First Edition: April 24, 2013

Today's headlines include stories about the health law's implementation as well as health policy developments from Capitol Hill.  

Kaiser Health News: Nurses Fighting State By State For Minimum Staffing Laws
Reporting for Kaiser Health News, David Schultz writes: "How many nurses does it take to run a hospital? Legislatures in at least seven states and the District of Columbia are trying to answer that question as they debate bills that would require hospitals to have a minimum number of nurses on staff at all times" (Schultz, 4/23). Read the story.

Kaiser Health News: Capsules: Baucus Vows To Keep Watch On Health Law Rollout Before Leaving Senate; Insurer Centene: We Can Do Arkansas-Style Medicaid
Now on Kaiser Health News' blog, Mary Agnes Carey reports on the announcement by Sen. Max Baucus, D-Mont., that he will not seek re-election: "Senate Finance Committee Chairman Max Baucus stunned his colleagues Tuesday when he announced he would not seek a seventh term next year. But don't expect him to go quietly. Implementation of the 2010 health care law is a top priority for the Montana Democrat, as is overhauling the tax code, tackling the nation's debt and pushing 'job-creating trade agreements' through the Senate, Baucus said in a statement" (Carey, 4/24).

Also on Capsules, Jay Hancock reports on one insurer's plans for the health law's Medicaid expansion: "Last week the Arkansas legislature approved a plan to give Medicaid beneficiaries money to buy individual policies from private insurers on the state's health insurance exchange -; the subsidized, online marketplaces due to be in business next year. The governor signed the bill Tuesday -; making it law. The Department of Health and Human Services, which has said it "will consider approving a limited number" of such arrangements, still needs to negotiate details and sign off. One insurer is already expressing interest" (Hancock, 4/23). Check out what else is on the blog.

The Associated Press/Washington Post: Poll Finds People In Denial About The Need For Long-Term Care As They Get Older
We're in denial: Americans underestimate their chances of needing long-term care as they get older -; and are taking few steps to get ready. A new poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging, and found two-thirds say they've done little to no planning (4/24).

The New York Times: Racing To Spread Word About New Health Plans
President Obama and the Democrats passed the 2010 health care law to make medical insurance available to more than 30 million people who do not have it. But with recent studies showing that as many as three-fourths of those people are unaware of their new options, health care providers are joining community organizers and insurance companies in an ambitious effort to spread the word in the six months remaining before the health plans become available (Pear, 4/23).

The Associated Press/Washington Post: Governments May Push Workers Out Of Employer Health Care And Into Health Exchange
In a move that would capitalize on provisions under President Barack Obama's health care law but could cost the federal government millions of dollars, Washington state lawmakers have found a creative way to pass a large chunk of their health care expenses along to Washington, D.C. -; and analysts say others are likely to follow suit. The plan threatens to affect the federal budget and the pocketbooks of some part-time workers, as it would push a group of employees out of their current health care plans and into an exchange developed under the Affordable Care Act (4/24).

The New York Times: A Health Provider Finds Success In Keeping Hospital Beds Empty
For most health care providers, that would be cause for alarm. But not for Advocate Health Care, based in Oak Brook, Ill., a pioneer in an approach known as "accountable care" that offers financial incentives for doctors and hospitals to cut costs rather than funnel patients through an ever-greater volume of costly medical services. Under the agreement, hospital admissions are down 6 percent. Days spent in the hospital are down nearly 9 percent. The average length of a stay has declined, and many other measures show doctors providing less care, too (Lowry, 4/23).

The New York Times: Baucus, Powerful Montana Democrat, Will Leave Senate
If Democrats do keep control of the Senate next year, Senator Ron Wyden of Oregon would be next in line for the chairmanship of the Finance Committee, which has jurisdiction not only over taxes but health care and entitlements like Medicare. If anything, Mr. Wyden has been more of an iconoclast on the committee's issues than Mr. Baucus, teaming with Representative Paul D. Ryan, Republican of Wisconsin, on a drastic overhaul of Medicare that still rankles many Democrats (Weisman, 4/23).

Los Angeles Times: Montana's Max Baucus Announces Retirement From The Senate
Baucus first went to Washington in 1974 as part of a post-Watergate wave of Democrats. Despite his rank, he was never one to adhere to party lines. He angered many Democrats by working closely with former President George W. Bush on tax and Medicare legislation, and some blamed him for complicating the passage of President Obama's sweeping healthcare law. Although he voted for the measure, Baucus has criticized its implementation (Barabak, 4/23).

The Washington Post: Baucus Retirement Opens Way For Sweeping Legislative Changes
Baucus, chairman of the Senate Finance Committee, which has jurisdiction over tax issues, said his decision not to seek reelection frees him from the demands of a campaign and will also allow him to focus on new trade agreements and implementation of the Obama health-care initiative, which he played a major role in drafting (Kane and Montgomery, 4/23).

The Associated Press/Washington Post: House Bill Uses Prevention Money To Extend Health Care Law Coverage To High-Risk Patients
House Republicans are coming to the aid of high-risk patients trying to get insurance under the new health care law. But they do so by diverting money from a prevention program that is key to the law, ensuring stiff opposition from Democrats and a veto threat from the White House. The GOP bill would provide up to $3.6 billion to ensure that people with pre-existing conditions continue to have access to private coverage until Jan. 1, when the law will fully take effect. In February the administration said it would stop taking applications for the Pre-Existing Condition Insurance Plan because it was running out of money (4/24).

The Associated Press/Washington Post: White House Threatens To Veto GOP Bill To Redistribute Funds Under Obama's Health Care Law
The White House is threatening to veto a Republican bill that would shore up one part of President Barack Obama's health care law by siphoning funds from another part. The House bill would add billions to a temporary program to help uninsured people with pre-existing medical problems. Obama's health care law requires companies to cover those people, but that provision doesn't kick in until Jan. 1. The cash-strapped program has stopped taking new applicants to ensure it doesn't run out of money (4/23).

The Wall Street Journal: Senate Panel Clears Medicare Nominee
The Senate Finance Committee voted Tuesday to advance the nomination of Marilyn Tavenner to formally head the Centers for Medicare and Medicaid Services, bringing the former hospital executive one step closer to becoming the programs' first confirmed administrator in seven years (Dooren, 4/23).

The New York Times: U.S. Accuses Novartis Of Providing Kickbacks
Federal prosecutors in New York filed a lawsuit on Tuesday accusing Novartis of providing illegal kickbacks to pharmacies, in the form of discounts and rebates, to promote use of one of the company's drugs (Pollack, 4/23).

The Associated Press/Washington Post: US Sues Pharmaceutical Firm Novartis In NY, Accusing It Of Prescription Drugs Kickback Scheme
The U.S. government sued Novartis Pharmaceuticals Corp. Tuesday, claiming it gave kickbacks to pharmacies to switch kidney transplant patients from competitors' drugs to its own. The civil health care fraud lawsuit in U.S. District Court in Manhattan seeks unspecified damages and civil penalties for a scheme that the government said has been carried out since 2005 (4/23).

The Wall Street Journal: U.S. Alleges Novartis Kickbacks To Pharmacies
In a civil-fraud lawsuit filed Tuesday in federal court in Manhattan, prosecutors said Novartis Pharmaceuticals, the U.S. unit of Swiss drug giant Novartis AG, used a program of rebates and discounts to boost sales of its anti-rejection drug, Myfortic, at the expense of Medicare and Medicaid, which they said paid tens of millions of dollars in reimbursements to pharmacies for which they were never entitled (Bray and Loftus, 4/23).

Los Angeles Times: Gov. Brown's Donors Rally Against His Health Care Cuts
In the healthcare world, there's not a whole lot that insurers, doctors and union workers all agree on. But a new coalition of powerful Capitol players from all three groups is hoping to reverse recent budget cuts, pushed by Gov. Jerry Brown, to those who provide care to the poorest Californians. But doctors, hospital officials and others say the rate cuts could threaten the success of the federal law. They say lower reimbursements for treating poor patients will reduce the number of people who agree to treat Medi-Cal patients (York, 4/23).

The Associated Press/Washington Post: New Federal Health Reform Regs Cut Hours, Pay For
Some Va Community College Adjunct Faculty
Many adjunct instructors at Virginia's 23 community colleges will see their hours cut starting this summer thanks to Virginia's response to the new federal health reform law, a change that could cripple or kill livelihoods teachers like Ann Hubbard worked hard to build. The onrushing 2010 Patient Protection and Affordable Care Act is forcing governments at all levels to scramble to accommodate changes -; some intended, some not -; to public- and private-sector jobs over the next year (4/24).

The Associated Press/Washington Post: Appeals Court Upholds Md. Doctors Convictions For Implanting Unnecessary Stents
A federal appeals court has upheld the convictions of a Maryland cardiologist who implanted unnecessary heart stents in more than 100 patients. A three-judge panel of the 4th U.S. Circuit Court of Appeals on Tuesday unanimously rejected John McLean's claim that the evidence was insufficient to convict him on six counts of health care fraud. McLean was sentenced to eight years and one month in prison after his November 2011 trial (4/23).