric services in Kissimmee
KISSIMMEE, FL—It’s time to pay the piper for Florida Hospital’s Kissimmee facility.
The financially healthy facility is closing its maternity ward Nov. 8 for at least six years, thus meeting the terms of a unique agreement that allowed Florida Hospital to open a hospital at Disney World’s planned community, Celebration.
To placate competitors contesting the Certificate of Need (CON) required to open Celebration Health, Florida Hospital agreed to curtail certain services in Kissimmee if the new hospital caused its competitors to lose market share in the community.
The three-way deal was signed by Florida Hospital, Columbia/HCA Healthcare Corp., Orlando Regional Healthcare System and the state Agency for Health Care Administration. Florida Hospital was especially anxious to complete a deal, as the company had built Celebration Health before obtaining a CON and could not operate the facility as a hospital without such approval.
When Columbia’s Osceola Regional saw its obstetrics market share drop from 72.9% to 70.6% in the last two years, Columbia exercised its option to force Kissimmee’s cutback in services. The effect is that Columbia’s Osceola Regional becomes the sole provider of obstetric services in downtown Kissimmee.
—Orlando Business Journal, Nov. 1
Plastic surgeons call for mandatory coverage of reconstructive services for children
WASHINGTON, DC—The professional association representing 92% of the nation’s plastic surgeons has renewed its efforts to mandate insurance coverage for treating children’s deformities.
The American Society of Plastic Surgeons (ASPS) is backing the Treatment of Children’s Deformities Act, introduced into the Senate on Oct. 28 by Sen. John McCain (R-AZ) and Sen. Olympia Snowe (R-MA).
The bill would require insurance companies to cover reconstructive surgical procedures for those children with congenital or developmental deformities, diseases, or injuries. Coverage would be required for surgical procedures designed to improve the function of abnormal body structures, or to restore those body structures to a more normal appearance.
Currently, 15 states have laws that address insurance coverage for children’s deformities or craniofacial disorders, with Texas the most recent to pass such legislation.
The Treatment of Children’s Deformities Act was first introduced in the House of Representatives near the end of the last congressional session and was re-introduced on Jan. 6, 1999 by Rep. Sue Kelly (R-NY) as H.R. 49.
—PRNewswire/NEWSdesk, Nov. 3
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