KHN Morning Briefing

Summaries of health policy coverage from major news organizations

La. Drops Plans For Quickly Setting Up New Health Plan For Poor; National Health Insurer Accused On Providing “Junk Insurance” In Calif.

The (Baton Rouge) Advocate: "In the face of mounting opposition, the Jindal administration dropped plans late Wednesday to expedite approval of rules needed to implement a new health-care delivery system for the poor. … The move is a setback for administration plans to start allowing private insurance companies to enroll Medicaid patients. The program - called 'coordinated care networks' - would change the way services are delivered in the government health-care program for the poor and uninsured" (Shuler, 10/21).

San Diego Union Tribune: "For the 2.5 million Californians who buy their own health insurance, the 6.6 million who are uninsured and the million-plus who get their insurance through their jobs at the state's smallest businesses, finding a good health plan is a daunting task. … Last month, California became the first state to pass legislation establishing a health insurance exchange as part of federal health care reform, which requires most Americans to have coverage by 2014 or pay a fine. The California Health Benefit Exchange will provide a place for small businesses and people without employer-based insurance to join together to buy health insurance at lower rates, aided by federal subsidies to low- and middle-income consumers" (Lavelle, 10/20).

Kaiser Health News: "A sweeping agreement this week between the Justice Department and the state of Georgia highlights an aggressive new campaign by the Obama administration to ensure that people with mental illness and developmental disabilities can get services in their communities and not be forced to live in institutions. The settlement, announced Tuesday, will be used 'as a template for our enforcement efforts across the country,' said Thomas Perez, assistant attorney general for the Civil Rights Division at Justice, in a statement announcing the accord. The agreement ends three years of legal wrangling over Georgia's mental health system" (Miller, 10/21).

The Los Angeles Times: "A national health insurer and its majority owners, Wall Street powerhouses Goldman Sachs Group Inc. and Blackstone Group, were accused in a lawsuit Wednesday of defrauding their California customers with 'junk insurance' that provided little or no protection. The suit filed by the Los Angeles city attorney's office alleges that HealthMarkets Inc. and its affiliates trained sales agents to deceive customers - mostly self-employed individuals and small businesses - into buying confusing policies riddled with exclusions and limitations. ... The lawsuit is the latest trouble for the Texas company, which conducts business in 41 states. In the last two years, regulators from California and more than 30 other states have fined HealthMarkets or its affiliates nearly $40 million over alleged deceptive business practices" (Helfand, 10/21).

The Asheville (N.C.) Citizen-Times: "Medicaid netted more than $3.5 million from recent agreements with five pharmaceutical manufacturers to settle kickback cases, in keeping with Gov. Bev Perdue's crackdown on Medicaid fraud, waste and abuse. North Carolina's public schools received a share of two of the settlements negotiated by the state Department of Justice against AstraZeneca, Omnicare and three other pharmaceutical giants. Kickback violations alleged by investigators ranged from using gifts as an inducement for prescribing certain drugs, to encouraging 'off-label' prescribing of drugs not approved to treat various conditions" (10/20).

Dayton (Ohio) Daily News: "If the region's economic gloom has a silver lining, CareSource may very well be it. The nonprofit Medicaid provider has added about 100 jobs so far this year, in part to keep pace with record Medicaid enrollment driven by job losses and the poor economy. And with Medicaid rolls projected to grow again next year and the health care overhaul further expanding the federal/state health insurance program for the poor and disabled, CareSource's growth spurt appears to be just beginning. CareSource expects to add 200 jobs in 2011. While job numbers are expected to plateau in 2012, another 150 jobs are expected in 2013, and 240 more in 2014" (Sutherly, 10/21).

The Hartford Courant: "A group of cities and towns including Hartford and Waterbury, along with state employee agencies, have asked Hartford Hospital to back off from its demand for double-digit rate increases for Anthem Blue Cross and Blue Shield of Connecticut, as the standoff between the region's largest hospital and the state's largest health insurer nears a Nov. 1 deadline. The municipalities, and the state employee pool, are self-funded in the Anthem network -- meaning higher reimbusement rates for hospital services would be passed directly to them. … The letter ... is part of the debate over a new pact between Anthem and Hartford Healthcare, the parent of Hartford Hospital and Windham Community Memorial Hospital. At issue are reimbursement rates for procedures done at the hospitals" (Sturdevant, 10/20).

The Associated Press/Bloomington Pantagraph: "An Indiana University administrator has been recommended to oversee a sweeping transition in housing choices for mentally ill people in Illinois. Both sides in a class action lawsuit recommended Dennis Jones in a motion filed Wednesday in federal court in Chicago. A judge will hear the motion Oct. 28" (10/21).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.