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Tuesday, Jul 28 2015

Full Issue

State Highlights: UMass Health Care Plans Tech Upgrade; Fla. Medicaid Managed Care Insurers Seek Pay Raise

Health care stories are reported from Massachusetts, Florida, New Jersey, Georgia, California, North Carolina, Colorado, Connecticut, Tennessee and Illinois.

UMass Memorial Health Care will spend $700 million over the next decade to upgrade its patient records and information technology systems, its chief executive, Dr. Eric W. Dickson, said Monday. Central Massachusetts’ largest health network has agreed to buy clinical and billing software programs from Epic Systems Corp. of Verona, Wis., the country’s biggest vendor of electronic health record systems, Dickson told the Globe. (Dayal McCluskey, 7/27)

Insurers participating in Florida's new Medicaid managed care program say they've lost $542 million through 2014 and want the state to raise their rates. But after losing major federal funding for hospitals, Gov. Rick Scott doesn't want to use any more state money for the Medicaid program. Scott and the insurers are locked in intense negotiations that could undermine the fledgling program that gives federal funds to private health insurance companies to oversee medical care for poor and disabled people instead of reimbursing doctors and hospitals for each service. (7/27)

Two New Jersey hospital chains are suing the state over a New Jersey law that could result in a major change in paramedic service in Camden. Virtua, which operates paramedic services in Camden and Burlington counties, said a law signed this month by Gov. Chris Christie violates the state constitution as "special legislation" aimed at benefiting just one community. The law gives hospitals with Level 1 trauma centers the right to run ambulance and paramedic services in their host communities. (7/27)

Virtua Health Inc. sued the State of New Jersey on Monday to block a law, signed earlier this month by Gov. Christie, that transfers control of emergency medical services in Camden to Cooper University Hospital. Virtua, which currently provides the advanced life support, or paramedic, portion of those services, contends that the law gives Cooper an "exclusive privilege" without any rational medical basis, thereby violating the state constitution. (Avril and Boren, 7/27)

About 3,000 Georgians have been told that some of their health information was inadvertently disclosed. The data breach affected clients in the Community Care Services Program, which helps people at risk of nursing home placement to remain in their communities. (Miller, 7/27)

Nearly four months after a California healthcare software company won a patent infringement verdict against UnitedHealth Group, it filed a new lawsuit alleging the insurance giant obtained its patents fraudulently and violated federal antitrust laws. San Mateo, California-based Cave Consulting Group and it's attorney Richard Brophy of Armstrong Teasdale launched the new complaint on Friday in the U.S. District Court for the Northern District of California against UnitedHealth's OptumInsight subsidiary, which also makes healthcare-related software. (Chung, 7/27)

A judge on Monday dismissed a lawsuit against the state on behalf of three terminally ill Californians seeking doctor-prescribed fatal medication. San Diego Superior Court Judge Gregory Pollack said his court is not unsympathetic to their plight but lawmakers — not a judge — would need to change the law barring such prescriptions. Pollack said in his written ruling that the current law that makes it a felony to assist a suicide in any way is constitutional and so he does not have the power to suspend its enforcement. (Watson, 7/27)

Legislative researchers say North Carolina can save up to $64 million annually by switching health costs to federally-funded Medicare Advantage plans, but they caution that additional action is needed to close the state's unfunded liability. A report released Monday by the Program Evaluation Division of the General Assembly says the state would need to provide around $2.2 billion more each year to be on track to fully fund an estimated $25.5 billion shortfall in covering long-term benefits to retired state employees. (7/27)

State audit says Robeson County's school system used $3 million meant for special needs students for other purposes — and other districts may have made a similar mistake. The audit issued Monday says for three fiscal years starting in 2011, the school system did not use about $1 million per year in Medicaid reimbursements to provide services for special-needs students as required. (7/27)

A Colorado transgender woman's insurance company has denied her coverage for gender reassignment surgery she says is medically necessary and should be ensured by state law and policy. Ashlyn Trider, 33, said Aetna Life Insurance Company's refusal to pay for gender reassignment surgery prescribed by her doctor violates Colorado law. The Transgender Legal Defense Fund & Education Fund has demanded Aetna reverse its decision. (Draper, 7/27)

The Lou Colen Children's Health and Wellness Center is part of a network of free clinics that have historically served uninsured patients in Los Angeles County. Though this branch — which opened in Del Rey last month — still treats many low-income families, its patient-friendly design and services reflect a shift in the way clinics across the nation are delivering healthcare. (Karlamangla, 7/27)

Ken knows there were many signs of how bad things got when he was drinking. Like the people who told him they were worried – the woman at the bank he’d done business with back when he was a successful mortgage broker, the officer manager at his doctor’s office, the friend who kicked him out of his home, saying he didn’t want to watch Ken kill himself. (Levin Becker, 7/28)

But the budget impasse is hitting a growing number of people, as social service agencies don't get promised payments, programs are reduced or eliminated and some agencies close their doors. The agencies estimate tens of thousands — most of them low-income working parents, seniors, people with disabilities and immigrants — have become the collateral damage in an ideological battle between the newly elected governor and Democrats that could go on for months. (Burnett, 7/27)

Real estate investment trust Medical Properties Trust Inc said on Monday it would buy privately held Capella Holdings Inc, owner of hospital operator Capella Healthcare Inc, for $900 million in cash. Based in Franklin, Tennessee, Capella Healthcare owns and/or operates acute care and specialty hospital facilities in six states and is one of the 10 largest for-profit acute care hospital operators in the United States based on revenue, Medical Properties Trust said. (7/27)

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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