State highlights: Blue Cross Blue Shield dominant in Texas

A selection of health policy stories from Texas, New Jersey, Connecticut, Georgia, Missouri and New Mexico.

The Wall Street Journal: Federal Appeals Court Denies Challenge To Texas Abortion Law
A federal appeals court on Thursday declined to review a decision upholding a Texas law that requires abortion doctors to have admitting privileges at nearby hospitals. The decision by the Fifth U.S. Circuit Court of Appeals was a blow to Texas abortion providers, who have had had to close many Texas abortion clinics partly because they were unable to obtain admitting privileges (Koppel, 10/9).

Texas Tribune: 5^Th Circuit Refuses To Reconsider Abortion Lawsuit
The full court decided against taking up the case, letting stand the earlier ruling by a three-judge panel of the court that unanimously sided with the state on the admitting privileges provision and a requirement that doctors follow the U.S. Food and Drug Administration's protocol, rather than evidence-based protocol, for drug-induced abortions. In a brief order filed on Thursday, the 12 judges of the 15-member conservative court who voted against reconsidering the case provided no explanation for their decision. In a 62-page dissent, Judge James L. Dennis wrote that the court's decision to uphold the admitting privileges requirement "flouts" precedent set by the U.S. Supreme Court, which is now abortion providers' last hope in overturning the admitting privileges requirement (Ura, 10/9).

Philadelphia Inquirer: New Jersey Yanks Abortion Doctor's License
Abortion doctor Steven Brigham's decades of disciplinary trouble came to a head Wednesday when the New Jersey Board of Medical Examiners yanked his last remaining medical license. The board cited Brigham for doing late-term abortions that began in New Jersey and ended in Maryland, violating the laws of both states. It ordered him to pay a $140,000 penalty and as-yet-unspecified costs of prosecution, even though Brigham revealed that he is in dire financial straits from IRS liens imposed on him for not paying employee taxes. The case began more than four years ago. The prosecution found that Brigham was using a two-state scheme so he could perform late-term abortions for which his New Jersey clinics were not licensed or equipped. In addition, New Jersey requires that such risky surgeries be performed by an obstetrician-gynecologist, and Brigham, a general practitioner, was not credentialed to do them (McCullough, 10/9).

Dallas Morning News: Doctors' Group: State's Insurance Market Less Competitive
Blue Cross Blue Shield of Texas is the dominant player in 25 of 26 Texas metropolitan areas, said a report issued Thursday by the doctors' group the American Medical Association. All of Texas' 26 metro markets except three -- Temple, Waco and Houston -- are "highly concentrated" when it comes to health insurance, said the study, using an index devised by trust-busters at the U.S. Department of Justice and Federal Trade Commission to gauge marketplace competition (Garrett, 10/9).

Dallas Morning News: Flagship Baylor Hospital In Dallas At Risk Of Losing Hundreds Of Millions In Federal Funding
Baylor University Medical Center, one of the largest hospitals in Dallas, will lose hundreds of millions of dollars in federal funding if it doesn't quickly remedy deficiencies that put patients in "immediate jeopardy" of their health and safety. The Centers for Medicare & Medicaid Services sent Baylor that warning this week after inspectors found several instances of psychiatric patients walking away from the hospital's emergency department before treatment concluded (Jacobson, 10/9).

CT Mirror: How Prepared Is CT For An Outbreak?
Public health officials often say that when things are going right, their jobs are largely unnoticed. But the presence of Ebola in the U.S. has put a spotlight on public health preparedness -- and on what some experts say has been a problematic reduction in steady federal funding for public health efforts. How prepared is Connecticut (Levin Becker, 10/10)?

Georgia Health News: Poll: Georgians Like Expansion, But Not ACA Overall
A new poll finds 60 percent of Georgians disagree with the state's decision not to expand the state's Medicaid program, a key provision of the Affordable Care Act. The health reform law overall, though, fares less well in popularity. According to the survey, conducted by the Schapiro Group in August and sponsored by Healthcare Georgia Foundation, 42 percent of Georgians approve of the ACA and 46 percent disapprove (Miller, 10/9).

Bloomberg: Casino Workers May Lose Jobs If They Don't Accept Health Benefit Cuts
New Jersey casino workers threatened with the loss of their jobs if they don't accept cuts in health and pension benefits plan a protest today in front of Carl Icahn's Tropicana in Atlantic City. Members of Unite Here Local 54 are locked in a battle with management of Trump Entertainment Resorts Inc., the Atlantic City casino operator that declared bankruptcy last month. Management is seeking to shift workers from a traditional pension to a 401(k) program and end the company's health-care plan, moving employees to an Affordable Care Act-sponsored program (Palmeri, 10/10).

Kansas City Star: Missouri Opens Health Plan To Same-Sex Spouses
The health care plan for Missouri employees has opened coverage to same-sex spouses following a recent court ruling. The Missouri Consolidated Health Care Plan says it will enroll same-sex spouses of state employees and retirees who have valid marriage licenses from other states. That decision comes after a Jackson County Circuit judge ruled last week that Missouri must recognize same-sex marriages legally performed elsewhere – even though the Missouri Constitution forbids gay marriage. Attorney General Chris Koster decided not to appeal. The state health care plan covers about 96,500 people, including state employees and retirees and their spouses and children (10/9).

The New Mexican: Presbyterian Says It Was Forced To Pay State $4M
Executives for a behavioral health company that reached a multimillion-dollar settlement with the state last year over allegations of Medicaid fraud told lawmakers Wednesday that Gov. Susana Martinez's administration exerted extreme pressure on the company to settle, even though the company believed it was innocent. The company, Presbyterian Medical Services, was one of 15 behavioral health providers the state Human Services Department accused last year of overbilling Medicaid by $36 million as part of a shake-up that rocked the state's mental health system. Presbyterian spent $4 million to settle the case and remained in business. One other company also settled, but the rest were replaced by companies that the Martinez administration brought in from Arizona. Presbyterian officials told the New Mexico Legislature's Behavioral Health Subcommittee on Wednesday that heavy-handed tactics by the state Human Services Department backed the company against a wall, leaving it little choice but to pay millions of dollars that the company says it didn't owe, or face being shut down (Malone, 10/9).