WeeklyFinancingNewsPulsefinal200900615.pdf (PDF | 410.43 kb)
SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 1 National Health Financing News Senate HELP Committee and House Democrats Release Health Care Reform Plans; Other Lawmakers Debate Health Reform Taxi ng Health Benefits May Streamline Health Care Frieden Takes Over as Director of the CDC Legislators Propose Medicare Reimbursement Changes Legislators Introduce Bills to Increase Returning Soldiers222 Access to Mental Health Care HHS Report Highlights Health Disparities, Focuses on Low - Income Americans and Minorities Legislature Approves Bill Allowing FDA to Regulate Tobac co Products Legislators Urge DOL to Extend Federal Wage and Hour Laws to Health Care Workers VA to Allow Researchers Access to Data From Medical Records Study Finds Small Busine ss May Benefit From an Employer Health Insurance Mandate Drug Price Cases to Reduce Wholesale Prices for Many Drugs FTC Report Says 12 to 14 Years is Too Much Protection for Biotech Drugs AHA Specialist Says 9 in 10 Hospitals Have Made Cutbacks Urban Institute Report Analyzes the Prospects of Equity in Capping a Potential Tax - Exclusion for Employer - Sponsored Health Care Health Affairs Publishes Six Papers on the Nursing Workforce, Find Nursing Shortage Reduced KFF Analyzes Changes in Medicare Prescription Drug Coverage Since 2006 Survey Finds Disease Prevention is Top Priority for Health Reform Q1Medicare Provides Analysis of Medicare Prescription Drug Benefit Standard Benefit Parameters, 2006- 2010 Around the Hill: Hearings on Health Financing Around the States: State and Local Behavioral Health Financing News Arizona California Connecticut Delaware Florida Illinois Indiana Louisiana Maine Mas sachusetts Michigan Mississippi Missouri New Jersey New York North Carolina Oregon Pennsylvania Rhode Island South Carolina Washington Washington D.C. West Virginia For questions or comments, please contact Sarah Wattenberg ( sarah.wattenberg@samhsa.hhs.gov ) SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 2 National Health Financing News Senate HELP Committee and House Democrats Release Health Care Reform Plans; Other Lawmakers Debate Health Reform : On June 9, the Senate Health Education Labor and Pensions (HELP) Committee and senior House Democrats released separate draft health care reform bills. Initial drafts of the HELP Committee legislation, circulated in Washington last week, contained provisions for a public health insurance plan and an employer insurance mandate; however, the official draft circulated June 9 temporarily omitted those provisions pending further negotiations. Details of the HELP Committee222s legislation are available side - by - side with numerous other health care reform proposals at the Kaiser Family Foundation222s (KFF) website here . The House Democrats222 proposal , not yet available through KFF, would impose both individual and employer health care mandates, provide subsidies to those earning up to 400 percent of the federal poverty level (FPL), include a public insurance option designed to compete on a level playing field with private insurance, make numerous changes to Medicare payments, and base Medicaid eligibility solely on income ( Kaiser Health News, 6/10 ; Kaiser Health News, 6/9 ; AP, 6/10 ). Republicans, moderate Democrats, and the American Medical Association (AMA) have criticized the House plan for the inclusion of a public insurance option and both bills have been criticized for their failure to outline payment options ( Kaiser Health News, 6/9 ; CQ Politics, 6/9 ; Kaiser Health News, 6/11 ). Meanwhile, Senator Kent Conrad (D - ND) has proposed a co - operative plan, not available yet via the KFF222s tool, that he hopes may provide a bipartisan compromise. Senator Conrad222s plan, which has tentative support from Sen. Baucus and ranking Finance Committee member Sen. Chuck Grassley (R- IA), would pool ownership of health insurance into cooperatives thereby eliminating the government-involve ment opposed by Republicans and the profit - drive insurance industry that Democrats seek to regulate ( Kaiser Health News, 6/12 ; Kaiser Health News, 6/11 ). Finally, President Barack Obama has said he is flexible on all health reform issues but urged lawmakers to get a bill to the Senate floor by July. The president also noted that , though he is asking Congress to require that new spending is deficit neutral, he would not apply that requirement to the early years of health care reform legislation ( Kaiser Health News, 6/11 ; Kaiser Health News, 6/10 ). The HELP Committee222s draft reform bill is available on the committee222s website . Taxing Health Benefits May Streamline Health Care: Some economists, including Katherine Baicker at the Harvard School of Public Health, say that taxing health care benefits may streamline the country222s health care system in addition to funding health care reform. Baicker notes that the current system promotes consuming more health care than necessary, effectively subsidizing health benefits by not taxing them as income. She suggests that taxing the benefit, in addition to gener ating as much as $150 billion annually to fund health care reform, will also make the health care more efficient and reduce unnecessary treatment ( Kaiser Health News, 6/8 ; NPR, 6/8 ). In related news, Senate Finance Committee Chair Max Baucus (D - MT) believes that health care reform will be at least partially funded by taxing health benefits that are significantly better than those provided by the basic federal health plan. Sen. Baucus believes that the tax could generate as much as 60 percent of the estimated $1.2 trillion needed to pay for reform ( Kaiser Health News, 6/10 ). Frieden Takes Over as Director of the CDC: Thomas Frieden assumed his position as the Director of the Centers for Disease Control and Prevention (CDC) on June 8 after Presi dent Obama selected him for the post on May 15 (Financing News Pulse 5/18). Frieden previously served as New York City Health Commissioner for seven years ( Kaiser Heal th News, 6/8 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 3 Legislators Propose Medicare Reimbursement Changes : On June 11, Senator Amy Klobuchar (D - MN) proposed legislation, the Medicare Payment Improvement Act , designed to shift Medicare reimbursement policy to an outcome - oriented system. The legislation would create a value index to determine physician fees where values are determined by quality and efficiency standards. Meanwhile, Senator Dian ne Feinstein (D - CA) and Rep. Sam Farr (D- CA) also proposed Medicare reimbursement legislation design ed to eliminate certain geographic distinctions resulting in lower Medicare reimbursements to physicians in areas currently classified as 223rural224 ( Kaiser Health News, 6/12 ). L egislators Introduce Bills to Increase R eturning Soldiers222 Access to Mental Health Care : On June 4, Reps. Todd Akin (R- MO) and Gabrielle Giffords (D - AZ) introduced two bills designed to expand mental health treatment for returning armed s ervice members and their families. The Armed Forced Behavioral Health Act ( HR 2699 ) would allow certain veterans from Operation Iraqi Freedom and Operation Enduring Freedom to access mental health services at Vet Centers, provide grants to non - profits who provide counseling to family members of deceased militarily personnel, and create a pilot program in the Army to enhance awareness of PTSD. The Veterans and Survivors Behavioral Health Awareness Act ( HR 2698 ) would create a program to help Vet Centers retain behavioral health staff, require the U.S. Department of Veterans Affairs (VA) to provide referrals to veterans seeking mental health care outside the VA system, and require the VA to inform veterans of their right to appeal discharges stemming for req uests for counseling ( TMCNet, 6/5 ). HHS Report Highlights Health Disparities, Focuses on Low -Income Americans and Minorities: A report by th e U.S. Department of Health and Human Servi ces (HHS), released June 9, highlights health disparities in the U.S. to strengthen the case for health reform. The report notes that 40 percent of low- income Americans do not have health insurance, that roughly one - third of uninsured residents have a chr onic disease, and that such residents are six times less likely to receive health care than those with insurance. In contrast, only 6 percent of high - income Americans lack insurance. The report also details numerous racial and ethnic health disparities for insurance, access to care, and specific health conditions ( Washington Post, 6/10 ; Kaiser Health News, 6/10 ). The report is available at HHS222 health reform website . Legislature Approves Bill A llowing FDA to Regulate Tobacco Products : On June 12, the House approved the Family Smoking Prevention and Tobacco Control Act ( HR 1256 ), passed by the Senate June 11, to allow the Food and Drug Administration (FDA) to regulate tobacco products. The bill no w heads to President Obama who said he will sign it. The legislation creates a tobacco control center within the FDA 227 funded by a fee on tobacco companies 227 allowing the FDA to regulate the content, sale, and marketing of tobacco products to protect public health. The bill would require tobacco companies to disclose all product ingredients and receive approval for new products while allowing the FDA to alter tobacco product contents for the public health but not permitting regulations eliminating nicotine ( AP, 6/11 ; CQ Politics, 6/11 ; New York Times, 6/11 ; CQ Politics, 6/12 ). Legislators Urge DOL to Extend Federal Wage and Hour Laws to Health Care Workers : On June 11 , a group of 15 Democratic Senators led by Senator Tom Harkin (D - IA) urged the Department of Labor (DOL) to extend federal wage and hour laws under the Fair Labor Standards Act of 1974 to home health care workers, reversing a Bush administration policy. A U.S. Supreme Court ruling upheld the Bush administration policy but allows for alterations by future administrations. The senators argue that home health care has become a form or regular full- time employment worthy of inclusion under the law ( AP, 6/11 ; Kaiser Health News, 6/12 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 4 VA to Allow Research ers Access to Data From Medical Records: The VA is opening up de - identified aggregate data from its electronic medical records to all researchers affiliated with its system. The project, the Consortium for Healthcare Informatics Research, will allow researchers access to one of the largest pools of electronic medical records to conduct comparative effectiveness research that, in turn, will be made publicly available through published articles and whitepapers. Previously, researchers could only access data from the local VA facilities with which they were affiliated ( AMNews, 6/8 ). S tudy Finds Small Business May Benefit From an Employer Health Insurance Mandate: A report by the non- profit Small Business Majority , released June 11, found that the health care reform plans currently under debate in Congress could save small businesses $546 billion to $855 billion over ten years. The report find that, even under a plan which requires sm all businesses to offer employer- sponsored care, small businesses would benefit from streamlining the purchasing process and lowering administrative costs as well as tax credits designed to defray much of the cost of the benefit. The report found that, wi thout reform, the cost of health care for small businesses will rise from an estimated $156 billion this year to $339 billion in 2018 ( New York Times, 6/10 ). The report is available on the Small Business Majority222s website . Drug Price Cases to Reduce Wholesale Prices for Many Drugs: Settlements stemming from two lawsuits against Hearst Corp222s First DataBank , McKesson Crop , and Medi - Span over the setting of average wholesale prices for about 400 drugs will result in a 4 percent reduction in the wholesale price of those drugs in September. In addition, the settlement provides $350 million to reimburse patients, employers, and insurers who paid for the over - priced drugs. Though the price rollbacks are expected to generate as much as $1 billion in savings the first year, experts estimate that patients will save only $100 million ( Wall Street Journal, 6/11 ; Kaiser Health News, 6/11 ). FTC Report Says 12 to 14 Years is Too Much Protection for Biotech Drugs: A report by the Federal Trade Commission (FTC), released June 11, says that the 12 - 14 years of exclusivity that firms are seeking for biotechnology drugs is too long to promote innovation. The report says that the period of exclusivity must be shorter to encourage greater development of generic versions to reduce the overall cost of health care in the U.S. ( Reuters via Yahoo, 6/10 ; Kaiser Health News, 6/11 ). The report is available on the FTC222s website . AHA Spe cialist Says 9 in 10 Hospitals Have Made Cutbacks: Speaking at the annual South Florida Healthcare Summit on June 5, an American Hospital Association (AHA) specialist said that nine out of 10 hospitals have made spending cutbacks as a result of the economic downturn. The spokesperson noted that almost half of hospitals have reduced staff, 20 percent have cut services, and 43 percent have a negative net return for the first quarter of 2009 227 up from 26 percent reporting negative return in the first quarter of 2008 ( Miami Herald, 6/6 ; Kaiser Health News, 6/8 ). Ur ban Institute Report Analyzes the Pr ospects of Equity in Capping a Potential Tax -Exclusion for Employer-Sponsored Health Care: An Urban Institute report by Stan Dorn, 223Capping the Tax Exclusion for Employer - Sponsored Health Insurance: Is Equity Feasible?224 examines the possible equity of caps on the tax exemptions for health insurance that are currently under debate in Congress. The report finds that, if the application of the employer - exclusion cap is based on premiums alone, factors other than the level of benefits provided will affect the benefits taxation. Under such a plan, workers in more expensive geographic areas, those with many coworkers in their 50s and 60s, and those with coworkers with serious illnesses would pay higher health benefit taxes than those with equivalent benefits. T he report suggests SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 5 that the cap should be based on benefit generosity alone, measured by an actuarial value accounting for a nationally representative population, to avoid such inequality ( Kaiser Health News, 6/11 ). The report is available the Urban Institute website . Health Affairs Publishes Six Papers on the Nursing Workforce, Find Nursing Shortage Reduced: On June 12, Health Affairs published six papers examining the nursing work force, including one that found that nearly 250,000 nurses have entered the workforce between 2007 and 2008, an 18 percent increase and the largest increase for 30 years. The paper attributes the increase to efforts to expand nursing schools across the country; however, the authors still project a 260,000 - nurse shortage by 2020 ( Kaiser Health News, 6/12 ; Wall Street Journal, 6/12 ). Abstracts of the papers are available on the Health Affairs website . KFF Analyzes Changes in Medicare Prescription Drug Coverage Since 2006: The KFF released a brief analyzing the changes in drug coverage and costs under the Medicare Prescripti on Drug Program (Part D) since 2006. The report, 223 Medicare Prescription Drug Plans in 2009 and Key Changes S ince 2006 224, examines trends in plan availability, premiums, cost sharing, gap coverage, and utilization management. The report concludes that pre miums, cost - sharing, the use of specialty tiers, and utilization restrictions have increased since 2008 and that, while most plans do not offer gap coverage, those that do primarily cover generic medication ( Kaiser Health News, 6/11 ). The report is available on the KFF website . S urvey Finds Disease Prevention is Top Priority for Health Reform: On June 9, the Trust for America222s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a public opinion survey that found that Americans rank disease prevention as the most important aspect of health reform. Survey respondents ranked disease prevention over providing tax credits to small businesses and over requiring health insurers to cover people regardless of preconditions. The survey also found that 77 percent of Americans believe increasing prevention programs will save money ( Trust for Healthy Americans, 6/8 ; Kaiser Health News, 6/11 ). Q1Medicare Provides Analysis of Medicare Prescription Drug Benefit Standard Benefit Parameters, 2006-2010 : Q1Medicare , owned by Q1 Group LLC, has published the Center for Medicare & Medicaid222s (CMS) final 2010 Medicare Part D Defined Standard Benefit parameters as well as plan par ameters from past years, allowing for easy trend analysis. The final 2010 Part D Defined Standard Benefit parameters are 4.66 percent higher than in 2009 ( PRWeb, 6/9 ). The table is available at Q1Medicare222s website . Around the Hill: Hearings on Health Financing House Veterans222 Affairs Subcommittee on Health: VA 222s Health Infrastructure 10:00 a.m. June 9, 334 Cannon Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies : Fiscal 2010 Appropriations: Labor, HHS, Education 2:30 p.m. June 9, 124 Dirksen House Education and Labor Subcommittee on Health, Employment, Labor and Pensions: Single Payer Health Care Option 10:30 a.m. June 10, 2175 Rayburn SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 6 Senate Health Education Labor and Pensions (HELP) Committee : HELP Nominations Vote June 10, TBA, TBA House Energy and Commerce Subcommittee on Health: Biologic Drug Competition 10:00 a.m. June 11, 2123 Rayburn Senate Indian Affairs Committee : Indian Health Care 2:15 p.m. June 11, 628 Dirksen House Energy and Commerce Subcommittee on Health: Medical Devices: Are Current Regulations Doing Enough for Patients? 9:30 a.m. June 18, 2322 Rayburn Around the States: State and Local Behavioral Health Financing News Arizona Legislature Approves GOP Budget, Some Worry it May Jeopardize ARRA Funding : On June 4, the Arizona Legisla ture passed a Republican - proposed budget designed to close the state222s $3 billion to $4 billion budget shortfall through spending cuts, $1.1 billion in American Recovery and Reinvestment Act (ARRA) funding, and budget maneuvers. However, Governor Jan Brew er (R) has said the legislative budget does not fully account for the state shortfall. In addition, state officials worry that some moves in the budget may make the state ineligible for federal ARRA funding. The budget222s delay of $100 million in universi ty funding may put the state out of compliance with the 223maintenance of effort224 rules in the ARRA because it cuts the state222s spending level. Furthermore, some lawmakers worry that a budget provision limiting the types of identification used to prove citizenship for enrollment in the state222s Medicaid program, the Arizona Health Care Cost Containment System , may also make the state ineligible for ARRA funding ( AP via Forbes 6/5 ; AP via Forbes 6/8 ). California Senate Democrats Propose Alternate Budget Cuts : In May, Governor Arnold Schwarzenegger (R) proposed a budget designed to close the state222s $24.3 billion deficit through cuts that include eliminating Healthy Families , California222s State Children222s Health Insurance Program (SCHIP), and the state222s welfare program, CalWORKS (Financing News Pulse 5/26, 6/1 editions). On June 9, Senate Democrats orally offered an alternate budget proposal, saying details of the written proposal was still under negotiations. The Democrats begin their budget assuming a $19 billion deficit, several billion less than the Governor222s budget. In addition, the Democratic plan would u se $3.5 billion of $4.5 billion that Governor Schwarzenegger wants to set aside as a reserve to fund Healthy Families and CalWORKS. The senator222s budget would cut spending by $13 billion, compared with $16 billion under the governor222s plan, and would stil l cut the budget for nearly all state programs ( California Health Line, 6/10 ; Sacramento Bee, 6/10 ). Assembly Approves Bill to Allow Clinics to Charge Medicaid for Same - Day Medical and Behavioral Health Visits : On June 3, the California Assembly approved a bill ( AB 1445 ) to allow federally qualified SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 7 he alth centers and rural health clinics to receive Medicaid reimbursements for one general medical visit and one behavioral health visit for the same patient on the same day. The current state law does not allow clinics to bill Medi - Cal , the state222s Medicai d program, for medical and behavioral health visits at the same location on the same day ( Lake County News, 6/6 ). SEIU Files Suit Against State For Planned Medicaid Home- Health Reductions: The Service Employees International Union (SEIU) has filed suit against the state of California claiming that a proposed reduction to the in - home care rate under the state Medicaid222s In - Home Support Services program violates both the Medicaid Act and the Amer icans with Disabilities Act. The legislature222s proposal would reduce the payment rate from $12.10 an hour to $10.10 an hour ( New York Times, 6/8 ). Update: Restaurant Association Asks U.S. Supreme Court to Hear Case on Contributions to Healthy San Francisco : The Golden Gate Restaurant Association filed a lawsuit against the City of San Francisco over requirements associated with the city222s Healthy San Francisco plan, which requires private companies with more than 20 employees to provide health insurance or pay into the public program (Financing News Pulse 3/13, 5/4, 5/6 editions). The Association lost its case and is now asking the U.S. Supreme Court to hea r the case, contending that the program violates the Employee Retirement Income Security Act (ERISA). The court will decide whether to the take the case by November ( Kaiser Health News, 6/9 ; San Francisco Chronicle, 6/9 ). Reduced Funding Forces Women222s Substance Abuse Center to Close : Hermanas Recovery Home, which operates on $400,000 from Santa Cruz County, will close this year because of lost funding from state and local governments. The $400,000 from the Santa Cruz County Department Health and Human Services includes state funding from CalWORKs, schedule d for elimination under Governor Schwarzenegger222s (R) budget. Without the funding, Hermanas would have only $5,000 to operate ( San Jose Mercury News, 6/8 ). I HS Plans Youth Substance Abuse Center : The Indian Health Service (IHS) announced that a site has been picked for a substance abuse center to treat American Indian and Alaskan Native teens for substance and alcohol abuse. The center, which has been planned since 1992, will be located in Oroville, California an d cost roughly $17 million to construct. In addition, once complete, the center will employ roughly 70 federal employees and have an operating budget of about $4 million annually ( Chico Enterprise Record, 6/9 ). San Bernardino County to Pool Health Services : On June 9, the San Bernardino County Supervisors approved a plan to provide a comprehensive health services center at a single loc ation. The plan will bring staff from the county hospital, Arrowhead Regional Medical Center, and the county222s public health and behavioral health services into a single facility to provide general medical services, M/SU services, and public health servic es. In addition, staff would be available to screen patients for Medi - Cal eligibility. The plan could take effect in as few as two years and is expected to lose $1 million the first year ( Press - Enterprise, 6/9 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 8 Napa County Plans to Cut Health Funding : A $296.5 million budget from the Napa County Board of Supervisors would cut $8 million from the Department of Health and Human Service222s $73 million budge t. The cuts would include eliminating programs for family planning, education, counseling, physical exams, and treatment for sexually transmitted infection. The cuts would also eliminate three positions and seek to reduce M/SU funding ( Weekly Calistogan, 6/11 ). Connecticut Report Says Cost of Treating Uninsured Up Since 2005 : A report from the Connecticut Office of Health Care Access found that the cost of hospital treatment for individuals without insurance increased 44 percent from 2005 to 2008, from $165 million to $239 million. The study found the trend continued despite 6.6 percent fewer uninsured hospital admissions in 2008. The report a lso provides breakdowns of uninsured hospital admissions by age, race, and ethnicity ( Kaiser Health News, 6/10 ; Hartford Courant, 6/10 ). The report is available through Connecticut222s website . Delaware Update: State to Publicize N on- Walgreens Pharmacies for Medicaid Prescriptions; Pharmacy Associations Sue State : On June 4, Walgreens Inc. announced it would no longer fill Medicaid prescriptions beginning on July 6 because the state lowered the brand - name reimbursement rate by 2 per cent (Financing News Pulse 6/8 edition). In response, the state launched a public education campaign to inform Medicaid enrollees of the non- Walgreens - owned pharmacies in the state that accept Medicaid prescriptions. Walgreens owns 66 Happy Harry222s locat ions in Delaware but state officials believe there will be enough participating pharmacies in every community and plan provide transportation to enrollees who cannot access a participating pharmacy ( News - Journal, 6/9 ). However, the National Association of Chain Drug Stores and the National Community Pharmacists Association have filed suit against the state, seeking an immediate injunction and claiming that the rate increase violates the care and access requirements of the Social Security Act ( AP via CBS, 6/11 ). Florida Palm Beach County Health District Faces Deficit, Plans Budget Cuts : Facing a $56 million budget deficit, the Health Care District of Palm Beach County plans to layoff 17 employees, lower payments to the county222s trauma hospi tals, eliminate funding for community health centers, reduce hours for school nurses, and raise premiums for its health coverage by about 20 percent while simultaneously reducing benefits. In total, the district plans to cut $19 million from its FY2010 bu dget ( Palm Beach Post, 6/10 ; Palm Bea ch Post, 6/11 ). Illinois State Budget Could Threaten Mental Health Treatment : An Illinois Department of Human Services spokesperson said the department is making plans to close state psychiatric hospitals and developmental centers in the event of a state budget that does not fully fund mental health treatment. Last week, Illinois passed a stopgap budget (Financing News Pulse 6/8 edition) but has yet to pass a permanent budget for the coming fiscal year ( AP via Chicago Tribune, 6/11 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 9 Indiana Officials Project Medicaid Shortfall After ARRA Funds Exhausted: Indiana will receive $1.4 billion in Medicaid funding through the ARRA, lowering the state222s share of M edicaid costs by $838 million over FY2010 and FY2011. However, based on an actuarial chart that indicates unemployment rates will drop in 2012 while Medicaid enrollment continues to rise, state officials project that the state will face a $289 million Med icaid shortfall in 2012 when ARRA funds run out ( Journal Gazette, 6/7 ). Louisiana Senate Passes Budget With More Spending Than House Budget : On June 5, the Louis iana Senate passed a $28.7 billion state budget ( HB 1 ), restoring hundreds of millions in cuts to education and health care outlined in the House budget passed last month. The Senate budget cuts $166 million from the Department of Health and Hospitals , ov er $200 million less than the $400 million cut in the House plan. The House is expected to reject the changes, sending the budget to a joint committee for resolution. The Senate version of the budget delays a tax- break, which Governor Bobby Jindal (R) has threatened to veto ( Times - Picayune, 6/5 ; New York Times, 6/6 ). House Vetoes Medicaid Oversight Legislation: The Louisiana House rejected HB 717 (Financing News Pulse 5/18 edition) that would have required the Department of Health and Hospitals (DHH) to consult with an advisory board prior to implementing any changes to the Medicaid program. The board would consist of eight doctors and dentists and function independently of DHH and the Legislature ( Times - Picayune, 6/4 ). However, the chairs of the House and Senate Health and Welfare Committees have offered resolutions to reactivate the Medical Care Advisory Council , inactive since 2004, to provided stakeholder input in to Medicaid ( Advocate, 6/11 ). Maine Behavioral Health Provider s Merge : Aroostook County222s Aroostook Mental Health Services announced plans to acquire Washington County Psychotherapy Inc., which operates in Washington and Hancock Counties. Financial details of the deal are not currently available, but both agencies have worked together in the past and spokespersons say the merger will improve service to needy residents ( Bangor Daily News, 6/3 ). Massachusetts Governor Proposed Updated Budget With Cuts to Medicaid: On June 4, Governor Deval Patrick (D) updated his budget proposal, originally released in January, to cut an additional $800 million from the state222s budget, including a $164 million reduction to the state222s Medicaid program eliminating adult dental benefits. The governor also proposed increasing state employee health insurance contributions by 5 percent to save the state $26 million ( Boston Globe, 6/5 ). Update: CHA to Direct Somerville and Cambridge Patients to Boston Area : The Massachusetts Department of Health directed the Cambridge Health Alliance (CHA) to create a plan to redirect patients when the company closes its detoxification and inpatient treatment on June 30 as a result of cuts made by Governor Patrick (D) (Finan cing News Pulse 5/26, 5/4, 4/27 editions). CHA has announced a plan to direct Cambridge and Somerville patients to Boston - area service providers ( Wicked Local, 6/5 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 10 Easton Voters Reject Plan to Eliminate Health Director : On June 8, voters at an Easton town meeting rejected a proposal that would have eliminated $83,046 from the Board of Health budget, replacing the director position with a lower- paid health agent. The Board of Health222s budget now totals $220,028 ( Enterprise News, 6/9 ). Mi chigan Farmington Budget Alters Retiree Health Benefits : The Farmington City Council altered the retiree health care benefit for non - union employees as part of the city222s $8.2 million budget. Previously, the city paid 100 percent of health care premiums for employees of 25 years or more; however, under the new plan, the city will pay a fixed benefit to retirees to allow them to purchase private insurance. A hearing to determine the amount of the benefit is scheduled for June 15. Retiree health care costs account for $1.3 million of the city222s coming- year budget ( The Observer & Eccentric Newspapers and Hometown Weeklies, 6/7 ). Mississippi State Says Medicaid Paid Medicare Prem iums for 9,300 Ineligible Residents : State officials report that the Mississippi Medicaid program has paid Medicare Part B premiums for roughly 9,300 state residents who were not eligible for Medicaid. The state says the payments may date back to 2003 and blames the mistake on the private company that handles the state222s Medicaid billing. State officials say they will try to recoup the expense from the billing company ( AP via WRE G, 6/11 ). Missouri Update: Missouri Universities Pledge Money for Health Programs : As part of the state budget, the Mississippi Legislature allocated $33.5 million in ARRA funding that the state222s public universities for 223any one - time purpose.224 Governo r Jay Nixon (D) convinced institutions to use the funding for his health program, Caring for Missourians (Financing News Pulse 6/1 edition). On June 8, the governor222s office released identical signed letters from the 11 institutions receiving the funding that pledged to use the money to further the Caring for Missourians program ( AP via Kansas City Star, 6/8 ). New Jersey State Changes Medicaid Hospital Reimbursements , Menta l Health Affected : New Jersey plans to alter the Medicaid reimbursement rates for hospital services, last updated 20 years ago. The changes, which are slated to take effect in August, will affect some hospitals positively but others negatively, according to an analysis by the New Jersey Hospital Association . The Association found that 42 hospitals will lose money under the change, while 24 will receive additional reimbursements. Because mental health reimbursements are cut under the plan, which the state says reflects changes in the cist if hospital- based mental health treatment, hospitals that treat a larger number of mentally ill patients will face disproportionate funding cuts ( Star - Ledger, 6/7 ). Report Finds State Uninsurance Rate Among Immigrant Youth Above the National Average : A report by the Rutgers University Center for State Health Policy, released June 9, found that 37 percent of immigrant children in New Jersey are uninsured, compared with 33 percent nationally. The report estimates that nearly 300,000 children in New Jersey are uninsured but that roughly 225,000 of them SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 11 qualify for free or subsidized health care, including Medicaid and SCHIP. The report comes as health care and immigrant advocacy groups protest a recent move that cut $1 million in immigrant health care outreach funding from the state budget ( AP via Philadelphia Inquirer, 6/10 ; Kaiser Health News, 6/10 ). The report is available on the Center for State Health Policy website . UMDNJ Settles with DOJ Over Medicaid Fraud; Will Pay $2 Million: On June 9, the U.S. Department of Justice (DOJ) announced that the University of Medicine and Dentistry of New Jersey (UMDNJ) agreed to pay $2 million to settle allegations that it double billed the state Medicaid program for outpatient services between 1993 and 2004. UMDNJ has already paid the state $4.9 million from a criminal complaint regarding the double billing. Half of the $4.9 million went back to CMS for the federal share of the Medicaid program ( AP via Philly.com, 6/10 ). New York C ourt Rules State Owes New York City $28.6 Million Medicaid Refund: An appeals court ruled that New York State owes New York City $28.6 million in illegally intercepted Medicaid payments for home health care. The state seized the money between 2003 and 2004, claiming that the city failed to meet targeted savings; however, the city contended that the state seized the funds after the deadline for interceptions ( AP via WTEN, 6/4 ). University of Buffalo Re searcher Receives ARRA Funding for Substance Abuse Research : A University of Buffalo researcher received a $431,000 grant from the National Institute on Drug Abuse (NIDA) to research the relationship between impulsivity and substance abuse. The grant is a mong the first awarded from the $8.2 billion set - aside in the National Institutes of Health222s (NIH) ARRA funding for scientific research ( Business First Buffalo, 6/11 ). N orth Carolina BCBS of North Carolina Launches Website on Health Reform : BlueCross BlueShield of North Carolina (BCBS) launched a website on June 9 to explain the company222s perspective on national health care reform. The website explains the company222s opp osition to a national health insurance plan, arguing that the plan would negatively affect quality of care ( WRAL, 6/9 ). The website is available at www.nchealthreform.com . Oregon Legislature Passes Two Health Care Reform Bills: On June 11, the Oregon Senate passed two health care reform bills, passed by the House on June 8, to create a new health agency, expand access to care, and contain costs . HB 2116 would tax hospitals and insurers to raise $300 million to $400 million over the 2009 - 2011 biennium and draw down an additional $1 billion in federal Medicaid matching funds (Financing News Pulse 6/8 edition). The additional funding is expe cted to increase coverage for 80,000 uninsured children and 35,000 adults. HB 2009 , however , would create the Oregon Health Authority , which would eventually assume most health care functions currently preformed by the Department of Human Services ( Kaiser Health News, 6/9 ; Oregonian, 6/8 ; Oregonian, 6/11 ; Kaiser Health News, 6/12 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 12 Pennsylvania Update: House Committee Rejects Senate Budget : On June 8, the House Appropriations Committee rejected the Pennsylvania Senate222s $27.3 billion state budget proposal passed May 6 (Financing News Pulse 5/11 edition). The Senate222s budget cuts numerous health care programs including removing 12,00 0 children form SCHIP, eliminating cancer screening for numerous low - income adults, and reducing Medicaid hospital funding ( AP via Intelligencer, 6/9 ). Rhode Island Senate Confirms Alexander as Health and Human Services Chief : On June 9, the Rhode Island Senate confirmed Governor Donald Carcieri222s (R) nominee, Gary Alexander , as chief of the Executive Office of H ealth and Human Services . The Office, where Alexander has served as interim director since February, oversees the state222s Departments of Health ; Human Services; Mental Health, Retardation, and Hospitals; Elderly Affairs; and Children, Youth, and Families ( Providence Journal, 6/10 ). South Carolina Legislature Increases State Assistance for Medicare Part D 223Doughnut Hole224 Coverage : The South C arolina Legislature has increased the amount the state will pay for Medicare Prescription Drug program (Part D) beneficiaries in the 223doughnut hole224 of coverage from 10 percent to 30 percent. Medicare pays for the first $2,700 of prescription expenses and resumes paying at $6,153 . The gap in coverage, which beneficiaries must pay out - of - pocket, is referred to as the doughnut hole. South Carolinas assistance rate will increase to 30 percent beginning July 1 ( CBS, 6/8 ; Kaiser Health News, 6/9 ). Washington Update: State to Raise Out - of - Pocket Costs for Basic Health, Not Reduce Enrollment : After cutting funding to the state222s Basic Health Program 227 which provides health care for those earning up to 200 percent of the FPL 227 by over 40 percent, the state estimated it would remove 40,000 residents from the program (Financing News Pulse 5/26 edition). However, the state considered alternate methods for cost reduction (Financing News Pulse 6/8 edition) and decided maintain current eligibility criteria. Instead, the state will raise the mo nthly premiums by an average of $25 and increase the yearly deductible from $150 to $250. New premiums will be larger for those with higher incomes ( AP via Seattle Times, 6/8 ; Seattle Times, 6/9 ). In related news, Washington Insurance Commissioner Mike Kreidler estimated that the number of uninsur ed residents could reach 876,000 this year, a 21 percent increase from 2008. The commissioner222s figure includes the 40,000 residents expected to lose coverage under Basic Health; however, it is no longer clear how many residents will drop Basic Health bec ause of the increased cost ( Seattle Post Intelligencer, 6/8 ). Washington D.C. District Medicaid Program to Implement Health Information Exchange : The Department of Health Care Finance, responsible for the District222s Medicaid program, plans to implement a health information exchange pilot to be implemented within one year. MedPlus, a subsidiary of Quest Diagnostics, is implementing the system, known as the Patient Data Hub. In addition to allowing sites to share information, the system will also allow officials to analyze data and track trends ( Fierce Health IT, 6/7 ; Healthcare IT News, 6/4 ). SAMHSA222s Weekly Financing News Pulse June 15, 2009 6/15/09 13 West Virginia Governor Signs Budget, Line Item Vetoes Some Health Spending : On June 5, Governor Joe Manchin (D) signed the state222s $11.5 billion budget, removing $7 million in proposed spending through line - item veto. Governor Manchin vetoed funding for free clinics, which had been increased above his funding recommendation, and eliminated more than $3 million in health care related funding, which legislators had financed through a Medicaid surplus the governor wants to keep intact. The governor also vetoed $1.5 million in funding for teaching hospitals ( AP via Charleston Gazette, 6/5 ). Up date: PEIA to Determine Final Retiree Health Care Benefits After Public Hearings : After voting May 14 to end the 60 percent subsidy for retiree health care premiums for new state employees, and return the 35,000 former state employees currently enrolled in Coventry Health Care222s Medicare Advantage (MA) plan to PEIA222s main program, the Public Employees Insurance Agency (PEIA) has decided to reserve final decision on retiree health benefits until after a series of public hearings (Financing News Pulse 5/18 ed ition; AP via Forbes, 6/5 ).
