Advocates say that enrollees get turned down for coverage of some services that are tied to gender. (Lisa Gillespie, 7/22)
The wildly popular video game Minecraft teaches kids basic spatial reasoning concepts and helps them think critically. So, if you're using it for educational purposes, does it count as screen time, and should parents limit it? (Sarah Jane Tribble, WCPN, 7/22)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: '#cleanse?'" by Dan Piraro.
Here's today's health policy haiku:
A CRUMBLING BULWARK
Some red states dismiss fears to
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In a new report, federal investigators found that some screening problems persist among the 1.8 million providers enrolled in the program. For instance, about 23,400 addresses might be invalid.
The Wall Street Journal: Government Report Cites Shortfalls In Medicare’s Screening Process For Doctors
Over the past five years, the federal Centers for Medicare and Medicaid Services, which runs Medicare, has been revamping its enrollment system and verifying provider information, such as addresses and licensure. The overhaul is partly due to requirements of the 2010 Affordable Care Act. The CMS said Tuesday that as a result of its enhanced screening efforts, it has kicked more than 34,000 providers out of the program since February 2011. The GAO says that some screening problems persist, however, among the 1.8 million providers enrolled to bill Medicare from nearly a million addresses. The report estimated that about 23,400 addresses might be invalid. (Weaver, 7/21)
The New York Times: Federal Report Says Many Doctors Use False Addresses For Medicare
Federal investigators said Tuesday that thousands of doctors and other health care providers had signed up to bill Medicare using “questionable addresses” like mailbox rental stores, vacant lots and a fast-food restaurant. The investigators, from the Government Accountability Office, said Medicare officials did not adequately verify the addresses that providers listed as their practice locations. (Pear, 7/21)
In other Medicare news -
The Associated Press: Trustees Rating Health Of Social Security, Medicare
The federal government’s two largest benefit programs face short- and long-term financial problems as they close in on milestone anniversaries. The magnitude of those problems will become clearer when the trustees for Social Security and Medicare issue their annual report cards. (Ohlemacher and Alonso-Zaldivar, 7/22)
The company will make this payment to settle claims and avoid legal action in an agreement announced Tuesday.
The Baltimore Sun: State To Recoup $45M It Paid To Build Failed Health Exchange
The company state officials blame for the botched rollout of Maryland's online health exchange will repay $45 million to settle the claims in an agreement announced Tuesday. The settlement — just over 60 percent of what the state paid Noridian Healthcare Solutions — was approved unanimously by the health exchange board during a meeting Tuesday afternoon. U.S regulators still must approve the deal, because much of the funding was federal. (Cohn and McDaniels, 7/21)
The Washington Post: Noridian To Pay $45 Million To State, U.S. Government For Flawed Exchange
The prime contractor hired to build Maryland’s flawed online health exchange will pay $45 million to the state and federal governments to avoid a lawsuit over its performance, Attorney General Brian Frosh announced Tuesday. Maryland’s health exchange drew national attention last year when the Web site crashed moments after launching. It was plagued by glitches for months afterward. (Hicks, 7/21)
The Associated Press: Contractor For Maryland Health Exchange Website To Pay $45M
The main contractor in Maryland's initially flawed health care exchange website has agreed to repay $45 million to avoid legal action over its performance, officials announced Tuesday. Maryland's website crashed right after opening Oct. 1, 2013, as part of President Barack Obama's health care law, and it wasn't the only state to have problems. Oregon, Nevada and Hawaii abandoned their state-run exchanges and now use the federal one. (7/21)
In 2017, states will be on the hook for a small percentage of the cost of covering people who came into the Medicaid system through the health law's expansion efforts. The enrollment numbers are larger than many states anticipated, so they could look to hospitals to help cover the costs.
Modern Healthcare: States May Tap Hospitals To Help Pay For Medicaid Expansion In 2017
Policymakers in Medicaid expansion states likely will try to wring some cash from hospitals starting in 2017 when the federal government no longer pays the full tab for the coverage expansion, experts say. Higher-than-expected enrollment means expansion states will be on the hook for hundreds of millions more than they anticipated when they took advantage of the Affordable Care Act's Medicaid expansion to adults earning up to 138% of the federal poverty level. For instance, in Oregon, 386,000 people enrolled Medicaid in 2014, up from a pre-expansion estimate of 222,700. (Dickson, 7/21)
Meanwhile, Alaska officials move forward on expansion plans there.
The Associated Press: Consultant Hired To Help Recommend Alaska Medicaid Reforms
The state health department has hired a consultant to help recommend next steps as Gov. Bill Walker's administration plans to implement Medicaid expansion and looks to make further changes to the existing Medicaid program. The contract with Agnew::Beck Consulting LLC calls for a finalized report in January recommending alternative Medicaid expansion models and options to help contain costs within the Medicaid program. A report due in May would address a timeline and costs for carrying out the recommendations. (Bohrer, 7/21)
One report looks at anxiety about a future tax on generous health plans, while another article focuses on small business owners, whose worries include requirements for health coverage for employees and new costs from mandated pay increases and paid sick leave laws in some states and cities.
The New York Times: Labor And Employers Join In Opposition To A Health Care Tax
At the paper mill in Longview, Wash., Kurt Gallow and his wife, Brenda, are worrying about his company’s proposed new health care plan, which would require workers to pay as much as $6,000 toward their families’ medical bills. ... The union is now in heated negotiations with the mill’s owner, KapStone Paper and Packaging, over benefits, among other issues. The couple and many other employees have been enrolled in a popular Kaiser Permanente health maintenance organization, which charged just $25 for a doctor’s visit. But that may change by January. Pointing to the looming new tax on high cost insurance plans imposed under the federal health care law, KapStone wants to replace its existing policies with plans that could prove far more expensive for workers and their families. By doing so, the company would save almost $3 million in additional taxes in just the first two and a half years. (Abelson, 7/21)
The Associated Press: Costs From Regulations Pile Up, Hurt Small Business Profits
It’s getting more expensive to be an employer and small business owners say that’s making it harder for them to make money. The health care law, minimum wage increases and paid sick leave laws in some states and cities are increasing costs. ... They may be required to offer health insurance starting Jan. 1 if they go ahead with plans to offer dinner at the restaurant, which now serves breakfast and lunch. The expansion could give the Lamons 50 or more workers, the point at which employers must provide coverage. (Rosenberg, 7/22)
Meanwhile, Wis. Gov. Scott Walker raised more than $20 million from a PAC named after his battle with the state's public-sector unions in which he proposed ending collective bargaining for most public workers and also wanted public employees to pay more for health insurance.
The Wall Street Journal: Ohio Gov. John Kasich Enters Republicans’ Presidential Fray
The two-term Republican governor’s bid will test whether a candidate who has bucked the right flank of his party on issues ranging from Medicaid expansion to immigration can gain traction in a primary. (McCain Nelson, 7/21)
Fox News: Gov. Kasich Enters GOP White House Race Touting 'Skills And Experience'
One of his biggest challenges will be getting into the top tier of Republican candidates to qualify for some early debates. And he must convince primary voters who question his conservative credentials that his decision to expand ObamaCare in Ohio was a moral imperative to help the poor. (7/21)
The Washington Post: Groups Supporting Scott Walker Have Raised $26 Million
The Unintimidated PAC, which was started in April by two of Walker’s closest political advisers, has collected just over $20 million, The Washington Post has learned. The super PAC was named for Walker’s 2013 book that chronicled his highly visible fight with public-sector unions and is able to accept unlimited donations, although it is required to disclose its donor list. (Johnson, 7/21)
The Associated Press: Groups Raise $32M To Support Gov. Walker's Presidential Run
Three groups supporting Scott Walker's run for president have raised $32 million, which is less than what two of his Republican rivals have collected but on target with the Wisconsin governor's goal for this point in the campaign. ... Walker was first elected governor in 2010 and within months proposed effectively ending collective bargaining for most public workers, coupled with requiring them to pay more for health insurance and pension benefits to help solve a budget shortfall. The fight led to a 2012 recall election against Walker, which he won, further raising his national political profile in advance of this year's announcement that he hopes to run for the White House. Walker won re-election last year. (7/21)
Meanwhile, on the Democratic side, presidential hopeful Bernie Sanders
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