Roundup: Larger-than-expected Medicaid enrollment in Conn.; Texas bill renews rural abortion debate; Calif. details exchange self-sufficiency

Published on November 20, 2012 at 11:22 PM · No Comments

A selection of health policy stories from Connecticut, Colorado, Texas, California, Maryland and Florida.

CT Mirror: Medicaid Mystery: Who Are All The News Members?
Ron Harney is still looking for work after being laid off from his marketing firm job three years ago. He's used up nearly all of his savings and says he's grateful for the state's Medicaid program, which covers the medical care he needs to manage his HIV. … Harney is part of a group that took state officials by surprise, one of more than 37,000 people who joined a new portion of the Medicaid program since it was created in 2010 to replace a state-funded form of coverage. Enrollment in the program, Medicaid for Low-Income Adults, or LIA, now tops 83,000, including 46,156 who were in the predecessor program. That's far higher than had been anticipated or budgeted for by the state, which didn't expect that many enrollees until next August (Becker, 11/20).

The Texas Tribune: Bill Renews Debate Over Rural Access To Abortion
Before Texas' abortion sonogram law passed last legislative session, some women seeking to end pregnancies in rural communities relied on telemedicine, with physicians -- working in partnership with medical technicians or nurses -- administering prescription drugs via videoconference to induce early-stage abortions. If new legislation filed by Sen. Dan Patrick, R-Houston, passes in 2013, women in remote corners of the state may have even fewer options to get the procedure (Aaronson, 11/20).

California Healthline: Covered California's Plans To Become Self-Sufficient
California's health benefit exchange, now also known as Covered California, eventually is supposed to run by itself without state or federal money. The exchange board took a couple of steps toward that end at Wednesday's board meeting. It released its draft Level II establishment grant proposal, which now will be forwarded to federal officials. The proposal is a blueprint for how the exchange will operate in California. As part of the proposal, exchange officials laid out plans for the exchange to be self-sufficient by 2017 (Gorn, 11/20).

Modern Healthcare: Four Colo. ASCs File Antitrust Lawsuit
Four Colorado ambulatory surgery centers have filed an antitrust lawsuit in U.S. District Court in Denver against HCA, HCA-HealthOne, Centura Health, the Colorado Ambulatory Surgery Center Association and Kaiser Foundation Health Plan of Colorado charging them with anti-competitive activities and restraint of trade agreements. The ASC plaintiffs accuse the defendant hospital systems of abusing their market share power to convince Kaiser not to sign a contract that it had negotiated with one of the ASCs and attempting to further use their market power to influence other health insurance companies that do business in Colorado from putting the ASCs in their provider networks (Robeznieks, 11/19).

California Healthline: Saving Money, Lives With Mental Health Program
A new study by the UCLA Center for Healthier Children, Families and Communities suggests an intensive and integrated mental health program called Full Service Partnerships is likely to save the state money at a return rate of $1.27 for every dollar spent. The FSP program is designed to care for individuals with serious mental illness by taking a holistic approach to their care, according to Renay Bradley, chief of research and evaluation at the UCLA center (Gorn, 11/20).

Baltimore Sun: Insurer To Pay $3 Million To Avoid Prosecution In Medicare Case
A Bethesda-based insurance company that gained advantage over competitors by allowing its employees to inappropriately access a federal Medicare database has agreed to pay the federal government $3 million to avoid criminal prosecution, according to the Maryland U.S. attorney's office. According to an agreement with prosecutors, top officials at Coventry Health Care Inc., which is incorporated in Delaware but headquartered in Bethesda and provides group and individual health insurance to some five million members nationally, knew of the inappropriate use of the database and did nothing to stop it until a federal agency raised concerns (Rector, 11/19).

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