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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, Oct 31 2014

Full Issue

State Highlights: Ga. Official On Insurer's Contract With Docs; Calif. Nursing Home Audit

A selection of health policy stories from Georgia, California, Texas, Pennsylvania, Montana, West Virginia and Louisiana.

Georgia鈥檚 insurance commissioner, in a rare regulatory action, has told the state鈥檚 largest health insurer to rescind newly added amendments to contracts with thousands of physicians. Physicians had complained that the Blue Cross and Blue Shield of Georgia contract revisions lacked clarity on the insurer鈥檚 payment rates for medical services. (Miller, 10/30)

The California Department of Public Health has failed to effectively investigate nursing home complaints, a state audit released Thursday found, with a total of 11,000 unresolved complaints in its system. The department, which is responsible for monitoring more than 2,500 nursing homes, classified more than 40% of these complaints and incidents as having caused or being likely to cause harm to a resident. Yet the state auditor鈥檚 office found that the average number of days these complaints were open ranged from 14 to 1,042 days. (Flores, 10/30)

Stockton had asked the court to approve its plan, which calls for budget cuts, haircuts for bondholders and even a sales tax increase, which city residents approved in a referendum last year. But it did not touch pensions, not even the benefits that current workers hope to earn in future years. Prospective pension cuts are routine when companies go bankrupt under Chapter 11 and even outside of bankruptcy. But Judge Christopher Klein of the United States Bankruptcy Court for the Eastern District of California in Sacramento said he found Stockton鈥檚 proposed plan acceptable, noting that it eliminated the retirees鈥 health benefits. (Walsh, 10/30)

A judge is siding with Highmark Inc. in a dispute with state regulators over an insurance plan that doesn't cover doctors working for the University of Pittsburgh Medical Center. Commonwealth Court Judge Dan Pellegrini ruled Thursday that Highmark hadn't violated terms of a consent agreement meant to alleviate tensions between the healthcare competitors. The judge rejected calls from the state attorney general's office and the health and insurance departments to hold Pittsburgh-based Highmark in contempt. (10/30)

A Glendive veteran says his confidential medical diagnosis, birth date, address and Social Security information were compromised when the VA Montana Health Care System mishandled his request for medical services. Kip Braden, a U.S. Army, Air Force and National Guard veteran, was waiting for authorization papers from the VA for outpatient services, but when his paperwork arrived, it was for a Bozeman veteran. The authorization papers included the Bozeman veteran鈥檚 name, address, date of birth, Social Security information and his medical condition. VA officials have characterized the mix-up as a 鈥渕ishandling鈥 of correspondence. (Uken, 10/30)

Randy Hodges, the hospital鈥檚 administrator, has asked the Putnam County Development Authority to buy the hospital鈥檚 only two smoking areas 鈥 for one dollar 鈥 while the hospital continues to maintain the areas and assume legal liability for them. ... An accreditation company that determines whether the hospital can continue getting paid to serve Medicare and Medicaid patients 鈥 representing more than half of its total patient volume 鈥 requires CAMC Teays Valley to move toward being a 鈥渟moke-free campus.鈥 (Quinn, 10/30)

Two civil rights groups called for a federal investigation into a Jindal administration program that they allege is failing to deliver on promised services to keep at-risk youth with mental health problems out of detention centers and hospitals. In response, the state health chief acknowledged Wednesday that there are 鈥渃hallenges鈥 in getting providers to meet the specialized needs of the youth and their families, but said the administration remains committed to the program. The Southern Poverty Law Center and the Advocacy Center complained to the federal Centers for Medicare and Medicaid Services, called CMS, about shortcomings of the program that attorneys claim violate federal law. (Shuler, 10/30)

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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