First Edition: May 21, 2014

Today's headlines include status reports on the health exchanges in Nevada and Oregon.  

Kaiser Health News: Medicare May Be Overpaying Hospitals For Short-Stay Patients
Reporting for Kaiser Health News, Susan Jaffe writes: "The federal government may be overpaying hospitals an estimated $5 billion as a result of the 18-month moratorium on enforcing a controversial rule that tells hospitals when patients should be admitted, an independent Medicare auditing company told a congressional panel Tuesday" (Jaffe, 5/29). Read the story.

Kaiser Health News: California Doctors Among Those Charging Medicare The Most For Office Visits
Reporting for Kaiser Health News, Lisa Aliferis, April Dembosky and Lisa Pickoff-White write: "When people think of seeing a doctor, generally the first thing that comes to mind is an office visit. But not all visits are the same. Frequently, patients have minor problems, which can be dispensed with quickly. Other problems are much more complex and require more of a doctor's time and expertise. Not surprisingly, doctors get paid more for these more complex visits. Office visits for established patients are billed across five levels" (Aliferis, Dembosky and Pickoff-White, 5/21). Read the story.

Los Angeles Times: Federal Funds Earmarked To Offset Affordable Care Act Insurer Losses
The Obama administration has quietly adjusted key provisions of its signature healthcare law to potentially make billions of additional taxpayer dollars available to the insurance industry if companies providing coverage through the Affordable Care Act lose money. The move was buried in hundreds of pages of new regulations issued late last week. It comes as part of an intensive administration effort to hold down premium increases for next year, a top priority for the White House as the rates will be announced ahead of this fall's congressional elections (Levey, 5/21).

The Wall Street Journal: ER Visits Rise Despite Law
Early evidence suggests that emergency rooms have become busier since the Affordable Care Act expanded insurance coverage this year, despite the law's goal of reducing unnecessary care in ERs. Almost half of ER doctors say they are seeing more patients since key provisions of the health law took effect Jan. 1, while more than a quarter say their patient volume has remained the same, according to a survey to be released Wednesday by the American College of Emergency Physicians (Armour and Radnofsky, 5/21).

The New York Times: Health Site Under Fire, Nevada Alters Path
The board of Nevada's problem-plagued online health insurance exchange voted Tuesday to end its contract with the vendor in charge of building it and to rely on the federal enrollment system for at least a year. The board voted unanimously to sever ties with the vendor, Xerox, which had a $72 million contract to build the Nevada exchange and has been paid $12 million to date. The exchange has been riddled with problems, including billing and enrollment errors that led to a class-action lawsuit by 200 customers who said they paid for exchange plans but still have no coverage (Goodnough, 5/20).

The Wall Street Journal: Nevada Scraps Xerox For Health Site
Nevada's health-care exchange board voted Tuesday to cut ties with Xerox Corp. , which helped build the state's troubled insurance website, and instead use the federal government's technology for the next insurance enrollment season. A spokesman for the exchange, known as Nevada Health Link, said lawyers were examining provisions in the state's $75 million, five-year contract with Xerox to allow it to terminate it early. The state has paid Xerox around $12 million for work that had been completed to its satisfaction, said C.J. Bawden, the spokesman (Radnofsky, 5/20).

Politico: Nevada Latest State To Scrap Its Obamacare Exchange
Nevada has become the latest state to scrap its crippled Obamacare exchange and join the federal HealthCare.gov for at least a year. The Silver State, which had seemed to start strong last October before smashing into a wall of technical problems, is the only state with a Republican governor that ran its own health insurance exchange in 2014. Gov. Brian Sandoval had argued that it was important for his state to steer its own exchange, even though he opposed Obamacare (Cheney, 5/20).

The Associated Press: US Subpoenas Oregon Insurance Website Documents
Federal prosecutors have subpoenaed state records for a grand jury investigation of the troubled Cover Oregon health insurance website, the governor's office said Tuesday (5/20).

The Wall Street Journal: GOP Sees Primaries Taming The Tea Party
Mr. Boehner, asked Tuesday whether he believed the tea party's influence was waning, didn't seem tempted to gloat. Instead, he argued that the conflict between the tea party and GOP leaders had been overblown. "The tea party has brought great energy to our political process," he said. There isn't "that big a difference between what you all call the tea party and your average conservative Republican: We're against Obamacare; we think taxes are too high; we think the government's too big" (Hook and O'Connor, 5/21).

Los Angeles Times: GOP Vs. GOP: Key Primary Races In Georgia, Kentucky, Idaho and Oregon
Tuesday marks the biggest day of primary elections so far this year, with voters in six states casting ballots in state and congressional elections that will offer another test of Republican establishment efforts to curtail the influence of outside tea-party-inspired groups. Here are some key races where Tuesday's outcome will help shape the midterm battle for Congress this fall (Memoli and Mascaro, 5/20).

Los Angeles Times: $10-Million Ad Campaign Joins 'Avalanche' Of Anti-Obamacare Ads
The big-spending conservative group American Crossroads and its nonprofit arm launched a new offensive Tuesday in the 2014 campaign for control of the U.S. Senate with an ad targeting North Carolina Sen. Kay Hagan and her support of the Affordable Care Act (Reston, 5/20).

The New York Times: Political Memo: Ex-Senators On Both Sides of Aisle Join Forces On Health Care
As a Republican senator, Trent Lott was among those who successfully dug in against the Clinton-era health overhaul. Tom Daschle, then the Senate Democratic leader, fought Republicans on their prescription drug plan. John B. Breaux, a centrist Democrat who led a blue-ribbon Medicare commission, often found himself at odds with both parties. Now these three retired Senate powers are combining to push an expansion of tele-medicine as a way to improve health care access and cut costs. They say the idea of using the nation's growing digital capacity to provide more health care has significant bipartisan support and could be an solution to the partisan schism over the Affordable Care Act (Hulse, 5/20).

Propublica/NPR: Following Abuses, Medicare Tightens Reins On Its Drug Program
The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year. Under the rule finalized Monday, the Centers for Medicare and Medicaid Services also will compel health providers to enroll in Medicare to order medications for patients covered by its drug program, known as Part D. This requirement closes a loophole that had allowed some practitioners to operate with little or no oversight from Medicare (Ornstein, 5/20).

The Associated Press:Obama Aide Tasked With VA Review Going To Phoenix
President Barack Obama's choice to help carry out reforms at the Veterans Affairs Department will travel to Phoenix this week to meet with staff at the local VA office as pressure mounts in Washington for an overhaul of the beleaguered agency (5/20). 

The Associated Press: IG:VA Investigations Expanded To 26 Facilities
A spokeswoman for the IG's office said 26 facilities were being investigated nationwide. Acting Inspector General Richard Griffin told a Senate committee last week that at least 10 new allegations about manipulated waiting times and other problems had surfaced since reports of problems at the Phoenix VA hospital came to light last month (5/21).

NPR: Tell Me More: Waiting At VA Hospitals: A Matter Of Life And Death
The Department of Veterans Affairs is under scrutiny after reports say it makes patients wait too long to see doctors. NPR correspondent Quil Lawrence discusses what happened and the possible fallout (5/20).

Los Angeles Times: San Francisco Supervisors Get Behind Laura's Law Mental Health Program
A dozen years after state passage of Laura's Law -; which allowed counties to set up programs mandating outpatient treatment of the severely mentally ill -; San Francisco supervisors Tuesday vowed to take the matter to voters if a board majority does not approve one by summer. The law approved in 2002 was named for Nevada County's Laura Wilcox, who was killed by a man who had been refusing treatment when he entered the county's behavioral health offices and opened fire (Romney, 5/20).

The Washington Post: District Age-In-Place Program Faces Shutdown
But the program that brought them there -; Home First, which is run by the nonprofit Seabury Resources for Aging -; says that under the proposed city budget, it might not have enough money next year to continue its 20-year-old age-in-place component, which provides regular home help to about 300 older District residents in wards 4 and 5 (Bahrampopur, 5/29).

The Associated Press: Senate Democrats Reintroduce Women's Rights Bills
A series of bills dubbed the Women's Equality Act were reintroduced Tuesday in the New York Senate after the package was derailed last year over a contentious late-term abortion proposal (5/20).