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Tuesday, Jan 6 2015

Full Issue

State Highlights: Blue Shield of California, Sutter Health Contract Dispute; Maine Gov. Spent Big In Medicaid Fight

A selection of health policy stories from California, Maine, Ohio, Texas, Georgia, Oregon, Florida and Vermont.

In a high-stakes fight over healthcare costs, insurance giant Blue Shield of California contends that a major hospital chain is trying to hide some of its business practices from public scrutiny. The dispute has prevented Blue Shield and Sutter Health, which runs 23 hospitals in Northern California, from reaching a new contract that could affect numerous employers and consumers. Their previous agreement expired Dec. 31. (Terhune, 1/5)

Gov. Paul LePage's administration spent nearly $53,000 on private lawyers in its failed attempt to remove thousands of low-income young adults from the state's Medicaid program after being told by Maine's attorney general that he couldn't win the case, according to documents obtained by The Associated Press. The Republican governor went to the 1st Circuit Court of Appeals after the federal government denied his request to end Medicaid coverage for about 6,000 19- and 20-year olds. He was forced to seek outside counsel after Attorney General Janet Mills, a Democrat, declined to represent the state. (Durkin, 1/5)

Hundreds of health professionals engaged in a spirited debate Monday about the proposed sale of a nonprofit Lynwood hospital to a for-profit hospital company in Ontario. St. Francis Medical Center is one of six struggling Roman Catholic nonprofit hospitals that Prime Healthcare Services has agreed to buy for about $843 million in cash and assumed liabilities. (Pfeifer, 1/5)

A 43 percent cut in Medicaid payments to primary-care physicians that began on Thursday could leave some low-income Ohioans searching for care 鈥 and a doctor. ... With Congress unlikely to extend enhanced fees, the Ohio State Medical Association is lobbying Gov. John Kasich to pick up the $630 million-plus annual cost in his proposed two-year state budget. (Ludlow, 1/3)

States have enacted 231 new restrictions on abortion since Republicans swept legislative elections in 2010, according to a new study released Monday. The Guttmacher Institute, a research group that supports abortion rights, found a dramatic spike in limitations on the procedure around the country between 2011 and 2014. (Viebeck, 1/5)

Texas abortion rights advocates will be in a U.S. appeals court this week to challenge state abortion restrictions they say are aimed more at shutting clinics than protecting women's health. A panel of the 5th U.S. Circuit Court of Appeals in New Orleans convenes on Wednesday to consider whether a requirement under Texas law for abortion clinics to have certain hospital-like settings for surgeries is warranted. (Garza, 1/5)

Mental health experts in Georgia say federal spending cuts will weaken a program that trains ordinary citizens to provide 鈥渇irst aid鈥 for a person experiencing a mental health crisis. (Adcock, 1/5)

Portland police have drafted a new policy for dealing with mentally ill people that says sometimes it鈥檚 OK for an officer to walk away if a confrontation could jeopardize a suspect or other people. The policy follows a settlement last summer between the city and the U.S. Justice Department, which found that officers had a pattern of excessive force against people who have, or seem to have, mental illness, the Oregonian reported Monday. (1/5)

The Justice Department said it joined two whistleblower lawsuits against one of the highest-billing doctors in the Medicare program. The two whistleblower suits allege that Ocala, Fla., cardiologist Asad Qamar performed and billed for numerous procedures that were medically unnecessary, and illegally waived co-payments so that patients wouldn鈥檛 second-guess his treatment recommendations. (Stewart and Carreyou, 1/5)

Vermont Gov. Peter Shumlin attracted national attention last January when he devoted his entire State of the State address to Vermont's opiate addiction problem. For the first time, he said, the number of people seeking drug addiction treatment had surpassed those getting help for alcoholism, and many had nowhere to go. (Zind, 1/6)

No overall training is required for the more than 400,000 caregivers in California鈥檚 $7.3 billion In-Home Supportive Services Program (IHSS) for low-income elderly and disabled residents. Without instruction even in CPR or first aid, these caregivers can quickly become overwhelmed and their sick or disabled clients can get hurt, according to interviews with caregivers, advocates and elder abuse experts. (Gorman, 1/6)

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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