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HHS rejects two MLR waiver requests

The Department of Health and Human Services on Monday delivered the news that health law waiver requests from Indiana and Louisiana had been given the thumbs down, making these two states the third and fourth to have their applications for relief denied outright.

30 Nov 2011

Texas pharmacists assail Medicaid cuts; Ariz. could restore kids' coverage

Texas pharmacists say a plan to have health maintenance organizations manage the drug needs of Medicaid enrollees will drive them out of business. Meanwhile, Arizona officials announce a plan that will leverage federal Medicaid funds and allow them to restore insurance to some children who lost it in recent budget cuts.

30 Nov 2011

State roundup: No Mass. insurance mandate referendum

If you chafe against the Massachusetts requirement that you have health insurance, sorry but you won't have a chance to vote against it - not in the next election, anyway. Backers of a ballot measure to repeal the state's insurance mandate sent out an email last week saying they had failed to gather the needed signatures.

30 Nov 2011

Viewpoints: GOP leaders, Obama share link to mandate; expensive benefits for seniors

I don't want to focus on the differences between Romney and Gingrich. I want to focus on the commonalities. Because these two men have a lot in common with not only each other but also with President Obama. Both Gingrich and Romney, for instance, supported a universal health care plan backed by an individual mandate requiring all Americans of means to purchase health-care insurance - just as Obama does.

30 Nov 2011

First Edition: November 29, 2011

Reporting for Kaiser Health News, and working in collaboration with The Washington Post, Sandra G. Boodman writes: "Propelled by the Post-9/11 GI Bill, which took effect in 2009, 2 million veterans, many of whom served in Iraq and Afghanistan, are eligible for generous benefits that can amount to a full scholarship.

29 Nov 2011

Ariz. insurer to offer ACOs for small biz; Md. plans rated by state; Calif. maternity rules

Aetna will roll out a new health-insurance plan with Banner Health that will pay the health provider based on measures of quality, efficiency and patient satisfaction.

29 Nov 2011

Some states take slower implementation pace as they wait for Supreme Court decision

Many of this slow down is related to the creation of health exchanges, as some states wondering if they should hold tight until the high court's decision is made. In other news, media outlets detail some of the specifics of the measure's preventive benefits as well as rate review processes.

28 Nov 2011

Viewpoints: What now for deficit cutters; Berwick's replacement

There's already a bipartisan group of senators, the maverick "Gang of Six," that is volunteering to produce a new compromise package. ... The Gang of Six plan won't make anybody happy.

28 Nov 2011

State roundup: Calif. hospital allegedly overbilling Medicare; Wash. hospitals ER 'boom'; Rehab scams in Florida?

Health policy news from California, Florida, Washington state, Oregon, Vermont and Texas.

28 Nov 2011

UnitedHealth buying Medicare advantage plan with chronically ill specialty

UnitedHealth Group Inc. (UNH), the largest U.S. health insurer by sales, said it will buy XLHealth Corp., a provider of managed care for chronically ill Medicare members, to strengthen a growth area likely to gain increasing support from the U.S. government as it trims costs. The purchase price was about $2 billion, according to a person familiar with the deal who asked not to be identified because the price wasn't disclosed. … The purchase of XLHealth, with 111,000 members, is the seventh since Jan. 1 involving companies that manage Medicare coverage.

24 Nov 2011

Health industry raising alarms about cuts to Medicare after super committee failure

Automatic Medicare cuts triggered by the congressional super committee's failure would hit hospitals harder than any other health industry, according to an analysis from Avalere Health. The report puts hard numbers to across-the-board cuts that stakeholders have mostly viewed in broad, general terms. But Avalere chief executive Dan Mendelson cautioned that the figures also assume the automatic cuts will actually happen - an assumption he's not ready to make.

24 Nov 2011

State roundup: Another Medi-Cal lawsuit; medical homes in Tenn.; Pa. moving forward on exchanges

Some California hospitals would take a significant and long-lasting hit from Medi-Cal reimbursement cuts recently approved by CMS, according to the California Hospital Association, which this week filed a petition in federal court to put a temporary halt to those reductions. CHA's lawsuit and injunction request are separate from the court action taken earlier this week by the California Medical Association and other provider organizations.

24 Nov 2011

Obama administration calls on Pa. insurer to lower rate hike

The Obama administration on Monday called on a Pennsylvania insurer to lower its proposed 12 percent rate increase for a small business health insurance plan. It's the first time the administration has used such new powers given it in the health reform law.

23 Nov 2011

Defending Washington's basic health plan; Questioning Wisconsin's proposed health care cuts

The Basic Health program has played an important role in extending the safety net to provide coverage to many low-income people who can't afford to purchase coverage on their own and don't qualify for Medicaid. It's much easier to retain an infrastructure than to build a new one from scratch. Simply put, leaving people without health insurance lengthens the recession and imposes costs on us all.

23 Nov 2011

State roundup: Calif. retirees to retain health benefits; Emory, MinuteClinic partner in Ga.; Free services in Md.

Health benefits for government retirees may not be eliminated if state and local governments had clearly promised workers those benefits, the California Supreme Court ruled in an Orange County case Monday. The unanimous ruling is expected to make it more difficult for state and local governments to shave costs by cutting health benefits to retirees if elected officials in previous years made it clear that those benefits would last a lifetime.

23 Nov 2011

Post-surgery death risk high among thinner people: Study

A new study has found that thinner people are at a higher risk of dying within 30 days of an operation than heavier people. The cause behind this trend is not clear.

22 Nov 2011

Essence Healthcare, CompCare sign new multi-service agreement

Comprehensive Care Corporation announced today it has signed a new multi-service agreement with Essence Healthcare to provide managed behavioral health and pharmacy management services to the Medicare Advantage population serviced by Essence Healthcare in Missouri, Washington and Illinois.

22 Nov 2011

Calif. high risk pool may overflow; seniors and long-term care costs

In California, the PCIP exceeds expected costs and small businesses are struggling. Minnesota insurers are worried about long-term care policies and a Michigan pay-to-play probe is opened.

22 Nov 2011

Supreme Court names lawyers to participate in health law case

The high court named two lawyers to argue specific elements of the health law case - both of which are related to the individual mandate. Meanwhile, Republicans step up questions on Justice Elena Kagan's level of involvement regarding the health law in her prior position when she was the Obama administration's solicitor general. In addition, Democrats continue to push on Justice Clarence Thomas' possible conflicts of interest.

22 Nov 2011

Racial disparities in emergency diverticulitis surgery

Black senior citizens who need surgery for the intestinal disorder diverticulitis are significantly more likely to die in the hospital than their equally ill white counterparts, even when each racial group carries the same health insurance, new Johns Hopkins research suggests.

22 Nov 2011

Health Insurance News and Research

HHS rejects two MLR waiver requests

Texas pharmacists assail Medicaid cuts; Ariz. could restore kids' coverage

State roundup: No Mass. insurance mandate referendum

Viewpoints: GOP leaders, Obama share link to mandate; expensive benefits for seniors

First Edition: November 29, 2011

Ariz. insurer to offer ACOs for small biz; Md. plans rated by state; Calif. maternity rules

Some states take slower implementation pace as they wait for Supreme Court decision

Viewpoints: What now for deficit cutters; Berwick's replacement

State roundup: Calif. hospital allegedly overbilling Medicare; Wash. hospitals ER 'boom'; Rehab scams in Florida?

UnitedHealth buying Medicare advantage plan with chronically ill specialty

Health industry raising alarms about cuts to Medicare after super committee failure

State roundup: Another Medi-Cal lawsuit; medical homes in Tenn.; Pa. moving forward on exchanges

Obama administration calls on Pa. insurer to lower rate hike

Defending Washington's basic health plan; Questioning Wisconsin's proposed health care cuts

State roundup: Calif. retirees to retain health benefits; Emory, MinuteClinic partner in Ga.; Free services in Md.

Post-surgery death risk high among thinner people: Study

Essence Healthcare, CompCare sign new multi-service agreement

Calif. high risk pool may overflow; seniors and long-term care costs

Supreme Court names lawyers to participate in health law case

Racial disparities in emergency diverticulitis surgery

Bringing real-time analytics to downstream bioprocess monitoring

Designing fluidic architecture for scalable diagnostic platforms

Evaluating new approaches for rare disease genomics

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