State roundup: Pittsburgh insurer, hospital extend contract despite ongoing fight

Published on May 4, 2012 at 5:28 AM · No Comments

News outlets report on a variety of health policy issues in California, Colorado, Connecticut, Iowa, Kansas, Louisiana, Massachusetts, New York, Oregon and Pennsylvania.

Los Angeles Times: L.A. Program Offers Health Care For Illegal Restaurant Workers
A restaurant workers' group and a Los Angeles community clinic have launched a unique cooperative to provide health coverage to a group of people excluded from federal health care reform -- illegal immigrants. The pilot program, believed to be the first of its kind in the nation, offers preventive and primary care to low-wage, uninsured workers in the restaurant industry. Legal immigrants and other restaurant workers who don't meet the criteria or cannot afford coverage under the health care law are also eligible (Gorman, 5/3).

The Wall Street Journal: Highmark, Hospitals Reach Pact
Under pressure from Pennsylvania officials, insurer Highmark Inc. and the University of Pittsburgh Medical Center reached an agreement to extend their contracts until the end of 2014, and negotiate new terms for certain services after that date (Mathews, 5/2).

Philadelphia Inquirer: Highmark, UPMC Extend Relationship
Hospitals and insurers never have an easy time negotiating contracts, but the level of brinkmanship in Pittsburgh between Highmark Inc. and the University of Pittsburgh Medical Center was unusual by any measure. In a bid to compete if it failed to get a contract with UPMC, which has more than 20 hospitals and its own health insurance company, Highmark even went as far as buying the financially ailing West Penn Allegheny Health System in a deal valued at up to $475 million when it was announced last year (Brubaker, 5/3).

Des Moines Register: After Abortion Foe Rejected, Branstad Nominates Priest To Medical Board
Three weeks after the Iowa Senate rejected a Dubuque anti-abortion activist for a seat on the Iowa Board of Medicine, Gov. Terry Branstad has nominated a prominent Catholic priest for the spot. Msgr. Frank Bognanno, the pastor at Des Moines' Christ the King Catholic Church, has spoken against abortion, which his faith condemns. The medical board, which licenses physicians, gets involved in the issue when abortion opponents file complaints about abortion providers (Leys, 5/2).

Kansas City Star: Kansas Lawmakers Pass Bill Giving Pharmacists Leeway On Abortion Drugs
A bill that would allow pharmacists to bow out of providing drugs they believe might cause an abortion cleared the state legislature Wednesday. The Senate voted 23-16 to approve the bill, which is primarily intended to broaden legal protections for health care providers who don't want to be involved in abortion procedures. Already passed by the House in March, the bill now awaits the signature of Republican Gov. Sam Brownback, a staunch opponent of abortion (Cooper, 5/2).

The Wall Street Journal: Espada's Clinic Is Scaling Back
As Pedro Espada Jr. awaits a verdict in his corruption trial, the Medicaid-funded Bronx health clinic controlled by the former state senator says it plans to stay open despite efforts by the state to shut it down. Officials at Soundview Health Center in the South Bronx, say the nonprofit is running out money, claiming it is owed hundreds of thousands of dollars from Medicaid managed-care plans and the state (Gershman, 5/2).

The Connecticut Mirror: Privacy Dominates Debate On Health Care Database
After a lengthy debate centered on patient privacy, the House of Representatives on Wednesday approved a proposal to develop a statewide database of medical, dental and pharmacy claims information aimed at getting a comprehensive view of health care usage, cost and quality. ... Several other states have or are developing similar programs, known as all-payer claims databases (Levin Becker, 5/2). 

Boston Globe: Haverhill To Save $1.1M In Health Care Costs
Haverhill Mayor James J. Fiorentini announced the city has reached an agreement with its local unions on a new health care plan for municipal employees and retirees that officials predict will save local taxpayers more than $1.1 million annually. The plan, which is scheduled to go into effect with the start of the new fiscal year July 1, affects all city and school department employees and retirees except for those whose contracts run until 2014 (Buote, 5/3).

Kansas Health Institute News: Senate Approves Budget
The Kansas Senate today, by a wide, bipartisan margin, approved its latest version of the state budget after members agreed to add about $77 million for public schools, $5 million to help reduce the waiting list for services for the disabled and $1.9 million to help deal with understaffing at Larned State Hospital (Shields, 5/2). 

California Healthline: Health Plans' Quality For Duals In Question
Seven of the eight health plans in California's pilot project to shift dual eligibles into managed Medi-Cal have inferior quality ratings for treating Medi-Cal beneficiaries, according to a report released yesterday. The ambitious plan for 1.1 million Californians eligible for both Medicare and Medi-Cal benefits will start with a pilot program in four counties -- Los Angeles, Orange, San Diego and San Mateo. The state hopes to expand the pilot project to as many as 10 counties (Gorn, 5/3). 

KQED's State of Health blog: Cash-Only Practices: Better For Patients Or Just Better For Doctors?
Some wealthy patients pay thousands of dollars each month to keep a personal physician on call at all times. ... Now this "concierge medicine" model is being scaled down to reach people with more modest financial resources. One such practice that's starting up in Northern California is called MedLion. ... there is a monthly fee to buy a spot on the doctor's limited roster, and an additional $10 fee for each office visit. For everything else, the patient pays out of pocket -- including basics like x-rays and blood tests (Menghrajani, 5/2). 

WBUR: State Legislature Readies Next Chapter Of Health Care Reform
The House and Senate plan to roll out separate bills soon that will launch the next round of health care reform in Massachusetts. Chapter One of the great Massachusetts health care novel -- what some people call health reform 1.0 -- built to this dramatic moment. ... The House and Senate are expected to build on movements that are already under way: global payments, electronic health records and the increased focus on primary care (Bebinger, 5/3). 

Related, from KHN: Different Takes: How Massachusetts Can Control Health Care Costs (4/12). 

The Lund Report (an Oregon news service): Regence BlueCross BlueShield Sets Off Fury Among Members
When Regence BlueCross BlueShield of Oregon decided to slash the medical benefits for people in the Portland metropolitan area, its management team could never have imagined the fury that it set off. ... Unless people are willing to pay more out-of-pocket costs to see their physician of choice, they'll be transitioned to the provider networks at Tuality Healthcare or Adventist health care systems (Lund-Muzikant, 5/2). 

Health Policy Solutions (a Colorado news service): The Town That's Tackling Obesity
[W]hen it comes to the most stubborn health epidemic now facing the U.S., Las Animas wants to succeed at a tough goal -- becoming the little town that beats the highest obesity rates in Colorado. Health is a key component of the area's new comprehensive plan. And the irrepressible head of LiveWell Bent County, Tammy Westerman-Pryor, is attacking obesity on three key fronts: creating safe paths for walking and bike riding, increasing access to healthy foods and empowering young people through school wellness initiatives (Kerwin McCrimmon, 5/2). 

New Orleans Times-Picayune: House Committee Rejects Expanded Role For Nurse Practitioners
Nurse practitioners and other advanced practice nurses met an unfriendly House committee Wednesday that rejected the profession's push to provide their services in certain locales without being affiliated with a physician. The Health and Welfare Committee's 12-4 vote to spike House Bill 951 honored the wishes of the Louisiana State Medical Society, which asked lawmakers to leave in place existing requirements that the advanced practice nurses see patients only with a "collaborative agreement" with a physician (Barrow, 5/2).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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