WeeklyFinancingNewsPulsefinal200900810.pdf (PDF | 418.98 kb)
SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 1 National Health Financing News Legislators Make Slow Progress on Health Reform, Consider Options CEA Report Says Health Care Reform Would Benefit Small Business Senate Committee Passes USPS Retiree Health Bill Senator Introduces Bill to Tweak Medicare Payments CMS Releases Final 2010 Payment Changes for Acute and Long - Term C are Hospitals and Inpatient Rehabilitation Facilities CMS Awards IPRO Medicaid Integrity Contract AHRQ, NIH to Use ARRA Funding to Study Costs of Drugs, Treatments VA and NIH Offer $7 Million in Grants to Study Substance Abuse Among Military Personnel TRICARE Expands Behavioral Health Offerings DOE Honors 5 Campus Alcohol and Drug Abuse Prevention Programs, Awards Grant Funding NGA Commission Releases Guide to Prepare for Health Information Exchanges CNN/Opinion Research Corp. and Quinnipiac University Release Health Care Reform Polls Article Investigates Methods to Improve Drug Prices in Medicare 223Part D224 AHRQ Finds U.S. Mental Health Spending on the Rise Urban Institute Releases Analysis of Nursing Shortage KFF Rele ases Health Care Resources HHS Site Provides Medicare Information Aetna to Acquire Horizon Behavioral Services Around the Hill: Hearings on Health Financing Around the States: State and Local Behavioral Health Financing News Arizona California Connecticut Delaware Florida Georgia Idaho Louisiana Maryland Massachusetts Michigan Minnesota Mississippi Missouri Nevada New Hampshire New Jersey New York North Carolina Ohio Oregon Pennsylvania South Carolina Tennessee Texas Washingt on West Virginia SAMHSA222s Weekly Financing News Pulse will take a two - week hiatus beginning August 10 . SAMHSA will not publish the Financing News Pulse August 17 or August 24 but will resume publication August 31. For questions or comments, please contact Sarah Wattenberg (sarah.wattenberg@samhsa.hhs.gov). SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 2 National Health Financing News Legislators Make Slow Progress on Health Reform, Consider Options : After reaching a deal with the Blue Dogs last week, the House Energy and Commerce Committee (Fi nancing News Pu lse 8/3 edition) passed its version of the House health care reform package ( HR 3200 ) on July 31 , before recessing for the summer ( Bloomberg, 8/1 ). The Energy and Commerce C ommittee222s bill includes amendments providing 12 years of exclusivity to companies producing biologic drugs and a provision allowing the government to negotiate public plan reimbursement rates and drug prices . However, the committee left for the recess wi thout considering 55 to 60 pending amendments. The move will require the committee to vote on those amendments when the House reconvenes in September, likely combining them with the Energy and Commerce Committee222s bill in the House Rules Committee ( Kaiser Health News, 8/6 ; Kaiser Health News, 8/3 ). In addition, the p rovision allowing direct government negotiation on Medicare rates prompted President Barack Obama to reassure pharmaceutical companies that the deal they reached with the White House (Financing News Pulse 6/29 edition) will still limit their losses to $80 billion , raising objections from House Democrats, including House Speaker Nancy Pelosi (D - CA) ( Kaiser Health News, 8/6 ; Kaiser Health News, 8/7 ). Meanwhile, in the Senate, Senate Finance Committee Chair Max Baucus (D - MT) announced August 5 that Senate Finance Committee negotiators have reached an agreement on Medicare rate - setting procedure. Under the agreement, recommendations by the Medicare Payment Advisory Commission (MedPAC), which the committee calls the 223Medicare Preservation Commission,224 would automatically take effect unless Congress vetoed them or came up with alternative cost - cutting measures ( Kaiser Health News, 8/5 ). Meanwhile, o n August 6, m embers of the Senate Finance Committee met with Pr esident Obama at the White House to discuss progress and strategy and held their last official meeting before the summer recess. However, the bipartisan group of six senators announced a tentative teleconference schedule for the recess and said they may a lso continue in- person talks ( Kaiser Health News, 8/7 ; Kaiser Health News, 8/6 ). The plans come after Senator Baucus announced a September 15 deadline for his committee to produce a complete bi partisan health reform bill and Senator Charles Schumer (D - NY) announced that , if the Finance Committee fails to pass bipartisan legislation by mid - September, Democrats may decide to pass health care reform without GOP cooperation, possibly through the reconciliation process ( Kaiser Health News, 8/4 ). CEA Report Says Health Care Reform Would Benefit Small Business : A report released July 25 by the Ex ecutive Office of the President222s Council of Economic Advisors (CEA) says that current drafts of health care reform legislation would benefit small businesses seeking to provide health care for their employees. The report notes that small businesses currently pay up to 18 percent more per worker than large businesses for the same insurance policy. The report notes that, under the proposed reform legislation, certain small businesses would be eligible to participate in insurance exchanges and receive tax credits for money spent on health care ( Kaiser Health News, 8/4 ). Senate Committee Passes USPS Retiree Health Bill : The Senate Homeland Security and Governmental Affairs Committee passed the Postal Service Retiree Health Benefits Funding Reform Act of 2009 ( SB 1507 ) to provide the United States Postal Service (USPS) with more time to meet its retiree health benefit obligations for FY2009 and FY2010. The committee approval came as the Post m aster General rec ently informed Congress that the USPS will be unable to make its $5.4 billion pre - funding payment for retiree health care before a September 30 deadline ( Logistics Management, 8/3 ). SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 3 Se nator Introduces Bill to Tweak Medicare Payments: Senate Majority Whip Dick Durbin (D - IL) introduced the Rural Access to Nurse Anesthesia Act to allow Medicare to reimburse rural hospitals for anesthetic services provided by nurses. Medicare traditionally reimburses for such services at critical access hospitals in rural areas; however, a change three years ago restricted some of that funding. Durbin222s bill would undo that change ( AP via Chicago Tribune, 8/7 ). CMS Releases Final 2010 Payment Changes for Acute and Long- Term Care Hospitals and Inpatient Rehabilitation Facilities : On July 31, the Centers for Medicare & Medicaid Services ( CMS ) announced final 201 0 payment rates for long - term and acute care hospitals and for inpatient rehabilitation facilities ( Kaiser Health News, 8/5 ). The rules will be formally publish ed in the Federal Register August 27; however, detailed descriptions of the changes are available at CMS222 website . CMS Awards IPRO Medicaid Integrity Contract : CMS has awarded a Medicaid Integrity Program (MIP) Task Order to IPRO to audit Medic aid claims for Regions I and II. Regions I and II include Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Puerto Rico, Rhode Island, Vermont, and the Virgin Islands. The $5.5 million contract is for one base year with four option years ( PR Newswire, 8/6 ). AHRQ, NIH to Use ARRA Funding to Study C osts of Drugs, Treatments : In a report to Congress, the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH) unveiled their approach to spending American Recovery and Reinvestment Act ( ARRA ) funding for comparative effectiveness research . Both entities said that they will fund studies that look, in part, at the comparative costs of certain drugs and other medical treatments. AHRQ, which has $300 million in ARRA comparative effectiveness funding to spend largely in FY2010, announced that it will fund studies focusing on arthritis, cancer, and 12 other conditions. The NIH, which has $400 million to fund studies over two years, has yet to announce which of over 1,800 research applications will receive ARRA funding ( Wall Street Journal, 7/31 ; Kaiser Health News, 8/3 ). VA and NIH Offer $7 Million in Grant s to Study Substance Abuse Among Military Personnel : The National Institute of Drug Abuse (NIDA), the National Institute of Alcohol Abuse and Alcoholism (NIAAA), the National Cancer Institute (NCI), and the Department of Veterans Affairs ( VA ) have partnere d to offer $7 million in grants to study substance abuse treatment and prevention and associated problems. Each agency will fund grants related to its own mission. NIDA, NIAA, and the VA will fund $2 million each and NCI will fund an additional $1 millio n ( Kansas City infoZine, 8/1 ). TRICARE Expands Behavioral Health Offerings : Beginning August 1, TRICARE initiated two programs that use telecommunication technology to off er behavioral health services to military personnel and their families. The web - based TRICARE Assistance Program (TRIAP) is available to active duty military personnel, those eligible for the Transitional Assistance Management Program (TMAP), members with TRICARE Reserve Select, and spouses and dependents of eligible recipients. TRIAP offers unlimited 24 - hour web - cam access to licensed counselors who perform assessments, short - term counseling, and are authorized to refer individuals to more comprehensive levels of care. In addition, TRIECARE222s telemental health services will provide all aspects of behavioral health care v ia web - cam, including psychotherapy and medication management ( Military Family Network, 8/2 ). SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 4 DOE Honors 5 Campus Alcohol and Drug Abuse Prevention Programs, Awards Grant Funding : The U.S. Department of Education (DOE) named five schools as 2009 Model s of Alcohol or Other Drug Abuse Prevention Program on College Campuses. The DOE classified programs at the University of Florida , the University of North Carolina Wilmington, and the University of West Florida as 223promising,224 and classified programs at University of California Santa Barbara and the University a t Albany, State University of New York as 223effective.224 The honor comes with a $100,000 grant for the school222s prevention program ( University of Florida News, 8/4 ). N GA Commission Releases Guide to Prepare for Health Information Exchanges : The State Alliance for e -H ealth, created by the National Governors Association (NGA), has released a guide for state implementation of health information exchanges to facilitate implementation of electronic health records ( EHRs ) through the Health Information Technology for Economic and Clinical Health ACT (HITECH) that is part of the ARRA. The guide recommends establishing a state office to lead the health IT expansion, determine the information exchange best suited to the customers, and prepare the state for privacy issues ( McKnight222s Long- Term Care News & Assisted Living, 8/7 ; Kaiser Health News, 8/7 ). CNN/Opinion Research Corp. and Quinnipiac University Release Health Care Reform Poll s : A CNN/Opinion Research Co r p. poll , conducted between July 31 and August 3, found that 50 percent of respondents supported President Obama222s health care reform plans while 45 percent opposed them. The poll found that the president222s plans were more popular among those under 50 years old and that 30 percent of respondents believe the president222s plan will help their family, 44 percent believe it will not help but will help other families, and 20 percent believe the plan will not help anyo ne ( CNN, 8/5 ; Kaiser Health News, 8/5 ). A Quinnipiac University (QU) poll, conducted July 27 to August 3, found that 52 percent of voters disapprove of President Obama222s handling of the health care issue while 39 percent approve, compared with a 46 percent approval to 42 percent disapproval split in the QU poll conducted in June. The poll also found that nearly 75 percent of respondents did not believe that Congress can pass deficit neutral health care reform ( Kaiser Health News, 8/5 ). Article Investigates Methods to Improve Drug Prices in Medicare 223Part D224 : An article published in Health Affairs on July 30 examines poss ible mechanisms to lower drug prices through the Medicare Prescription Drug Benefit program (Part D) if health care reform lifts the 223noninterference224 provision that prevents the government from negotiating drug prices for Part D. The article examines man datory rebates, value - based pricing, expansion of generic and therapeutically equivalent substitution, increased formulary diversity, importation, and limited anti- trust waivers ( Kaiser Health News, 8/6 ). AHRQ Finds U.S. Mental Health Spending on the Rise : On August 5, the AHRQ released data showing that U.S. spending on mental health is rising faster than spending in any other health care category, increasing from $35 billion in 1996 to $58 billion in 2006. However, AHRQ also found that the number of Americans seeking treatment for mental health has nearly doubled over the same period , from 19 million to 36 million ( Health Day, 8/5 ; U.S. News and World Report, 8/5 ). Urban Institute Releases Analysis of Nursing Short age : On July 27, the Urban Institute released a report , 223Professional Nurse Workforce Dilemmas : Understanding and Responding to Dynamic and Complex Market,224 analyzing the curre nt and anticipated nursing shortage in America and making recommendations to alleviate that shortage in the future ( Kaiser Health News, 8/6 ). SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 5 KFF Release s Health Care Resources : The Kaiser Family Foundation ( KFF) recently released new reports on health care reform. KFF released 223 Rising Health Pressures in an Economic Recession: A 360 - Degree Look at Four Communities ,224 223 Struggling with Financing: The Recession and National Health Reform Dominate State Medicaid Concerns ,224 223 Emerg ency Departments Under Growing Pressure ,224 and an updated factsheet on state fiscal conditions and Medicaid. H HS Site Provides Medicare Information : The U.S. Department of Health and Human Services ( HHS ) has created a website , 223Ask Medicare,224 designed to help caregivers navigate the Medicare system. The site provides detailed information on topics ranging from Medicare enrollment to local Medicare services ( Kaiser Health News, 8/4 ). Aetna to Acquire Horizon Behavioral Services: On August 2, Aetna Inc. announced that it will acquire Horizon Be havioral Services, LLC from its parent company, Psychiatric Solutions Inc. , for roughly $70 million. Horizon provides Employee Assistance Programs (EAPs) to mid - sized and large employers ( dBusinessNews, 8/2 ). Around the Hill: Hearings on H ealth Financing The House is out of session for the August recess and will reconvene Tuesday, September 8. The Senate will recess August 7 and reconvene September 7 . Senat e Homeland Security and Governmental Affairs Subcommittee on Disaster Recovery : Evacuation and Mental Health Recovery of Children in Disasters August 4, 10:30 a.m. 342 Dirksen Senate Health, Education, Labor and Pensions Committee: Defective Medical Devi ces August 4, 2:30 p.m. 430 Dirksen House Agriculture Subcommittee on Operations, Oversight, Nutrition and Forestry: Field Hearing on Nutrition and Wellness August 5, 10:00 a.m. Madonna Pro Active Gymnasium, Lincoln, NE Around the States: State and Loc al Behavioral Health Financing News Arizona Audit Finds AZ Substance Abuse Services Less Effective than Neighboring States : An audit released July 31 by the Arizona Office of the Auditor General found that the state222s public substance abuse treatment services are less effective than those in neighboring states. The audit found that only 33 percent of individuals who complete public substance abuse treatment in Arizona remain drug free one month after treatment, compared with 80 percent in other Western sta tes. The audit also found that Arizona performs below the national average at reducing unemployment, homelessness, and arrests among residents treated for substance abuse. The audit recommends that the Division of Behavioral Health monitor patient outcom es more closely and strengthen contractor oversight ( Arizona Republic, 8/1 ). SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 6 California Children222s Defense Fund Estimates Effects of SCHIP and Medicaid Cuts : T he Children222s Defense Fund estimates that the cuts to California222s Medicaid and State Children222s Health Insurance Program ( SCHIP ) , Medi - Cal and Healthy Families, in the state222s new budget (Financing News Pulse 8/3 edition) will increase the number of unins ured children by roughly 915,000. The UCLA Center for Health Policy Research calls the Children222s Defense Fund222s estimate that the state will have two million uninsured children, 223reasonable224 ( Wall Street Journal, 8/1 ; Kaiser Health News, 8/3 ). San Francisco Passes Budget, Feels Effects of State Budget Cuts : On August 4, Mayor Gavin New som (D) signed a $6.6 billion budget for San Francisco, closing the city222s $576 million deficit. The budget cut funding for social services and was affected by a $20.1 million reduction in state funding the city222s Department of Public Health and a $15.1 m illion cut from the city222s Human Services Agency ( San Francisco Chronicle, 8/5 ). Audit Suggests San Jose Reduce Deficit Through Employee Health Care Changes : A ci ty audit suggests that San Jose can save $20 million annually by bringing its employee health care plans more in line with plans offered by other governments and private employers. The audit suggests doubling employees222 share of health insurance premiums from 10 to 20 percent, raising copayments for physician visits from $10 to $25, and reducing the $5,560 payment that city employees receive if they decline health coverage. However, any changes to the city222s health plans would require approval from 10 emp loyee unions ( San Jose Mercury News, 8/2 ). Stanislaus County Accepts Prop. 63 Funds but Loses Prop. 36 Funds Through State Budget Cuts : The Stanislaus County Board of Sup ervisors voted to use $7.8 million in state funding from Proposition 63 , the 1 percent tax on individuals earning $1 million or more, to fund 18 new behavioral health prevention and early intervention programs and seven new positions for county employees. However, the board was forced to eliminate four county employees whose positions were previously paid through funding from Proposition 36 , the Substance Abuse and Crime Prevention Act . Prop. 36, which funded mandate d treatment for drug offenders. Prop 3 6 was eliminated from the state budget in the deal struck July 24 (Financing News Pulse 7/27 edition ) but t he mandate to treat drug offenders remains ( Turlock Journal, 8/4 ). Solano County H urt by Prop 36 Budget Cuts, Helped by ARRA : As result of the elimination of Proposition 36 (see above) Solano County will lose roughly $480,000 in state funding for substance abuse treatment for offenders. Solano County previously received $1.4 million fo rm Prop. 36; however, the state will also pass on some of the $45 million in ARRA funding it will receive for substance abuse treatment and a share of $18 million for an offender treatment program , reducing the county222s loss to $480,000 ( Vallejo Times - Herald via The Reporter, 7/31 ). Connecticut Update: Republicans Unveil Budget Plan, Social Service Providers Struggle Under Executive Order : After vetoing a state budget July 1, Governor M. Jodi R ell (R) issued an executive order to run the state SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 7 until a budget is passed (Financing News Pulse 7/6 edition). However, social service providers around the state report struggling to fund their programs through the reduced executive order funding. In ad dition, GOP legislators introduced their own budget plan on August 6 that, among other changes, would reduce spending for social service programs to 2007 levels ( AP via WTIC, 8/6 ; Connecticut Post, 8/4 ). Delaware Update: Walgreens to Continue Participating in Medicaid Program Until August 11, Seeking Deal with State : After the Delaware Department of Health and Social Services ( DHSS) announced plans to reduce the Medicaid reimbursement rate for brand name drugs from 86 percent of the average wholesale price to 84 percent in April, Walgreens threatened to withdraw from the program. In July, Walgreens and DHSS reached a d eal under which the company would remain in the program through August 5 with a brand name reimbursement rate of 85 percent of the average wholesale price (Financing News Pulse 7/13, 6/22, 6/18, 6/8 editions) . Walgreens and DHSS have extended that deadline to Augu st 11; however, Walgreens says it will withdraw from the program if a permanent agreement is not reached by that date ( Reuters, 8/5 ; Kaiser Health News, 8/6 ). Florida Computer Error Temporarily Eliminates 1 Million f rom Medicaid Rolls : During the weekend of August 1, a computer error mistakenly deleted roughly 1 million of Florida222s 2.6 million Medicaid enrollees; however, the Agency for Health Care Administration corrected the error by August 4. The reason for the error has yet to be determined ( AP via Miami Herald, 8/4 ). Georgia Macon City Council Puts Retiree Health Cuts on Hold : At a meeting on August 5, the Macon City Council voted to temporarily shelve two proposals to cut back city retiree health care. One proposal would have discontinued health coverage for employees retiring after September 30 and another would have eliminated retirement benefits for new city employees ( WMAZ, 8/6 ). Idaho Governor Announces F unding for All Child Immunizations in 2009 : Reversing an announcement made in April in which state officials said Idaho would only pay for immunizations for uninsured and underinsured children or those that qualify for Medicaid (Financing News Pulse 5/4 ed ition) , Governor C. L. 223Butch224 Otter (R) announced August 4 that the state will purchase required vaccinations for all children through January 2010. Governor Otter said the measure is an interim solution while legislative leaders find a way to fund childhood vaccinations after cutting $2 million in program funding during t he recent legislative session ( Idaho Statesman, 8/4 ). Hospital and University Partner to Offer Residency Program and Bolster Staff : Portneuf Medical Center222s Behavioral Health Services has partnered with the University of Washington to offer a psychiatric residency program at the medical center. The center222s leadership believes that the residents, who will also have rotations at State Hospital South, will boost resources for psychiatric care in southeastern Idaho ( AP via KPVI, 8/4 ). SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 8 Louisiana DHH Announces Medicaid Cuts : After Governor Bobby Jindal (R) signed a state budget June 25, reducing the Louisiana Department of Health and Hospitals (DHH) budget by $240 million and cutting Medicaid reimbursements by $180 million (Financing News Pulse 7/6 edition), DHH Secretary Alan Levine announced specific Medicaid reimbursement cuts on August 3. Effective August 4, private and community hospital222s rates will be reduced 5 to 6 percent and non - pediatric primary care physicians222 rates will be cut by 10 percent. Rural hospital and pediatric physician payment rates will remain constant; however, Levine is also considering implementing a small copayment for Medicaid enrollees visiting the emergency room for non - emergency services ( Kaiser Health News, 8/4 ; AP via Advocate, 8/3 ). Governor Approves Bill Authorizing EHR Funding Assistance : On July 9, Governor Bobby Jindal (R) signed a law allow ing DHH to apply for $25 million in ARRA funding to administer loans for EHR systems within the state. The bill also allocated $5 million in state matching funds as required under the ARRA provision ( American Medical News, 8/6 ; Kaiser Health News, 8/7 ). Maryland State to Invest in Health Information Exchange : The state of Maryland has awarded a $10 million grant to a non - profit collaboration between Johns Hopkins Medicine , Medstar Health, the University of Maryland Medical System , and Erickson Retirement Communities , to develop a statewide health information exchange . Additional funding for exchange, the Chesapeake Regional Information System for our Patients (CRISP), will come from ARRA funding and slight hospital rate increases . State health insurance companies also plan to provide incentives to hospitals for adopting the exchange in addition to the ARRA incentives available for EHR adoption ( Baltimore Business Journal, 8/5 ; Kaiser Health News, 8/6 ). Ocean City Council Bans Salvia : On August 3, the Ocean City Council voted to ban Salvia ( salvia divinorum ), a hallucinogenic herb that is unregulated by federal and state law. The new law, which took effec t immediately and has already been enforced, makes possession and sale of the substance a misdemeanor punishable by up to six months in jail or a $1,000 fine ( ABC, 8/4 ; AP via CBS, 8/4 ; Baltimore Sun, 8/3 ). Budget Cuts Affect Traveling Health Clinics : Budget cuts approved b y the Maryland Board of Public Works on July 22 (Financing News Pulse 7/27 edition), will reduce funding for the University of Maryland222s (UMD) traveling fleet of health clinics, Wellmobile, by $285,250. The clinics, which the UMD School of Nursing estimate s save $2.7 million annually, will no longer stop in Glen Burnie, Cumberland, and several locations on the lower Eastern Shore ( Baltimore Sun, 8/6 ). Massachuse tts Health Fund for Unemployment Running Low on Funds : On August 4, state officials announced that the Medical Security Program will run out of funding January 2010 because of increased unemployment. The program, which pays most of the health insurance co sts for unemployed residents who earn too much to qualify for other health insurance subsidies, currently pays the bulk of health care expenses for SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 9 27,000 state residents and is finan ced through an employer tax. However , enrollment has increased 186 perce nt June 2008 and, though the program had $49.2 million in reserves in June 2009, monthly expenditures are vastly outpacing previous estimates ( Boston Globe, 8/5 ). Alcohol Tax to Fund Substance Abuse Treatment Takes Effect, May be Repealed by Voters : On August 1, a 6.25 percent tax on alcoholic beverages took effect, designed to generate over $100 million to fund substance abuse treatment programs. However, a ballot measure this November will afford voters an opportunity to repeal the tax ( Metro International, 8/5 ). Michigan Social Service Groups Highlight Effects of Proposed Budget Cuts : Numerous social service groups have highlighted the effects of budget changes passed by the Senate for FY2010 in an attempt to close the state222s $1.8 billion budget shortfall. The Senate measu res would reduce funding for the Michigan Department of Human Services by 29.4 percent and cut fundi ng for community health programs by 24.5 percent. ( MLive, 8/5 ; Detroit News, 8/6 ). Minnesota Community Mental Health Center Cuts Staff Salaries : Beginning August 1, the Upper Mi ssissippi Mental Health Center cut salaries for its entire staff to avoid service reductions. The center cut upper - tier salaries by 10 percent and all other salaries by 5 percent. The board of directors reports that the center has struggled because it accepts patients with an inability to pay ( Bemidji Pioneer, 8/2 ). Mississippi Medicaid Program to Offer EHRs to Physicians : Mississippi announced that it will offer a free web - based EHR system to physicians participating in the state222s Medicaid program to better serve the state222s 600,000 Medicaid enrollees. The program, which will use Shared Health222s EHR and health information exchange software, includes Medicaid data on lab results, medications, immunizations, and allergies as well as electronic prescribing software, access to hospital discharge information, and decision support software ( Health Data Management , 8/4 ). Missouri Medicaid Enrollment Up Nearly 5 Percent ; State to Hire Contractors for Program Review : The Missouri Department of Social Services reports that the state222s Medicaid rolls are up by 39,000 enrollees 227 or 5 percent 227 since June 2008. As of June 2009, there were over 871,000 residents enrolled in the program ( AP via WDAF, 8/4 ). In related new s, Missouri222s Medicaid program plans to hire contractors to review the program to find mechanisms for both short and long- term savings . Medicaid spending consists of one - third of Missouri222s budget ( AP via WDAP, 8/5 ). Hospital Gambles on ARRA EHR Incentives : Sac - Osage Hospital, a 47 - bed hospital in rural western Missouri, has borrowed nearly $1 million to upgrade its medical records to an EHR system. In addition, the hospital has already laid off staff and is currently operating on a $ 370,000 deficit. H owever, the hospital is counting on $3 million in ARRA EHR funding to pay back its loan and solve its financing woes . Rules in the ARRA force h ospitals to act on EHR implementation prior to knowing exactly how the SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 10 federal government will define the qualification criteria for the program ( AP, 8/4 ; Kaiser Health News, 8/4 ). Nevada HHS Awards Grant to Fund Nevada222s Medicare Fraud Prevention Program : Nevada Attorney General Catherine Cortez Masto announced that HHS222 Administration on Aging has awarded the Office of the Attorney General a th ree - year $540,000 grant for the Nevada222s Senior Medicare Patrol Program, contingent on an additional $180,000 of in - kind services during the course of the program. The program is a multi-agency collaboration between the government, non - profits, and privat e industry to educate Medicare and Medicaid consumers about fraud prevention ( Reno Gazette-Journal, 8/5 ). New Hampshire Senate Appropriations Committee Approves Funds fo r NH Community Health Centers : U.S. Senators Judd Gregg (R- NH) and Jeanne Shaheen (D - NH) announced that the Senate Appropriations Committee has approved federal funding for New Hampshire222s community health centers in the FY2010 Labor, HHS, and Education Appropriations bill. The bill includes $600,000 for Bi- State Primary Care Association to provide medical, behavioral health, and dental services to the uninsured and underinsured and an additional $650,000 for Bi- State to defray the cost of employee recruit ment ( Sea Coast Online, 8/4 ). New Jersey Health Care Costs to Rise for Schools and Towns : In July, the State Health Benefits Commission and the School Employee Health Benefits Commission voted to increase towns and school districts222 share of employee health care costs by up to 25 percent. For municipalities participating in the State Health Benefits Program, health insurance rates will increase 1 8 percent for active employees, 11 percent for early retirees, and 7 percent for Medicare retirees. School districts222 average increase will be 23 percent for active employees, 12 percent for early retirees , and 1 percent for Medicare retirees. The rate i ncreases take effect January 1 ( Central New Jersey, 8/3 ). New York Governor Signs Two Health Care Bills : Governor David A. Paterson (D) has signed a law , effective September 1, which will allow parents to keep unmarried children on their health insurance policies up to age 29. The children need not be dependents nor must they reside with their parents. In addition, Governor Paterson signed a law extendi ng COBRA coverage, which allows laid - off employees to purchase health care for their previous employers , from 18 months to 36 months ( Newsda y, 8/5 ). North Carolina Legislature Passes Budget : On August 5, the North Carolina Legislature passed a $19 billion state budget after passing numerous stopgap budgets since failing to pass a final budget by the July 1 deadline (Financing News Pulse 7/6 edition). In addition to tax increases, the budget reduces state funding for health and human services programs by $1 billion but replaces much of it with ARRA funding. The budget reduces community support services funding by $65 million, group home fu nding by $15.9 million, mental health treatment funding by $40 million, and cuts Medicaid reimbursement rates to save $76 million ( AP via Forbes, 8/6 ; Charlotte Observer, 8/6 ) . SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 11 Hospital ER Adds Psychiatric Unit to Accommodate Rising Demand: New Hanover Regional Medical Center has opened a new nine - bed psychiatric unit to house the increasing number of behavior al health patients presenting at the hospital emergency room. Behavioral health patients are usually transferred to specialized hospitals or treatment centers; however, many patients remain at Hanover Regional until space is available at alternate facilit ies. The new unit, which cost $160,000 to $180,000, will allow Hanover to better care for behavioral health patients during such stays ( Star News, 7/31). Ohio Court Upholds Ruling Preventing Medicaid Eligibility Change : The 6th U.S. Circuit Court of Appeals upheld a temporary restraining order imposed by the U.S. District Court in Columbus, Ohio, which forced the state to co ntinue providing Medicaid services for autistic children. The District Court ruled that Ohio could not implement new Medicaid eligibility rules that would have eliminate d or severely curtailed Medicaid services for autistic children effective July 1, 2008 . The Appeals Court ruled that the lower court was within its rights to stay the state222s planned changes but has yet to rule on the broader issue. The ruling directly affects roughly 60 families in central Ohio ( UPI, 8/5 ). Sandusky County to Put Mental Health Levy on Ballot : In July, the Mental Health and Recovery Services Board of Seneca, Sandusky, and Wyandot Counties voted to put a . 8 mil levy on the November ballot in Sandusky County. If approved, the levy would generate roughly $886,000 annually for Sandusky County and cost the owner of a $100,000 home $24.50 per year. In addition, the measure would expire five years after passage ( News - Messenger, 7/31 ). Hospital Closes Behavioral Health Unit, Begins Relationship with M/SU Partner: On July 30, the Toledo Hospital announced that it will close its 2 0- employee Drug and Alcohol Treatment Center on September 1. However, the hospital has entered a partnership with Arrowhead Behavioral Health to refer M/SU clients for treatment at Arrowhead222s Maumee behavioral health hospital ( WTOL, 7/30 ; Toledo Blade, 7/30 ). Oregon Governor Signs Bill Expanding Children222s Health Care Coverage : On August 4, Gover nor Ted Kulongoski (D) signed a bill ( HB 2116 ), approved by the Oregon Legislature on June 11 (Financing News Pulse 6/15 edition) , that will provide state health care coverage to an additional 80,000 uninsured children and 35,000 low - income adults. Under the new law, the income eligibility cap for the Oregon Health Plan will increase from 185 percent of the federal poverty level ( FPL ) to 200 percent of the FPL on October 1, and to 300 percent of the FPL in January 2010. To increase enrollment the state has also established the Office of Health y Kids to advertize the program and enroll newly qualified children. In June, the governor also signed HB 2009 as a complimentary piece of health care legislation, creating the Oregon Health Authority to focus on con taining state health care costs ( AP via Forbes, 8/5 ; Oregon Legislature ). Pennsylvania Update: Governor Signs Stopgap B udget, Does Not Fund Health and Human Services : On August 5, Governor Ed Rendell (D) signed an $11 billion stopgap budget for FY2010. The budget will allow the SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 12 state to pay its employees and provide $5.7 billion for the Department of Public Welfare as well as funding for prisons and the governor222s office. However, the budget does not include funding for education, health care, or social services. The current measure does not allocate funding to reimburse M/SU providers and the state is expected to run ou t of funding for that purpose by the end of August ( Philadelphia Inquirer, 8/6 ). South Carolina State Recovers $7.3 Million in Medicaid Fraud: The South Carolina Department of Health and Human Services222 Bureau of Compliance and Performance Review reported that the state recovered $7.3 million in Medicaid fraud and abuse from health care providers during FY2009. The department reports that collections are up 129 percent from $2.9 million in FY2008 largely du e to increased recovery efforts. Department officials say the fraud program yields a 6 - to - 1 return on investment ( Greenville News, 8/1 ). State Diverts DDSN Funding, Forces Service Reduction: The South Carolina Department of Disabilities and Special Needs (DDSN) must reduce in - home care and other services for the disabled, i ncluding individuals with mental retardation and brain injuries. DDSN, which is partially funded by Medicaid , was slated to receive $40 million as its share of the ARRA Medicaid funding; however, the state used the bulk of that money to close the budget shortfall and to fund general health services, allocating DDSN only $17 million in ARRA funding and necessitating service cuts ( Greenville Online, 8/3 ; Kaiser Health News, 8/3 ). Tennessee Legislature Passes Law to Ease Prosecution of Medicaid Fraud: In the recent legislative session, the Tennessee Legislature passed a law that will allow TennCare, the state222s Medicaid program, to prosecute health care fraud in cases involving less than $10,000 before an administrative law judge. Under the current system, the Office of the Inspector General handles fraud cases involv ing Medicaid recipients and the Medicaid Fraud Control Unit within the Tennessee Bureau of Investigations handles provider fraud. The new law will allow those entities to focus on the more complicated cases that go through the federal court system ( Tennessean, 8/5 ). EDS Wins Tech. Services Contract Extension with State Medicaid Program : Electronic Data Systems (EDS), a subsidiary of Hewlett - Packard (HP) , ann ounced that it has won a four - year $170 million contract extension t o provide technical services to TennCare. Under the contract, EDS will upgrade the hardware and software that support the TennCare Health Management Information System, implement a busine ss intelligence system to allow policy makers to analyze and interpret data, and continue providing other technical services included under the previous contract ( Information Week, 7/31 ). Texas Gregg County, Hospitals to Access Additional Federal Medicaid Funds : The Gregg County Commissioners reached an agreement with Good Shepherd and Longview Regional hospitals to increase the available fun ds with which to treat low - income residents. Under the deal, the Medicaid Supplemental Payment Program will provide federal matching funds for local tax dollars paid into the SAMHSA222s Weekly Financing News Pulse August 10, 2009 8/10/09 13 program from Gregg County. The move, which became effective August 1, allows ho spitals that have executed an Indigent Care Affiliation Agreement with the local government to receive supplemental Upper Limit Payments ( Kilgore News Herald, 8/1 ). Wash ington Hospital Closes Youth Mental Health to Cut Cost : Lourdes Counseling Center closed its inpatient mental health unit for children and adolescents on July 31 to avoid an estimated $600,000 loss. The center will continue to provide outpatient services for children and adolescents and offer inpatient treatment for adults ( News Tribune, 7/31 ). King County Employee Health Care Costs Up 28 Percent Since 2005 : King County222s tot al health plan costs have increased 34 percent since 2005, from $115.7 million to over $155 million this year. The rising costs are driven largely by a 28 percent increase in the cost of monthly premiums . The county is contractually obligated to pay the full cost of employee health care premiums through 2012 ( Seattle Post Intelligencer 8/4 ). West Virginia PEIA Eliminates Retiree Health Insurance Subsidies for New Retirees : Adheri ng to plans they announced to the West Virginia Legislature on July 15 (Financing News Pulse 7/20 edition) , the Public Employees Insurance Agency (PEIA) Finance Board voted July 30 to eliminate retiree health subsidies for state and school employees hired after July 1, 2010. The PEIA had initially told the legislature that the eligibility cutoff date would be January 1, 2010. The state currently has a $7 billion retiree health care obligation that would increase to $18 billion by 2030 without the policy c hange. Retirees will still be eligible to pay for benefits; however, they could cost as much as $2,000 monthly for a non - Medicare eligible family ( West Virginia Gazette, 7/30 ). Update: Court Appoints Ombudsman to Oversee DHHR : Under an agreement reached between the West Virginia Department of Health and Human Resources (DHHR) and Judge Duke Bloom from the Kanawha County Circuit Court on a state mental health treatment plan dating back to a case filed in 1981, the department will spend $15.3 million over three years to build seven new group homes and seven new day treatment centers, devote $1.5 million to increased Medicaid reimbursement r ates for mental health services, alter staffing procedures at the state222s psychiatric hospitals, and convert the Office of the Ombudsman for Behavioral Health, which previously reported to DHHR, into to a court monitor position (Financing News Pulse 7/16, 5/4 editions). In late July, the court appointed Omb udsman for Behavioral Health David Sudbeck to the post and empowered him to oversee implementation of the agreement and conduct investigations on issues related to it ( Charleston Gazette, 8/4 ) .
