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Wednesday, Dec 10 2014

Full Issue

Colorado Legislative Panel Seeks Greater Oversight Of Exchange

After a partial audit found possible illegal payments by Colorado's health exchange, a legislative committee voted unanimously for a comprehensive audit next year. Meanwhile, a Montana economist testifies that Medicaid expansion is a good deal for that state but many lawmakers remain reluctant to move forward.

A bill that would expand state oversight of the state health insurance exchange advanced through a legislative committee Tuesday, a day after an audit criticized Connect for Health Colorado for mismanaging federal funds. The House bill, sponsored by Rep. Dan Nordberg, R-Colorado Springs, would allow the Office of State Auditor to look not only at Connect for Health's financial systems but to broaden its authority to look at the full performance of the exchange. (Draper, 12/9)

Following a scathing audit that found financial mismanagement and possible illegal payments for lobbying at Colorado鈥檚 health exchange, bipartisan members of the Legislative Audit Committee voted unanimously Tuesday to conduct a comprehensive exchange audit in 2015. (Kerwin McCrimmon, 12/9)

Accepting federal money to expand Medicaid to cover thousands of low-income Montanans looks like a good financial and policy deal for the state, a University of Montana economist told a health care conference here Monday. 鈥淭o the extent that you鈥檙e going to leave $200 million to $1 billion a year in Washington?鈥 said Bryce Ward, director of health care research at UM鈥檚 Bureau of Business and Economic Research. 鈥淚t seems like that would be something you鈥檇 want to get back.鈥 But whether Montana accepts that money remains a sticky political issue in the Republican-controlled Legislature, others said 鈥 and one that will require some compromise to solve. (Dennison, 12/8)

In a new report, federal health officials say low-income Americans on Medicaid may be having trouble accessing health care because more than half of the doctors who are listed as available to treat them are not. Officials at the Department of Health and Human Services called 1,800 doctors listed by health plans that contract with Medicaid programs in 32 states. They found that 51 percent of the doctors were not practicing at the location listed in the provider directories, not participating in Medicaid, or not accepting new Medicaid patients. (Florido, 12/9)

A new federal report suggesting a substantial percentage of U.S. doctors who are supposed to see Medicaid patients are unable or unavailable to do so bolsters outgoing Republican Gov. Tom Corbett鈥檚 claim that Pennsylvania鈥檚 working poor could be better served with private health insurance coverage. In a report issued Tuesday, the U.S. Office of the Inspector General found that 鈥渟lightly more than half of providers could not offer appointments to enrollees.鈥 Medicaid enrollees are supposed to select their doctors from a list of providers connected to each Medicaid managed care plan. (Toland and Giammarise, 12/10)

Getting enrolled in Medicaid is hard enough, with many people encountering enrollment delays this year. But once consumers get their cards for the health program, they face a new challenge: finding a doctor to treat them, according to a federal audit. More than half of the 1,800 primary care doctors or specialists that the Department of Health and Human Services inspector general contacted either were not at the location that their health plan listed for them, or refused to treat program enrollees. The biggest problem 鈥 affecting 35 percent of the providers that auditors contacted 鈥 was that private managed care plans administering Medicaid benefits were not providing accurate information about providers. In some cases, a doctor had retired. Other times, a physician group didn鈥檛 know the doctor listed in a plan鈥檚 provider directory as a member. (Adams, 12/9)

HealthyCT is one of at least a half dozen co-ops created through the Affordable Care Act that have lowered 2015 premiums in a bid to boost membership in their second year of operation. But those low premiums are upsetting so-called 鈥渓egacy鈥 insurance plans like Blue Cross and Blue Shield affiliates that have traditionally dominated insurance markets. ... For 2015 at least, co-ops are offering the lowest-cost silver plans in all, or large parts of Arizona, Connecticut, Colorado, Idaho, Illinois, Maine, Maryland, New Mexico and New Jersey, according to NASHCO. (Galewitz, 12/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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