KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Hospital Deductibles Are For Admitted Patients Only

KHN consumer columnist Michelle Andrews also answers reader questions about how insurance-provider networks function and parents’ responsibility to provide coverage for children who are not yet 26. (Michelle Andrews, 8/4)

Political Cartoon: 'Happy Belated?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Happy Belated?'" by Clay Bennett.

Here's today's health policy haiku:


If patients come back
Too often, hospitals get
Fined by Medicare.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Health Law Issues And Implementation

Health Law Reduces Out-Of-Pocket Expenses, But Medical Costs Can Still Be Overwhelming

One of the key aims of the health law was to protect consumers from ruinous medical debt, but some people still find it difficult to pay their health bills. Also, another health law provision created an organization to figure out which medical treatments work best to help consumers and the government save money on care.

The Center for Public Integrity: Obamacare Research Institute Plans To Spend $3.5 Billion, But Critics Question Its Worth
Business has been brisk at the Patient-Centered Outcomes Research Institute or, PCORI, as it is known. The institute was created by Congress under the Affordable Care Act to figure out what medical treatments work best — measures largely AWOL from the nation’s health care delivery system. Since 2012, PCORI has committed just over $1 billion to 591 “comparative effectiveness” contracts to find some answers, with much more spending to come. Money has thus far gone to researchers and medical schools, advocacy groups and even the insurance industry’s lobbying group, which snagged $500,000. (Schulte, 8/4)

Obama Administration Calls On States To Push Back On Big Insurance Rate Increases

The move could set up a clash with insurers that say they lost money on policies sold on the health law's marketplaces. Some are seeking premium hikes of 10 to 40 percent or more. Meanwhile, Politico reports that states with thorough rate review processes are likely to see smaller rate increases.

The New York Times: Obama Administration Urges States To Cut Health Insurers’ Requests For Big Rate Increases
Hoping to avoid another political uproar over the Affordable Care Act, the Obama administration is trying to persuade states to cut back big rate increases requested by many health insurance companies for 2016. In calling for aggressive regulation of rates, federal officials are setting up a potential clash with insurers. Some carriers said they paid out more in claims than they collected in premiums last year, so they lost money on policies sold in the new public marketplaces. After finding that new customers were sicker than expected, some health plans have sought increases of 10 percent to 40 percent or more. (Pear, 8/3)

The New Jersey Record: Affordable Care Costs May Rise In N.J.
Three insurers that sold health coverage this year to about 135,000 New Jersey residents through the federal Affordable Care Act are asking the state to approve double-digit price hikes for 2016. Price boosts also could be in the offing for the two other companies that participated in the marketplace set up by Obamacare, but there is no way to know because requests for increases under 10 percent don’t have to be disclosed in New Jersey until November. (Washburn, 8/3)

A quirk in the law may force thousands of federal retirees to pay higher Medicare premiums in 2016 than other beneficiaries -

The Washington Post: Some Federal Retirees Could Face Extra-Large Jump In Medicare Premiums
Hundreds of thousands of federal retirees could pay higher Medicare premiums in 2016 than most other enrollees will pay due to a combination of low inflation and a quirk in the law. Most of those retired under the Civil Service Retirement System are excluded from a “hold harmless” provision that keeps an individual’s Medicare Part B premium steady if his or her Social Security benefit does not rise enough to cover the increase in those premiums. (Yoder, 8/4)

Capitol Hill Watch

Senate Push To Cut Off Planned Parenthood's Federal Funds Blocked

Democrats are able to stall a bill that would halt funding for the women's health-care organization. Republicans pledge to continue the fight, which could extend into the budget debate this fall.

The Washington Post: Republican Effort To Strip Planned Parenthood Funding Stalls In Senate
The 53-46 procedural vote fell short of the 60 ayes needed to proceed with a bill that would immediately stop funding for the beleaguered women’s health-care provider. But the willingness of GOP leaders to bring the measure to a vote showed the new political importance of a social issue that had been sidelined just a month ago and heralded higher-stakes showdowns to come. (DeBonis, 8/3)

Politico: GOP: Planned Parenthood Fight To Go On
Republicans are divided over whether they should use this fall’s government funding bill to attack Planned Parenthood — and risk a high-stakes shutdown fight — after Senate Democrats blocked a standalone bill to defund the organization on Monday evening. (Everett and Bresnahan, 8/3)

The Associated Press: More Fights Ahead On Planned Parenthood After Senate Vote
In the aftermath of the Senate's derailing of Republican legislation halting federal dollars for Planned Parenthood, one thing seems clear: Many on both sides think they can ring up gains from the battle. Within minutes of Monday's Senate vote, abortion-rights groups were releasing TV ads attacking GOP supporters of the measure for stomping on women's health care needs. Conservatives were accusing Democrats of voting to protect taxpayer funds for an organization whose campaign contributions tilt lopsidedly to Democratic candidates. (Fram, 8/3)

Reuters: U.S. Senate Blocks Planned Parenthood Defunding Measure
Republican legislation to cut off federal funding for Planned Parenthood failed to gather enough support in the U.S. Senate on Monday, halting at least for now moves to punish the women's health group for its role in gathering fetal tissue from abortions for medical research. Senate Democrats succeeded in stopping the bill on a procedural vote. Sixty votes were needed to advance it in the 100-person chamber. It received 53 votes, with 46 senators opposing it. (Cornwell and Wilts, 8/3)

Fox News: Senate Fails To Advance Planned Parenthood Defund Effort
The Senate failed Monday to advance a Republican-led measure to halt federal aid to Planned Parenthood, but leaders of the GOP-controlled chamber appear ready to continue the fight, galvanized by a series of unsettling videos about the group. The vote to bring debate on the bill was 53 against to 46 in favor. (8/3)

CNN: Senate Vote To Defund Planned Parenthood Fails
The fight over funding for Planned Parenthood shifts to a must-pass government funding measure this fall after a procedural vote in the Senate on legislation that would have barred all federal funds for the group failed on Monday. (Walsh, 8/4)

The New York Times: Planned Parenthood Leader Defends Group As Senate Blocks Bill To End Its Funding
As president of Planned Parenthood, Cecile Richards tries to keep perspective while the group faces one of its biggest political crises. After all, she said on Monday, the founder, Margaret Sanger, was arrested 99 years ago for pamphleteering about birth control. “There hasn’t been a moment in our history, when we were pushing forward on reproductive health care rights and access for women, that someone wasn’t after us,” Ms. Richards said in an interview. (Calmes, 8/3)


Federal Officials Tell State Inspectors To Watch For Nursing Home Errors With Blood Thinners

The directive follows reports of hospitalizations and deaths. Also in the news are accounts of Medicare penalties for high hospital readmission rates, changes in Medicare coverage for men dealing with impotence and increases in new federal employees' long-term-care premiums.

ProPublica: Feds: More Scrutiny Needed Of Nursing Home Errors Involving Blood Thinner
The federal government is asking health inspectors nationwide to be on the lookout for errors by nursing homes in managing the blood thinner Coumadin, including those that lead to patient hospitalizations and deaths. In a memo sent last month to state health departments, the Centers for Medicare and Medicaid Services cited a report by ProPublica and The Washington Post that focused on the harm caused by homes’ failure to manage the drug. (Ornstein, 8/3)

Kaiser Health News: Half Of Nation’s Hospitals Fail Again To Escape Medicare’s Readmission Penalties
Once again, the majority of the nation’s hospitals are being penalized by Medicare for having patients frequently return within a month of discharge — this time losing a combined $420 million, government records show. In the fourth year of federal readmission penalties, 2,592 hospitals will receive lower payments for every Medicare patient that stays in the hospital — readmitted or not — starting in October. (Rau, 8/3)

The New York Times: ‘Sex Never Dies,’ But A Medicare Option For Older Men Does
On July 1, however, Medicare stopped covering vacuum erection devices, the result of legislation Congress passed in December. Since 2006, Congress has banned Medicare Part D coverage of medications for erectile dysfunction, too, after Representative Steve King, Republican of Iowa, scoffed at “lifestyle drugs” and said taxpayers wouldn’t foot the tab for “Grandpa’s Viagra.” That leaves millions of men with no Medicare option for what we used to call impotence, except far more expensive and invasive penile implant surgery. (Span, 8/4)

The Washington Post: Long-Term Care Insurance Rates Go Up For New Federal Enrollees — With No Warning
Premiums in the long-term care insurance program for federal and military personnel, retirees and certain family members have increased, with no prior notice, for those newly purchasing coverage. The Office of Personnel Management has said that rates rose as of Aug. 1 for new enrollees in the Federal Long Term Care Insurance Program, which offers in-home and nursing home care benefits for those with certain physical or mental incapacities. (Yoder, 8/3)


New Cancer Drug Cocktails Expected To Test Pricing Ceilings

Also, as concerns over skyrocketing prescription drug costs continue, Marketplace reports on the powers Medicare might have to negotiate prices.

Reuters: New Cocktails To Test Limits Of Cancer Drug Pricing
New cancer drug cocktails set to reach the market in the next few years will test the limits of premium pricing for life-saving medicines, forcing company executives to consider fresh market strategies. The growing reluctance of governments and private insurers to fund very expensive drugs - even remarkably effective ones - points to a showdown as manufacturers mix and match therapies that harness the immune system to fight tumors. (Hirschler, 8/3)

Marketplace: What If Medicare Could Bargain Over Drug Prices?
The government health care programs Medicare and Medicaid turned 50 this year. But, more recently, back in 2003, the feds expanded Medicare to include a prescription drug benefit. The law establishing that benefit specifically prevented Medicare from directly negotiating the prices for those drugs, which some say translates to higher costs for the program. The Obama administration and some members of Congress want to change that, but— not surprisingly, drug companies say things are just fine as they are. (Adams, 8/3)

Deductibles and surprise billings are two areas of consumer costs KHN's columnist tackles -

First 3-D Prescription Drug OK'd By FDA

The Food and Drug Administration approved the first three-dimensional printed drug -- a medication to treat seizures. Elsewhere, statistics on medical scope safety are called "outdated," rules on e-cigarettes lag and medical marijuana legislation stalls.

The Associated Press: FDA Clears First 3-D Printed Prescription Drug
The Food and Drug Administration has approved the first prescription drug made through 3-D printing: a dissolvable tablet that treats seizures. Aprecia Pharmaceuticals said Monday the FDA approved its drug Spritam for adults and children who suffer from certain types of seizures caused by epilepsy. The tablet is manufactured in a layered process via 3-D printing and dissolves when taken with liquid. (8/3)

CQ Healthbeat: Wait Continues For FDA Rule On E-Cigarettes
A proposal to give the Food and Drug Administration authority to police electronic cigarettes and other unregulated tobacco products remains in limbo more than a year after it was first released and a month after the agency estimated it would be published. Health and Human Services Secretary Sylvia Mathews Burwell told a Senate panel in April that the administration hoped to finalize the so-called deeming rule this summer and there is still time to meet that goal. She dialed back the tone during a House hearing last week, saying she hopes the rule will emerge “as quickly as possible.” (Attias, 8/3)

CQ Healthbeat: Pot Bills Stalled Despite Increased Support
Even though Senate support for a medical marijuana bill is building, it’s not getting the backing it needs to advance. Two influential Democratic senators, Charles E. Schumer of New York and Barbara A. Mikulski of Maryland, announced their support for the bill that would reschedule marijuana and let states set medical marijuana policy. But it needs more Republicans. (Fleming, 8/3)

Community Health Will Spin Off 38 Hospitals In Rural And Suburban Communities

The new publicly traded hospital company, Quorum Health Corp, created by the spinoff, aims to tap into the expanded markets driven by greater Medicaid coverage.

Forbes: New Hospital Company Poised To Tap ACA's Medicaid Expansion
As more states opt to expand Medicaid under the Affordable Care Act, a new investor-owned hospital company is poised to tap an emerging market of Americans in rural areas and smaller communities gaining health coverage. Community Health Systems (CYH) said Monday it will spin off to its shareholders a group of 38 smaller hospitals, primarily in rural and suburban markets with populations of “no more than 50,000.” In 84 percent of these markets, Community said the hospital is the “sole provider of acute hospital services.” Only 14 of these hospitals are located in states that have not expanded Medicaid coverage for poor Americans such as Alabama, Georgia, Texas, Tennessee and Wyoming. (Japsen, 8/4)

Reuters: Community Health To Spin Off 38 Hospitals
Community Health Systems Inc, the No. 2 U.S. publicly traded hospital operator, said on Monday it plans to spin off 38 hospitals and a consulting business into a separate company so that it can focus on larger markets. Quorum Health Corp, the new publicly traded company, will include hospitals primarily in cities and counties with populations under 50,000, Community Health said. (Kelly, 8/3)

The Wall Street Journal: Community Health Plans Spinoff, Reports Jump In Earnings
Community Health Systems Inc. raised its earnings guidance for the year as its second-quarter profit more than doubled thanks to its acquisition of Health Management Associates Inc. Separately, the hospital operator also announced plans to spin off a group of 38 hospitals and Quorum Health Resources LLC, its hospital management and consulting business. (Jaramillo, 8/3)

In other marketplace news, Aetna topped profit estimates while Tenet Healthcare reported Q2 losses -

Bloomberg: Aetna Beats Profit Estimates On Government Insurance Growth
Aetna Inc., the No. 3 U.S. health insurer by enrollment, raised its full-year earnings forecast after reporting profit that topped analysts’ estimates as it added more members in government insurance programs. Aetna agreed last month to buy Humana Inc. to expand in Medicare, while Anthem Inc. announced a deal for Cigna Corp. The health-insurance industry is consolidating as it absorbs new customers and contends with added regulation from President Barack Obama’s Patient Protection and Affordable Care Act. (Tracer, 8/3)

The Wall Street Journal: Tenet Healthcare Loss Widens
Tenet Healthcare Corp. said its second-quarter loss widened as the hospital operator was hit by $136 million in write-downs, restructuring charges, acquisition-related costs and other one-time items. However, excluding such items, per-share earnings beat expectations, while revenue topped Wall Street views. The company’s guidance for the current quarter also was above analysts’ predictions. (Stynes, 8/3)

Campaign 2016

Health Law, Planned Parenthood Get Airtime At Republican Presidential Forum In N.H.

Fourteen of the candidates vying for the 2016 Republican nomination participated in the event. Another debate is planned for this Thursday. Meanwhile, one of the GOP 2016 hopefuls, La. Gov. Bobby Jindal, is terminating his state's Medicaid contract with Planned Parenthood.

Los Angeles Times: Crowded GOP Presidential Field Races Through Campaign Forum
A Republican presidential forum on Monday felt more like speed dating than a typical political event. Candidates faced rapid-fire questions and spent a few minutes in the hot seat before being rotated offstage. ... The 14 who showed up offered near unanimous agreement on talking points popular with Republican voters: Obamacare must be repealed. Planned Parenthood must be cut off from federal funds. President Obama’s proposed agreement with Iran to curb that nation’s ability to acquire a nuclear weapon jeopardizes Americans. (Mehta, 8/3)

Bloomberg: Louisiana’s Jindal Cuts Planned Parenthood Medicaid Funds
Jindal said he was terminating the contract because of videos circulated by an anti-abortion group. ... Jindal said the state is also concerned that chapters could be recommending abortions to clients in violation of Louisiana law. ... Jindal is one of four sitting governors vying for the Republican nomination. Although Wisconsin’s Scott Walker called for a state-by-state campaign to defund Planned Parenthood last month, Jindal is the first to terminate its Medicaid contract, giving the organization a 30-day notice of its cancellation. (Newkirk and Tracer, 8/3)

New Orleans Times-Picayune: Louisiana To Terminate Medicaid Contract With Planned Parenthood
The Louisiana Department of Health and Hospitals (DHH) is terminating its Medicaid provider contract with Planned Parenthood, Gov. Bobby Jindal's office announced Monday (Aug. 3). "In recent weeks, multiple videos have surfaced showing Planned Parenthood Federation of America senior personnel and other employees describing how they actively engage in illegal partial birth abortion procedures and conduct these abortions in a manner that leaves body parts intact so that they can later be sold on the open market," the announcement from Jindal's office said. "Since these videos have surfaced, Governor Jindal has directed DHH to investigate Planned Parenthood's activities in Louisiana and also sent a letter to both the Louisiana Inspector General and the F.B.I. asking them to assist in the investigation." (Quinlan, 8/3)

On the Democratic side of the campaign, Hillary Clinton takes a Planned Parenthood stand -

Politico: Hillary Clinton Comes Out In Support Of Planned Parenthood
Hillary Clinton is making her position on Planned Parenthood very clear: She is in full support of the organization. “I’m proud to stand with Planned Parenthood, I’ll never stop fighting to protect the ability and right of every woman in this country to make her own health decisions,” Clinton said in a video released Monday. (Collins, 8/3)

Public Health And Education

Many Women Not Getting Effective Treatment For Ovarian Cancer, Study Finds

Despite efforts by federal officials to alert physicians, fewer than half of women with the disease are getting special abdominal chemotherapy, according to the research. In other women's health news, outlets look at heart disease treatment and wellness programs.

The New York Times: Effective Ovarian Cancer Treatment Is Underused, Study Finds
In 2006, the National Cancer Institute took the rare step of issuing a “clinical announcement,” a special alert it holds in reserve for advances so important that they should change medical practice. In this case, the subject was ovarian cancer. A major study had just proved that pumping chemotherapy directly into the abdomen, along with the usual intravenous method, could add 16 months or more to women’s lives. Cancer experts agreed that medical practice should change — immediately. Nearly a decade later, doctors report that fewer than half of ovarian cancer patients at American hospitals are receiving the abdominal treatment. (Grady, 8/3)

Reuters: Women, Blacks Lose More Years Of Life After Heart Attack
Heart attacks seem to have a bigger effect on life expectancy for women and African Americans than for white men, a new study shows. Women and men live equally long after heart attack -- but because women in general tend to live longer than men, the women should be living longer after a heart attack, too, according to lead author Dr. Emily M. Bucholz of the Yale School of Medicine and Yale School of Public Health in New Haven, Connecticut. (Doyle, 8/3)

The Detroit Free Press: Black Women: Heart Disease Your No. 1 Killer, Says Cardiologist
She sees it routinely: Women — African-Americans especially — who are so busy taking care of others even as they have no idea it is their own hearts that pose their own greatest risk. Heart disease [affects] about 1 in 2 African-American women 20 years and older, and it kills about 50,000 African-American women each year, according to the American Heart Association. But just 36% of African-American women know their hearts are their biggest killer, said Dr. Kimberli Taylor Clark, a Texas cardiologist who will speak in Detroit Tuesday. (Erb, 8/3)

Reuters: American Heart Association Calls For Focus On Social Factors
The American Heart Association said today that more attention needs to be paid to the social factors that influence heart health, such as race, education, and address. Those factors may be partly responsible for the increase in rates of cardiovascular disease expected over the coming decades, according to a statement in the journal Circulation. (Seaman, 8/3)

Universal Autism Screening Not Recommended By Task Force

The U.S. Preventive Services Task Force declined to support testing all young children for autism, saying there is not enough evidence to support such a guideline. The panel's decision is a departure from the guidance issued by other medical and advocacy groups.

The New York Times: Expert Panel Withholds Support For Early Autism Screening
For years experts have urged physicians to screen infants and toddlers for autism in order to begin treatment as early as possible. But now an influential panel of experts has concluded there is not enough evidence to recommend universal autism screening of young children. The findings, from a draft proposal by the U.S. Preventive Services Task Force published Monday, are already causing consternation among specialists who work with autistic children. (Caryn Rabin, 8/3)

Reuters: U.S. Panel: More Research Needed To Justify Universal Autism Screening
An influential U.S. health panel said on Monday it needs more evidence to support universal screening for autism in young children who show no developmental problems, in a departure from recommendations issued by other medical groups. The proposed guideline, from the U.S. Preventive Services Task Force, an independent, government-backed panel that recommends whether to adopt screening tests for various conditions, applies to children aged 18 to 30 months who show no signs of an autism spectrum disorder (ASD). (Seaman, 8/3)

CQ Healthbeat: Task Force Declines To Endorse Autism Screening In Young Children
An influential federal health panel said Monday there’s not enough scientific evidence to recommend for or against widespread screening for autism in children who don’t show signs of this developmental disorder. With the draft recommendation, the United States Preventive Services Task Force again finds itself at odds with highly organized advocacy groups. The panel also is in the midst of revising its recommendation on mammography, which call for widespread screening only in women ages 50 to 74. (Young, 8/3)

In other children's health developments, a study links extreme picky eating to future anxiety or depression. And researchers say that kids who suffer head injuries are more likely to develop attention issues -

The Wall Street Journal: What Picky Eating Might Mean For Children Later
Children’s picky eating may not be as harmless as is commonly believed. A new study found that moderate and severe cases of selective eating were associated with elevated symptoms of anxiety and depression in later years. Moderate cases also were associated with symptoms of separation anxiety and attention deficit hyperactivity disorder, or ADHD. (Reddy, 8/3)

NPR: Could Your Child's Picky Eating Be A Sign Of Depression?
One of the frequent trials of parenthood is dealing with a picky eater. About 20 percent of children ages 2 to 6 have such a narrow idea of what they want to eat that it can make mealtime a battleground. A study published Monday in the journal Pediatrics shows that, in extreme cases, picky eating can be associated with deeper trouble, such as depression or social anxiety. (Harris, 8/3)

Successful Workers Who Have Mental Health Conditions Offer Advice To Other Employees

The group, called the Stability Network, aims to help people cope with the difficult task of telling co-workers or bosses about their mental illness. Elsewhere, a look at solitary confinement for people with mental illnesses, and Hawaii struggles with how to deal with an increasing prison population that has mental illness.

The New York Times: Solitary Confinement: Punished For Life
Dr. Haney’s interviews offer the first systematic look at inmates isolated from normal human contact for much of their adult lives and the profound losses that such confinement appears to produce. The interviews, conducted over the last two years as part of a lawsuit over prolonged solitary confinement at Pelican Bay, have not yet been written up as a formal study or reviewed by other researchers. But Dr. Haney’s work provides a vivid portrait of men so severely isolated that, to use Dr. Haney’s term, they have undergone a “social death.” (Goode, 8/3)

The Honolulu Star Advertiser: Mental Illness Appears Criminal
Half of all the people arrested in Honolulu suffer from serious mental illness, severe substance abuse or both — a share that has doubled since 2010. The number of psychologically troubled people placed in handcuffs is climbing despite a successful effort to funnel people who need mental health treatment toward hospitals and other care rather than arresting and locking them up. (Essoyan, 8/3)

Veterans' Health Care

VA To Check Disability Status Of Marines Exposed To Tainted Water

For more than 30 years, some developed cancers after exposure to chemicals at Camp Lejeune. In other military health news, the Navy looks at its fitness assessment tests.

The Associated Press: VA To Review Status Of Marines Affected By Tainted Water
The Department of Veterans Affairs announced Monday it will begin reviewing the disability status of Marines who developed cancers and other conditions due to exposure to chemicals that contaminated the water at Camp Lejeune (luh-ZHERN') for more than 30 years. A statement from the VA said the move is in addition to the health care it provides for more than a dozen conditions to eligible veterans who were stationed at the North Carolina base for at least 30 days between August 1953 and December 1987. (8/3)

Navy Times: Navy Changing Body-Fat Rules, Fitness Assessment
The Navy is shaking up its body composition assessment, increasing body fat limits for sailors, moving away from career-ending punishments for failures and taking a deeper look at how it measures health in general. The shifts are a new direction in the fitness program designed to move away from a punitive system to one that encourages year-round fitness, with a focus on helping those struggling to stay fit. (Faram and Myers, 8/3)

State Watch

State Highlights: Fla. Governor Orders Hospital Audits; Ind. Medicare Software Firm Hacked; Ariz. Medicaid Plan Includes Lifetime Limits

Health care stories are reported from Florida, Indiana, New Mexico, California, Arizona, Kansas, Texas, Arkansas and Michigan.

The Associated Press: Scott Wants Examination Of Medicaid Insurance, Hospital Contracts’ Rates
Gov. Rick Scott is targeting health insurers participating in [Florida's] Medicaid program, accusing them of negotiating hospital rates that are too high, which he says is the reason the new managed care program is not generating enough savings. Scott instructed state health officials in a letter Monday to examine hospital contracts, warning that those with rates higher than 120 percent of the Medicaid cap will be subject to an “immediate corrective action plan” that could nullify the contracts and kick insurers out of the Medicaid program. (Kennedy, 8/3)

Tampa Bay Times: Gov. Scott Instructs AHCA Secretary To Audit Hospitals, Insurance Plans
After demanding that hospitals and insurance companies prove their Medicaid contracts are below state-mandated limits, Gov. Rick Scott is dispatching Agency for Health Care Administration to audit those that did not send the state information by an Aug. 1 deadline. The audit announcement came in a letter Scott sent to AHCA Secretary Liz Dudek Monday. Hospitals and insurance plans whose contracts AHCA auditors find are above a cap in state law of 120 percent of the Medicaid rate limit could be cancelled by the agency, Scott wrote. Those hospitals could also become ineligible for taxpayer funding under the Low Income Pool. (Austen, 8/3)

The Associated Press: Indiana Medicare Software Company Hack Affected 3.9M People
Indiana medical software company has reported the private information of 3.9 million people nationwide was exposed when its networks were hacked earlier this year, the U.S. Department of Health and Human Services said Monday. Medical Informatics Engineering reported the number of people affected by the hack to the federal agency on July 23. (8/3)

The Arizona Republic: Gov. Doug Ducey’s Medicaid Plan Calls For Lifetime Limits, Copays
Gov. Doug Ducey’s plan to modernize Arizona’s Medicaid program has numerous details yet to be worked out. And much of it hinges on approval from the federal Centers for Medicare and Medicaid Services. Its intent is clear: Require the estimated 350,000 able-bodied adults on AHCCCS to take more responsibility for their health coverage through copays and incentives to find work. The idea is to promote healthy, employable people and move them out of the Arizona Health Care Cost Containment System before a five-year lifetime limit would cut them off for good. (Pitzl, 8/3)

Kaiser Health News: Competition Improves Obamacare Choices In Rural Northern California
People who live in rural Northern California will see more choice and competition in the health insurance marketplace next year, giving consumers a better chance of finding a plan — and a doctor — that can meet their needs. The changes, announced last week by the state’s Affordable Care Act marketplace Covered California, will now allow some consumers to cross state lines for care. That means Californians living near the Oregon or Nevada borders can get subsidies to buy plans that pay for care in those states, something that previously was not allowed. (Bartolone, 8/4)

Albuquerque Journal: ‘Amazing’ Drug To Cost NM Medicaid $140M
A revolutionary but expensive treatment for hepatitis C will cost New Mexico’s Medicaid program an estimated $140 million this year, even though the drugs are available only to the sickest patients who number fewer than 1,800, according to a recent report by the state Legislative Finance Committee. The report offers the first public data about costs New Mexico faces for new “near-perfect” treatments for hepatitis C, a deadly viral disease that attacks the liver. The high cost of the drugs – up to $93,000 for a single course of treatment – has led New Mexico and most other states to limit Medicaid coverage to patients diagnosed with advanced liver disease. (Uyttebrouck, 8/3)

The Kansas Health Institute News Service: Deaf Kansans Request Medicaid Changes
It’s common knowledge that a child’s first years are critical for language development. But what if that child is deaf and has parents who don’t know sign language? Chriz Dally, a board member of the Kansas Association of the Deaf, posed that scenario last month at a meeting of state officials and members of the National Council on Disability. Between 90 percent and 95 percent of deaf children have hearing parents with no experience with deaf people or American Sign Language (ASL), Dally said. That sets back deaf children academically, compared to their hearing peers, by the time they arrive in school. (Marso, 8/3)

The Texas Tribune: Lawmakers Ditch $200 Fee For Lawyers, Doctors, Brokers
For tens of thousands of lawyers, doctors and engineers, a new Texas law is going to mean more money in their pockets. Fourteen years after the Legislature first tacked on a $200 annual licensing fee for some occupations, lawmakers passed a law this year repealing the so-called professionals tax. Over the years, as the state's business tax structure had changed, the fee had morphed into a form of double taxation, critics argued. (Batheja and Lin, 8/3)

The Miami Herald: Miami Mental Health Director's Medicare Conviction Thrown Out
An imprisoned woman who worked for a Miami-based mental health clinic at the center of a massive Medicare racket will likely be freed after a federal appeals court Monday threw out her conspiracy conviction. Vanja Abreu, PhD, former program director of American Therapeutic Corp. in Miami, was convicted with others in 2012 of defrauding the taxpayer-funded federal program by submitting false claims for psychological treatment that patients either didn’t need or receive. (Weaver, 8/3)

The Associated Press: Arkansas Governor Names New Senior Health Policy Adviser
Arkansas Gov. Asa Hutchinson has hired a staffer for fellow Republican U.S. Sen. Tom Cotton as his new senior health policy adviser. Hutchinson's office on Monday announced he had hired John Martin to the post, starting Sept. 8. Martin is currently Cotton's deputy legislative director, which he has advised the freshman senator on domestic policy issues such as health care and agriculture. Martin previously worked on former Health and Human Services Secretary Tommy Thompson's unsuccessful U.S. Senate bid in Wisconsin and also has worked as a consultant for Deloitte. (8/3)

The Detroit Free Press: Urgent Care Without The Wait Comes To Downtown Detroit
As the heartbeat of Detroit's downtown grows stronger, an urgent care clinic opens today to serve the residents and workers who stream through its arteries each work week with laptops and lattes. Many of them have grown up on smartphones and expect immediate service for their health needs, said Frederika Robinson, a nurse practitioner who will help lead medical care at the new Henry Ford Health System clinic, 1515 Woodward. Patients can reserve a spot that day online, avoiding the need for a waiting room — a service much like a restaurant's call-ahead seating. Texts remind patients of their visits. (Erb, 8/3)

Editorials And Opinions

Viewpoints: Planned Parenthood Debate; Rising State Health Budgets; Christie's Plans For Medicaid

A selection of opinions on health care from around the country.

The New York Times: The Failed Attack On Planned Parenthood
Senate Republicans’ latest ploy to choke off all federal funding to Planned Parenthood failed, as expected, on Monday afternoon in a 53-46 procedural vote. The measure fell short of the 60 votes needed to move it forward. It shouldn’t have been anywhere near that close. But the perennial conservative effort to cripple the nation’s largest family-planning organization got a boost last month from a string of grainy, edited undercover videos released by an anti-abortion group, and purporting to show Planned Parenthood officials discussing the illegal sale of fetal tissue. (Jesse Wegman, 8/3)

Forbes: Now 60% Chance Of A Government Shutdown
But the biggest change from last week in the odds of a government shutdown is because of the emergence of the one big thing that has been missing so far from the appropriations debate: a highly emotional, politically toxic and take-no-prisoners issue. In the past that line-in-the-sand issue has been budget-related: the national debt, the federal deficit and taxes. This time it’s the new GOP push to defund Planned Parenthood – a highly emotional social issue that has quickly become a political litmus test for Republicans. Republicans are vowing with ever-increasing vehemence to vote against legislation – including a CR — that includes funding for Planned Parenthood and that means that a continuing resolution that simply extends existing funding at current levels won’t be acceptable to the GOP majorities in the House and Senate. (Stan Collender, 8/3)

Bloomberg: Abortion Politics Could Shut Down Government
[S]ome conservatives outside Congress are demanding a government shutdown as a way to force Democrats to agree to defund Planned Parenthood. There's a good chance that these activists, led by Erick Erickson, can get many Republican presidential candidates, both inside and outside of Congress, to join them. They haven't been particularly clear on the mechanism this would take, but presumably they would insist that any temporary funding measure to keep the government running beyond Sept. 30 include a provision ending all funding to Planned Parenthood. ... Never mind that government shutdowns invariably end badly for Congress. It's possible the Tea Party radicals just reject that reality. (Jonathan Bernstein, 8/3)

The New York Times' The Upshot: Don’t Blame Medicaid For Rise In Health Care Spending
Health care spending growth has moderated in recent years, but it’s still putting tremendous strain on state and local governments. A recent analysis by The Pew Charitable Trusts revealed that it consumed 31 percent of state and local government revenue in 2013, nearly doubling from 1987. But Medicaid — the state-based health care program for low-income Americans — is not the chief culprit. Health care benefits for public employees and retirees, not Medicaid, account for a majority of the growth in state and local health care spending. (Austin Frakt, 8/3)

Newark Star Ledger: Christie's Medicaid Proposal Would Cost NJ — Big Time
More than two years ago, when Chris Christie finally decided to accept federal money to expand Medicaid in New Jersey, he said, "I will make all my judgments as governor based on what is best for New Jerseyans." My, how times have changed. Christie the presidential candidate has since pitched a draconian plan to cut federal Medicaid spending nationwide, which would land like a grenade on our state budget, and utterly devastate our health care safety net for the one in five New Jerseyans on Medicaid who are poor, elderly and disabled. (8/3)

Billings Gazette: When Will Montanans Get HELP?
Montana’s plan for covering all very low income adults with Medicaid is a mixture of health care expansion and political compromise. To enact a law that makes 70,000 Montanans eligible for Medicaid, health coverage proponents had to agree to charge monthly premiums to impoverished people and to contract with a private company to administer the coverage and premium collections. The state must convince federal health authorities that the usual provisions of federal law should be set aside to let Montana demonstrate how its plan works. The Centers for Medicare and Medicaid Services should grant Montana the waivers. The agency has already allowed similar exceptions for five other states. (8/2)

Bangor (Maine) Daily News: Time Is Now For Action On Addiction, Medicaid Expansion In Maine
Gov. Paul LePage’s five vetoes of bipartisan Medicaid expansion bills have shortchanged the recovery community of [a detox center coupled with either an inpatient or outpatient rehabilitation program] ... in the Bangor area. This governor, however, has seen fit to extend legislation expanding law enforcement and prosecution at the expense of treatment. This mentality of incarceration as a means of curbing drug use has utterly failed. (Arthur Adoff, 8/2)

The Hill: Medicare And Medicaid: Achieving Health Equity In America
In tandem, Medicare and Medicaid — with important expansions in coverage through subsequent legislative efforts such as the Affordable Care Act — have made great strides in promoting health equity in America. Yet while many states have expanded Medicaid through the ACA, the states that have elected not to expand coverage continue to exacerbate health disparities, disproportionately affecting poor African-Americans. Currently, there are 2.9 million African-Americans nationwide without coverage as a result. Medicaid expansion would ensure coverage to six in 10 uninsured African-Americans. (Rep. Robin Kelly, D-Ill., 8/3)

The Philadelphia Tribune: Medicare And Physicians, 50 Years Together: It's Complicated
Fifty years ago last week, President Lyndon Baines Johnson signed Medicare (and Medicaid) into law. Medicare’s relationship with physicians since then can best be described as a complicated one. First, recall that Medicare became law notwithstanding the American Medical Association’s fierce opposition to it. Three years prior to its enactment, AMA President Ed Annis warned that "We doctors fear that the American public is in danger of being blitzed, brainwashed, and bandwagoned" by the Kennedy administration’s proposal to provide compulsory health insurance to the elderly. The AMA continued to fight tooth-and-nail against Medicare, even after the Johnson administration took up the cause following President Kennedy’s assassination. (Bob Doherty, 8/3)