Morning Briefing
Summaries of health policy coverage from major news organizations
State Highlights: Fla. Advisory Panel Urges Lawmakers To Pass More Health Plan Consumer Protections; Survey Finds State Workers' Comp Measure Cut Payments To Medical Providers
Florida lawmakers should enact more protections for health-insurance consumers and families of workers in small businesses, a state advisory board says. The legislative recommendations that emerged from the Florida Health Insurance Advisory Board on Monday included two aimed at fixing problems that have recently erupted in the health-insurance system: 鈥渂alance-billing鈥 and the 鈥渇amily glitch.鈥 The first would protect members of preferred provider organizations (PPOs) and certain other network plans from being billed by a hospital or doctor outside their network for charges run up through no fault of their own. (Gentry, 11/17)
Three years ago, Gov. Jerry Brown and the Legislature enacted a major overhaul of the system that compensates workers for job-related injuries and illnesses. Senate Bill 863, backed by employers and labor unions, affected many specific aspects of the system but was aimed largely at reducing medical costs and redirecting savings into cash benefit increases for disabled workers. (Walters, 11/16)
It took handcuffs and a blast of pepper spray for police to drag a 72-year-old man from his downtown apartment. Neighbors had called for help after hearing banging and other noises. Ronnie Medenwaldt answered the door with a knife and refused to leave. He was arrested, charged and jailed for three months before a judge ordered a mental health evaluation. His journey through the justice system stalled there. Medenwaldt sat in the Minnehaha County Jail for another eight months waiting for a psychiatrist to determine what role his mental illness played in the confrontation with police. (Walker, 11/14)
The Florida House and Senate will reform the state's troubled mental-health system during the 2016 legislative session, predicts one of the lawmakers spearheading the effort. "I think everyone understands that this is the year to get it done," said Senate Health and Human Services Appropriations Chairman Rene Garcia, a Hialeah Republican who during the 2015 session tried to pass a sweeping bill to streamline delivery of mental-health and substance-abuse treatment --- only to see the measure die at the tumultuous end of the session. (Menzel, 11/16)
The leaders of the legislature's Democratic majority Monday recommended suspending the state's public-financing of elections for 2016, cutting social services, and retreating from two major initiatives on transportation and municipal aid. The suggested cuts are part of continuing negotiations with Gov. Dannel P. Malloy, a Democrat, and the Republican legislative minority over how to eliminate growing deficits projected for this fiscal year and the one that begins July 1. ... Faced with growing red ink, Democrats proposed reductions in areas they traditionally have avoided. Almost $24 million would be cut from the Office of Early Childhood and the departments of Social Services, Mental Health and Addiction Services, Public Health, and Children and Families. (Phaneuf, Levin Becker, Rabe Thomas and Pazniokas, 11/16)
The head of the Massachusetts Medical Society (MMS) is calling for lawmakers to change two key provisions in a bill that Gov. Charlie Baker says is needed to fight the state鈥檚 growing opioid addiction epidemic. The Joint Committee on Mental Health and Substance Abuse held a hearing on the legislation Monday, during which MMS President Dr. Dennis Dimitri urged changes to two controversial proposals: limiting first-time opioid prescriptions to a three-day supply, and letting hospitals hold addiction patients against their will for up to three days while trying to place them in treatment. (11/16)
An incurable disease has given Jose Gonzalez Ortiz the health of an old man at age 42, and the collapsing Puerto Rican health system only adds to his pain. He was refused the $300 worth of monthly medications he needs to treat the degenerative illness known as Lou Gehrig's disease that attacks the cells that control his muscles. His health care plan won't pay for the respiratory equipment that doctors say would ease his breathing. Unable to walk, he lurches about on a walker donated by his church because he was denied a wheelchair for his amyotrophic lateral sclerosis, or ALS. (Coto, 11/16)
Federal prosecutors announced Monday they鈥檝e filed criminal charges against 28 people involved in a 鈥渃omplex and sprawling health care fraud scheme鈥 that cost the government $8.7 million. All 28 have signed documents indicating they would plead guilty, according to the U.S. Attorney鈥檚 office in Dallas. Others could still be charged. (Mosier, 11/16)
A couple have been convicted of health care fraud in a scheme prosecutors say stole $80 million in Medicaid payments from the District of Columbia government. The U.S. Attorney鈥檚 Office in Washington said in a news release Monday that a federal jury in the District convicted 52-year-old Florence Bikundi and her husband, 63-year-old Michael Bikundi Sr., last week. (11/16)
With dementia cases rising rapidly around the world, the University of California, San Francisco and the University of Dublin announced Monday the launch of an institute aimed at helping developing countries learn more about the disease and cope with the burden it places on patients, families and caregivers. The Global Brain Health Institute, which will be housed both in San Francisco and Dublin, will train 600 neuroscientists, policymakers, economists and others over 15 years in an effort to help developing countries better understand dementia, as well as how to delay and prevent it. The institute plans to focus initially on countries in Latin America and the Southern Mediterranean region. Training is expected to begin next fall. (Gorman, 11/16)
When Hilda Sims earned her release from prison last year after serving 22 years for murder, she got something that could dramatically reduce the odds that she'd ever have to return: health insurance. For years, many who left California lockups on parole or probation would do so without easy access to medical care. For someone like Sims, who survived breast cancer behind bars, that meant health problems might go untreated or result in big medical bills just as they were struggling to return to society. (Karlamangla, 11/16)
What the heck is a Health Hack? It's no traditional hackathon, with computer geeks, pizza, and Red Bull. Instead, think medical professionals, engineers, artists, tech types, and an insurance company banding together to come up with creative solutions to improve delivery of health care. Toss in some yoga, zumba, and kickboxing, and add a vegetarian lunch for good measure. That was the scene at Thomas Jefferson University Hospital this weekend as about 250 participants in the first Independence/Jefferson Health Hack came together to brainstorm solutions to 60 health-care challenges, including reducing hospital admissions, wearable devices, and drone delivery of health care. (Schaefer, 11/14)