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The toughest challenge ahead for states in the coming year is Medicaid, “the area of state budgets that is usually the most difficult to control.” While states have been able to contain Medicaid costs in recent years, the introduction of the president’s health-care reform law and its Medicaid expansion introduces new variables for budget managers to grapple with, [credit rating agency] Fitch finds. (Chokshi, 12/2)

Supporters of a plan to make Vermont the first state in the country to enact a single-payer health care system urged Gov. Peter Shumlin and the Legislature on Tuesday to move forward with the overhaul, despite Shumlin's narrow victory in the November election. Sixteen groups, including the state employees and teachers unions, held a Statehouse press conference to rebut critics of Green Mountain Care who say the election was a referendum on the publicly funded system. They say the election was so close because of property taxes and other issues. (Rathke, 12/2)

Doctors talking privately to patients or families after a medical mishap could acknowledge responsibility or even admit a mistake without that conversation being used against them later in court, according to a proposal in the Ohio General Assembly pushed by physicians. (12/2)

Texas and the federal government tentatively resolved a high-stakes health care funding inquiry on Monday, averting a major disruption to hospital funding. The Texas Health and Human Services Commission and the federal Centers for Medicare and Medicaid Services reached the tentative agreement Monday. They expect a formal, written agreement during the next two weeks. After requesting records over the summer, the Centers for Medicare and Medicaid Services deferred a $74.9 million payment to the Health and Human Services Commission in September. The payment covered uncompensated care provided by hospital systems in Dallas County, Tarrant County and Nueces County — where the local Hospital District works with the Christus Spohn Health System to provide health care to the county's poorest residents. Driscoll Children's Hospital and Corpus Christi Medical Center also benefit from payments through the federal program. (Hendricks, 12/2)

More disabled Iowans are being added to waiting lists for state assistance, despite $6 million that legislators earmarked last spring to reduce the number of those waiting for help. More than 9,000 Iowans are waiting, often for more than two years, for therapies and services to help them deal with mental or physical disabilities. Patient advocates say they've been told that the Iowa Department of Human Services has spent little of the $6 million that was supposed to speed up access to the services, starting July 1. A department spokeswoman said Tuesday that the agency will soon ramp up the effort. (Leys, 12/2)

Biederman's study, published in the Journal of Community Health Nursing, found that homeless patients were more likely to be readmitted to "safety net" hospitals when they had no safe place to recover from illnesses. Sending them to a homeless shelter, a boardinghouse or back to the street did not provide the security and medical attention they needed. The patients in the study complained of developing infections in shelters. Their pain medications would be stolen. They couldn't handle stairs or had other impediments. (Jacobson, 12/2)

Florida lawmakers appear ready to reignite talks on the future of telemedicine. The issue of how to handle doctors who treat patients remotely was jumbled into a larger health-related bill, which contributed to its defeat last session. Florida TaxWatch’s Tamara Demko says lawmakers need to pare down their goals for addressing telemedicine in the state. (Hatter, 12/2)

Louisiana's Medicaid spending rose about $950 million while the state privatized public hospitals and much of Medicaid, a legislative audit found. Medicaid annual spending stayed about $6.6 billion to $6.8 billion from 2010 through 2012 but hit $7.6 billion by June 30, when fiscal 2014 ended, according to the report released Monday. (12/2)