Thursday, September 11, 2008

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Thursday, September 11, 2008
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BREAKING NEWS
MAJOR PRESIDENTIAL CANDIDATES DISCUSS PROPOSALS FOR HEALTHCARE, OTHER ISSUES AT AARP CONVENTIONDemocratic presidential nominee Sen. Barack Obama (Ill.) and Republican presidential nominee Sen. John McCain (Ariz.) on Saturday...
MEET NEVADA'S NEW ACTING INSURANCE COMMISSIONERNevada Department of Business & Industry Director Dianne Cornwall announced today that Betty C. Baker will serve as the Acting Commissioner...
WHISTLE-BLOWERS HELP U.S. RECOUP $9.3 BILLION Whistle-blowers helped authorities recover at least $9.3 billion from health care providers accused of defrauding states and the federal government...
FACING VETO, DEMOCRATS DROP PLAN FOR VOTE ON CHILD BILLCongressional Democrats have scrapped plans for another vote on expansion of the Children's Health Insurance Program, thus sparing...
STUDY: WORKERS TO PAY MORE FOR HEALTHCARE IN 2009Get ready for another hike in copays and deductibles. A survey being released Thursday by the Mercer consulting firm found 59 percent...
Today's Features
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MAJOR PRESIDENTIAL CANDIDATES DISCUSS PROPOSALS FOR HEALTHCARE, OTHER ISSUES AT AARP CONVENTION
Kaiser Daily Health Policy Report -Sept. 8: Democratic presidential nominee Sen. Barack Obama (Ill.) and Republican presidential nominee Sen. John McCain (Ariz.) on Saturday appeared via satellite at an AARP convention in Washington, D.C., and spoke about health care and other issues that affect seniors, the Washington Post reports.In his comments, Obama said that McCain would abandon seniors economically and tax their health benefits. He said, "Job shipped overseas? Tough luck. Pension disappeared? That's the breaks. No health care? The emergency room will fix it. You're on your own." McCain in his comments cited his ability to work with congressional Democrats to address a number of issues, such as health care and Medicare. He said, "We have to sit down together, Republican and Democrat, and reach across the aisle, and I have that record," adding, "I ask you to do something and that is to say put aside your partisan rancor. My friends, I have that record and you can count on it" (Shear/Slevin, Washington Post, 9/7).On Friday, Obama during a campaign event in Duryea, Pa., announced a proposal to fight cancer and promised to double federal funds for research and promote preventive care. Jill Biden, the wife of Democratic vice presidential nominee Sen. Joe Biden (Del.), appeared with Obama at the event and helped explain the proposal. She said, "This is a plan that will help save lives" (Douglas, McClatchy/Miami Herald, 9/6). Health Care, Other Economic Proposals Examined The New York Times' "The Caucus" on Monday examined the Obama and McCain economic proposals, which include their health care plans. According to the Times' "Caucus," Obama has "far outbid his Republican adversary" on his economic proposals, which include subsidies to help U.S. residents purchase health insurance. The "principle elements of Mr. McCain's economic agenda on taxes, trade, regulation and health care follow the philosophic outlines of a deeply unpopular Bush administration," with McCain's "most ambitious proposal" a plan to replace a tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families to purchase private coverage, according to the Times "Caucus." However, "for most workers, who already have employer-provided health insurance, the value of that credit would be offset by a new tax on those employer-provided policies," the Times' "Caucus" reports Harwood, "The Caucus," New York Times, 9/8).The AP/Tennessean on Monday also examined the Obama and McCain economic proposals, which included their plans for Medicare. According to the AP/Tennessean, "neither candidate is talking very much about tackling what all experts see as the biggest budgetary challenge facing the next president the explosion in the government's big benefit programs for Social Security and Medicare as the baby boomers retire." In addition, "neither campaign has put forward any proposals that experts say would make a meaningful dent in fixing Medicare, the far bigger entitlement problem because of soaring health care costs," the AP/Tennessean reports (Crutsinger, AP/Tennessean, 9/8).In addition, the Tribune/Long Island Newsday on Sunday examined the Obama and McCain economic proposals, which include their health care plans. Obama "wants all Americans to have health coverage and would spend tax dollars to do it," and McCain "would reduce regulations to permit more choices for consumers by allowing health care companies to sell across state lines," according to the Tribune/Newsday (Leckey, Tribune/Long Island Newsday, 9/7). Newsday on Monday compared proposals from Obama and McCain on health care and other issues (Jones, Long Island Newsday, 9/8). Ability of McCain To Work With Democrats Examined The Wall Street Journal on Saturday examined whether McCain as president would have the ability to work with congressional Democrats to pass legislation on health care and other issues. According to the Journal, health care reform is an "issue on which Sen. McCain and Democrats sharply disagree." Republicans maintain that the McCain health care proposal "would prod consumers to demand the most cost-effective coverage and would therefore drive down costs," but Democrats "worry that it would continue to leave many millions of people without insurance and have defeated Bush administration efforts similar to what Sen. McCain is proposing." Douglas Holtz-Eakin, senior policy adviser to McCain, said that McCain as president first would focus on areas of health care on which Republicans and Democrats agree such as efforts to increase use of health care information technology, allow prescription drug reimportation from Canada and expand use of generic medications. He said that health care reform would involve "steady work at doing better incrementalism" (Davis/Hitt, Wall Street Journal, 9/6). Palin Promise, Record on Advocacy for Special-Needs Children Examined Republican vice presidential nominee Alaska Gov. Sarah Palin, whose five-month-old son Trig has Down syndrome, during her speech at the Republican National Convention last week advocated for special-needs children, but "activists wondered whether that promise would be undercut by the Republican ticket's pledge to reduce government spending," the Journal reports (Kronholz, Wall Street Journal, 9/8). Palin did not release details on how she plans to advocate for special-needs children. In an e-mail sent on Friday, Palin spokesperson Maria Comella wrote, "She is going to be an advocate in the White House on multiple levels because she understands the issue, what's needed and what works.""To those in Alaska who work with children with special needs, Ms. Palin's pronouncement was surprising," as "the disabled have not been a centerpiece of Ms. Palin's 20 months in office or any of her campaigns for office," according to the New York Times. Palin "signed legislation that would increase financing for children in Alaska with special needs" but "she was not involved in its development," the Times reports (Steinhauer/Harmon, New York Times, 9/7). Retiree Concerns The AP/Akron Beacon Journal during the Republican National Convention last week interviewed several retiree delegates about their views on health care and other issues.According to the AP/Beacon Journal, "health care is a primary concern among retirees nationwide, regardless of income level or political affiliation." However, not "all would put health care at the top of the list -- just as Republicans and Democrats disagree on how to address soaring medical costs," the AP/Beacon Journal reports.AARP maintains that "access to affordable quality health care and lifetime economic security are by far the two most important issues for its members and for retirees," according to the AP/Beacon Journal (Carpenter, AP/Akron Beacon Journal, 9/8).NPR's "Talk of the Nation" on Friday reported on a questionnaire that Research!America sent to the Obama and McCain campaigns that asked for details on their proposals for health care, stem cell research, the Medicare prescription drug benefit and funds for NIH, FDA and CDC. The segment includes comments from Research!America President Mary Woolley ("Talk of the Nation," NPR, 9/5).Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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MEET NEVADA'S NEW ACTING INSURANCE COMMISSIONER
NV Dept of Insurance - Sept. 3: Las Vegas – Nevada Department of Business & Industry Director Dianne Cornwall announced today that Betty C. Baker will serve as the Acting Commissioner of the Division of Insurance, effective Monday, September 8. Baker will oversee the Division while a replacement is sought for Alice Molasky-Arman, who recently retired as Insurance Commissioner after 27 years of service.Baker has served as Chief Insurance Counsel of the Division of Insurance since October 1999. In this position, she has supervised the Division’s Legal and Enforcement Sections, handling a substantial case load which included prosecuting violations of the insurance code and defending the Division in administrative hearings. Baker’s role as Chief Insurance Counsel has involved acting as hearing officer for Division hearings when appointed to do so by Commissioner Molasky-Arman. She has also acted as Insurance Commissioner when appointed by Commissioner Molasky-Arman during her absences from the State. Additionally, Baker has served on various internal committees within the Division and has advised Division staff members on legal issues as they have arisen.“Betty’s hands-on knowledge of the Division’s many functions is a valuable asset,” said Director Cornwall. “Betty’s extensive experience will help ensure a smooth transition of leadership while maintaining the stability of this important regulatory agency.”Baker noted that she is looking forward to serving in her new role. “This appointment is an exciting challenge for me. I welcome the opportunity to guide such a dynamic agency through this change in management.” A nationwide search to find a new Insurance Commissioner has been launched. Baker will serve as Acting Commissioner until a final appointment is made.
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WHISTLE-BLOWERS HELP U.S. RECOUP $9.3 BILLION
Associated Press -Sept. 1: Whistle-blowers helped authorities recover at least $9.3 billion from health care providers accused of defrauding states and the federal government, according to an analysis of Justice Department records.The department ramped up efforts in the 1990s to combat health care fraud by using private citizens with inside knowledge of wrongdoing. They now initiate more than 90 percent of the department's lawsuits focusing on health care fraud. Whistle-blowers start cases by filing a sealed complaint in federal court. The department investigates the allegation and can intervene, assuming the lead role in the lawsuit. Whistle-blowers then get between 15 percent and 25 percent of the amount recovered.Of the $9.3 billion recovered between 1996 and 2005, whistle-blowers got more than $1 billion, say analysts, writing for the Annals of Internal Medicine. The analysts' findings are conservative.Information was only available for about three-quarters of the 379 cases reviewed. Second, some of the largest recoveries have taken place after the period reviewed.For example, the study doesn't include the single largest settlement, worth $920 million, which came against Tenet Healthcare Corp., one of the nation's largest hospital chains, in 2006.Still, the study highlights some important trends in health care fraud. While the number of claims pursued has dropped in recent years, recovery amounts have soared because of a late addition to the cast of defendants pharmaceutical manufacturers. Recoveries jumped from about $10 million a case in 2002 to $50 million by 2005.Drug makers are required to sell products to state Medicaid programs at the "best price" offered in the private marketplace. But the companies may artificially inflate the price, according to the report.Another common scheme is to market drugs for uses not approved by the Food and Drug Administration. The report's authors, Aaron S. Kesselheim of Brigham and Women's Hospital in Boston, and David M. Studdert of the University of Melbourne in Australia, said data on hundreds of whistle-blower lawsuits should be researched to identify what type of allegations turn out to be legitimate and lead to recoveries so that the department can fast-track such cases. Reports indicate the department rejects about three-quarters of the cases it gets.The law was recently changed to require larger health care companies to educate employees about protections for whistle-blowers. Some lawmakers also want to expand the class of people who can file whistle-blower suits, such as government employees, which the business community has opposed.The study indicates the current system is effective in generating significant recoveries for the government, said Matthew Webb, a senior vice president at the U.S. Chamber of Commerce Institute for Legal Reform."Some have said the law needs significant changes to make the cases actually stick," Webb said. "If their definition of 'not sticking' is $9.3 billion, I'd hate to see what their definition of sticking is."Officials representing the trade group for prescription drug manufacturers declined to comment on the Justice Department's greater focus on their members, but said the companies devote significant resources to internal compliance programs that complement the government's efforts to prevent misconduct.
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FACING VETO, DEMOCRATS DROP PLAN FOR VOTE ON CHILD BILL
New York Times -Sept. 8: Congressional Democrats have scrapped plans for another vote on expansion of the Children's Health Insurance Program, thus sparing Republicans from a politically difficult vote just weeks before elections this fall. Before the summer recess, Democrats had vowed repeatedly to force another vote on the popular program. But Democrats say they have shifted course, after concluding that President Bush would not sign their legislation and that they could not override his likely veto. Mr. Bush vetoed two earlier versions of the legislation, which he denounced as a dangerous step toward 'government-run health care for every American,' and the House sustained those vetoes. Congress returns on Monday for a session expected to last three or four weeks. Lawmakers say they will focus on energy legislation, essential spending bills and efforts to revive the economy and to create jobs.The fight over the children's insurance program prefigures a larger legislative debate, expected to start next year, over the future of health care and the role of government in providing it. Representative Rahm Emanuel of Illinois, chairman of the House Democratic Caucus, said: 'We are not going to change any votes on the children's health insurance bill. We still don't have enough to override a veto. Those who opposed this bill can face the voters and explain why they believe 10 million kids should not get health coverage.'The child health program has become an issue in some Congressional races. In almost every speech, Kay Barnes, a Democrat running for Congress in northwest Missouri, criticizes Representative Sam Graves, a Republican, for voting against the bill last year. Mr. Graves said the bill would have allowed illegal immigrants and some high-income people to get 'free taxpayer-funded health care.' House Democrats fell 13 votes short of the two-thirds majority needed to override Mr. Bush's first veto last October, and they were 15 votes short when they tried again in January. Democrats cited several reasons for their second thoughts about the wisdom of another vote on the child health bill. The cost of the bill has increased, according to the Congressional Budget Office, though the revenues expected from higher tobacco taxes are about the same. Under current rules, Congress would need to find a way to defray the extra cost. In addition, time is short, and the Congressional calendar is packed with other issues. Bruce Lesley, president of First Focus, a bipartisan advocacy group for children, said: 'We definitely would prefer for Congress to vote on the legislation next year rather than this year. Why would you pass a bill now when, in six months, you could get a better bill covering more uninsured children?' Since it was created with bipartisan support in 1997, the program has reduced significantly the number of low-income children who are uninsured. The Census Bureau reported last month that the number of people under 18 without health insurance had decreased, to 8.1 million in 2007, from 8.7 million in the prior year. Economists say the number could climb this year because of the weak economy and rising unemployment. The Congressional Budget Office estimates that the bill, financed by an increase in tobacco taxes, would reduce the number of uninsured children by 4.4 million by 2013. But at the same time, the budget office says, the bill could encourage some families to substitute public for private coverage, reducing by 2.3 million the number of children who would otherwise have private coverage. A few House Republicans in tight races might switch sides and vote for the bill, in an effort to win the approbation of voters, Democrats say. But supporters of the bill believe that they would still not have enough votes to override a veto by Mr. Bush. Hispanic, black and Asian-American members of Congress have complained that the bill does not provide coverage for legal immigrants who are now generally barred from benefits under Medicaid and the children's health program during their first five years in the United States. Many Democrats would like to lift those restrictions. But if they tried to do so, they could draw Congress into a bitter debate over immigration policy.
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STUDY: WORKERS TO PAY MORE FOR HEALTHCARE IN 2009
AP Online - Sept. 5: New York - Get ready for another hike in copays and deductibles. A survey being released Thursday by the Mercer consulting firm found 59 percent of companies intend to keep down rising health care costs in 2009 by raising workers' deductibles, copays or out-of-pocket spending limits.On average, health care costs will go up by an estimated 5.7 percent next year for both workers and their employers, the study found. That repeats this year's 5.7 percent hike and a 6.1 percent jump in 2007.The growth of health care costs has hovered at around 6 percent since 2005, according to Mercer. While that's down from the double-digit growth in previous years, it's still moving at a faster clip than inflation or workers wages."It's not something to cheer about, especially since costs are getting passed on to employees," said Blaine Bos, author of the survey. The results were preliminary findings, with about half of the 3,000 large companies surveyed reporting. Preliminary findings for the annual survey have historically been in line with final results.Between 2003 and 2007, the average deductible for an individual grew from $250 to $400. For a family, it rose from $1,000 to $1,500, according to Mercer.Deductibles are the amount workers pay for medical care out of pocket. Once workers spend that amount, they begin sharing costs with employers, with the company covering an average of 80 percent.Health plans are trying to rein in costs by offering choices such as disease management plans and incentives for greater use of prescription drugs, said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, a trade association representing nearly 1,300 insurers."But there's certainly still more work to be done," Zirkelbach said. He said AHIP has proposed a number of policies and measures to further curb costs. The Mercer survey also found 47 percent of companies are encouraging enrollment in plans with lower premiums and higher deductibles.Additionally, the survey found 19 percent of employers will start offering a consumer-directed health plan. These are high-deductible plans with employee-controlled spending accounts. They encourage employees to consider costs when by letting them save account money they don't spend for future needs.Last year, 12 percent of all employers said they were "very likely" to implement such a plan by 2009.
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