First Edition: June 23, 2014
Today's early morning highlights from the major news organizations, including news stories about healthcare.gov management changes.
Kaiser Health News: More Than 750 Hospitals Face Medicare Crackdown On Patient Injuries
Kaiser Health News staff writer Jordan Rau reports: “A quarter of the nation’s hospitals – those with the worst rates – will lose 1 percent of every Medicare payment for a year starting in October. In April, federal officials released a preliminary analysis of which hospitals would be assessed, identifying 761. When Medicare sets final penalties later this year, that list may change because the government will be looking at performance over a longer period than it used to calculate the draft penalties. Vidant, for instance, says it lowered patient injury rates over the course of 2013, and Handron praises their efforts” (Rau, 6/22). Read the story; a related article, Patient Injuries: Hospitals Most Likely To Be Penalized By Medicare; or an explanation of the methodology regarding how hospital-acquired infections are calculated.
Kaiser Health News: Drug Discount Policy For Hospitals, Clinics Under Scrutiny
Kaiser Health News staff writer Mary Agnes Carey reports: “A federal program designed to allow certain safety net hospitals and clinics to save money on drug purchases is under fire from critics who say the facilities are using that money to pad profits rather than help patients. The 340B drug pricing program lets thousands of hospitals, community health centers and family planning clinics buy outpatient prescription medications from manufacturers at an estimated 25 to 50 percent discount. Participants can then charge higher rates to insured patients and keep the additional revenue” (Carey, 6/23). Read the story, which also ran in The Washington Post.
The New York Times: Health Site Is Changing Supervision
The Obama administration hired a top executive from the UnitedHealth Group on Friday to bolster management of the federal health insurance marketplace and to prevent a repetition of the chaos that engulfed the program last fall. The executive, Andrew M. Slavitt, was in charge of work on HealthCare.gov by Optum, a unit of UnitedHealth, one of the nation’s largest insurers. Starting on July 10, the administration said, Mr. Slavitt will become the principal deputy administrator of the federal Centers for Medicare and Medicaid Services, in charge of policy and operations. He will supervise and coordinate the work of the federal insurance exchange, Medicare and Medicaid, which together provide coverage to more than 100 million people (Pear, 6/20).
The Wall Street Journal: HHS Forms New Positions To Oversee HealthCare.gov
The new head of the Department of Health and Human Services said she was creating two executive-level positions to oversee HealthCare.gov, and bringing in-house the head of the private contractor that had been tasked with fixing the site, to try to avert problems in the law's second sign-up period (Radnofsky, 6/20).
The Washington Post: HHS’s Burwell Makes Management Changes
Health and Human Services Secretary Sylvia Mathews Burwell announced a series of management changes Friday that are intended to put a single administrator in charge of the federal health insurance marketplace — something both critics and allies of the Obama administration have urged since the troubled rollout of HealthCare.gov last year (Goldstein, 6/20).
The Associated Press: New Health Chief Revamps HealthCare.gov
Health and Human Services Secretary Sylvia Burwell appointed a new high-level operations manager to closely supervise the online portal to coverage under President Barack Obama's health care law. She also announced that she's hiring a CEO and a technology leader to specifically handle all aspects of the health law's coverage expansion. The CEO would be able to take concerns directly to Burwell (Alonso-Zaldivar, 6/20).
The Washington Post: Gov. Terry McAuliffe Vetoes Portions Of Virginia Budget, Vows To Expand Medicaid
Virginia Gov. Terry McAuliffe vetoed portions of the state budget Friday and vowed to defy the legislature by expanding Medicaid without its approval, setting up a legal showdown with Republicans even as he averted a government shutdown. ... Legislators will act on McAuliffe’s vetoes Monday when they reconvene in Richmond, and the outcome is uncertain. The GOP’s majority is large enough in the House of Delegates to override a veto, but not in the Senate (Vozzella, Laris and Weiner, 6/20).
The Associated Press: Va. Governor Vows To Expand Medicaid On His Own
Democratic Gov. Terry McAuliffe vowed Friday to bypass the General Assembly and expand Medicaid eligibility for about 400,000 low-income residents on his own, a move Republican lawmakers immediately promised to fight. At a Capitol news conference, McAuliffe denounced leaders of the GOP-controlled House of Delegates, saying they are unwilling to help the state's poor (Suderman, 6/20).
The Wall Street Journal: States, Firms Spar Over Insurance-Exchange Funds
States and technology companies, including Xerox Corp. and Oracle Corp., are locked in disputes over more than $100 million allocated for Affordable Care Act insurance exchanges that had troubled rollouts. Oregon, Maryland, Massachusetts and Nevada are seeking to recoup funds or withhold money for work they say wasn't properly done. Poorly functioning exchanges in those states hampered enrollment last fall, and states blame contractors (Armour, 6/20).
Los Angeles Times: California Probes Obamacare Doctor Networks At Anthem And Blue Shield
California regulators are investigating whether Anthem Blue Cross and Blue Shield of California have violated state law in connection to patients struggling to find doctors under Obamacare. Officials at the California Department of Managed Health Care said they are looking into whether consumers were misled by inaccurate provider lists and the difficulty some patients are still having at locating a physician in narrower networks statewide (Terhune, 6/20).
The Washington Post’s Wonkblog: A guide To The Supreme Court’s Birth Control Decision
Two Junes ago, we were waiting on a major Supreme Court decision on Obamacare. It's funny how history repeats itself. Any day now, the high court is set to rule on challenges to the administration's requirement that employer health plans provide a wide range of birth control at no-out-of-pocket cost. The challenges, Sebelius v. Hobby Lobby Stores, Inc. and Conestoga Wood Specialties Corp. v. Sebelius, was were brought by two employers who argue the contraception mandate violates their religious freedom (Millman, 6/20).
USA Today: Eight Big Cases Await Supreme Court Rulings
The Supreme Court will issue decisions on three days this week as it seeks to conclude its 2013 term a week from today. … Abortion clinics. This is a First Amendment challenge to a Massachusetts law that restricted demonstrators outside abortion clinics by setting up 35-foot buffer zones. … Religious freedom. This is Obama's third major test pending before the court. His health care law mandates that most employers provide health insurance coverage for contraceptives. For-profit companies with religious objections are challenging (Wolf, 6/23).
The New York Times: Health Insurers Pressing Down On Drug Prices
Determined to slow the rapid rise in drug prices, more health plans are refusing to cover certain drugs unless the companies charge less for them. The strategy appears to be getting pharmaceutical makers to compete on price. Some big-selling products, like the respiratory medicine Advair and the diabetes drug Victoza, have suffered precipitous declines in market share because Express Scripts, the biggest pharmacy benefits manager, recently stopped paying for them for many patients (Pollack, 6/20).
The Wall Street Journal: Insider-Trade Probe Eyes Call With House Aide
About an hour before stock trading closed April 1, 2013, a lobbyist at the center of a federal insider-trading probe spoke on the phone with a senior House health-care aide. The disclosure of that conversation represents the latest twist in a long-running federal investigation into whether congressional aides or other federal officials leaked word of a change in health-care policy to traders or anyone seeking information on behalf of investors. The conversation between the lobbyist, Mark Hayes, and Brian Sutter, staff director of the House Ways and Means Committee's health-care subpanel, was revealed Friday in court filings by the Securities and Exchange Commission (Ackerman and Mullins, 6/22).
The Wall Street Journal: KPMG Expected To Announce Deal To Boost Health-Care Practice
KPMG LLP is buying Zanett Commercial Solutions, a Cincinnati-based technology-consulting firm that will help the Big Four accounting firm beef up the services it provides to health-care clients. The deal is expected to be announced Monday. Financial terms aren't being disclosed (Rapoport, 6/23).
The New York Times: Every Senior V.A. Executive Was Rated ‘Fully Successful’ Or Better Over 4 Years
All of the 470 senior executives at the Department of Veterans Affairs received annual ratings over the last four years indicating that they were “fully successful” in their jobs or even better, according to data released at a congressional hearing on Friday, despite delays in processing disability compensation claims and problems with veterans’ access to the department’s sprawling health care system. None of the department’s senior executives received either of the two lowest of five possible job ratings, “minimally satisfactory” or “unsatisfactory,” in any of the past four fiscal years (Oppel, 6/20).
The New York Times: Report Calls For Tracking Data On Stress Disorder
The Department of Defense and the Veterans Affairs Department should track their efforts to treat post-traumatic stress more carefully, to see how effective those efforts are, a government-sponsored report released Friday said (Carey, 6/20).
Los Angeles Times: Government’s PTSD Treatment For Veterans Lacking, Report Finds
Despite spending billions of dollars a year to treat military service members and veterans with post-traumatic stress disorder, the government has little evidence that its efforts are working, according to a new report commissioned by Congress (Zarembo, 6/20).
The Wall Street Journal: FBI Probes Medicare Billing At Los Angeles Clinic
The Federal Bureau of Investigation is examining a Los Angeles clinic that collected more than $2 million from Medicare in 2012 for a rarely used cardiac treatment, according to people familiar with the matter. In a page-one article earlier this month about some doctors' Medicare billings, The Wall Street Journal showed that the clinic collected more for the treatment than any provider in the nation by a large margin. Internal company documents reviewed by the Journal indicate that the clinic, which is owned by internist Ronald S. Weaver, and an affiliated lab collected about $17.5 million from Medicare between early 2006 and late 2012 (Stewart, Carreyrou and Weaver, 6/22).
The Washington Post’s Fact Checker: Four Pinocchios For Yet Another Democrat ‘Mediscare’ Ad
This ad, in the hard-fought congressional race between Rep. Nick Rahall and GOP state Sen. Evan Jenkins, is textbook example of why voters gets turned off by politics. It takes some misleading facts and then combines it with a statement taken grossly out of context. Let’s take a look (Kessler, 6/23).
Politico: Chris Christie Pushes ‘Pro-Life’ Reforms
New Jersey Gov. Chris Christie argued Friday for reforms in education and the treatment of non-violent drug offenders as part of a “pro-life” philosophy that extends beyond abortion. ... “I believe if you’re pro-life, as I am, you need to be pro-life for the whole life,” Christie said. “You can’t just afford to be pro-life when a human being is in the womb. You have to be pro-life after … Sometimes being pro-life is messy, sometimes it’s difficult. Because human beings make bad choices, we are flawed. And I doubt that there’s one person in this audience who hasn’t made a bad choice, or a bad decision in your life” (Glueck, 6/20).
The New York Times: Judge Upholds Policy Barring Unvaccinated Students During Illnesses
In a case weighing the government’s ability to require vaccination against the individual right to refuse it, a federal judge has upheld a New York City policy that bars unimmunized children from public school when another student has a vaccine-preventable disease (Mueller, 6/22).
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