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Monday, May 11, 2015

Health Care Reform Articles - May 11, 2015

White House Moves to Fix 2 Key Consumer Complaints About Health Care Law

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WASHINGTON — The White House is moving to address two of the most common consumer complaints about the sale of health insurance under the Affordable Care Act: that doctor directories are inaccurate, and that patients are hit with unexpected bills for costs not covered by insurance.
Federal health officials said this week that they would require insurers to update and correct “provider directories” at least once a month, with financial penalties for insurers that failed to do so. In addition, they hope to provide an “out-of-pocket cost calculator” to estimate the total annual cost under a given health insurance plan. The calculator would take account of premiums, subsidies, co-payments, deductibles and other out-of-pocket costs, as well as a person’s age and medical needs.
Since insurers began selling coverage through public marketplaces 19 months ago, many consumers and doctors have complained that the physician directories are full of inaccuracies. “These directories are almost out of date as soon as they are printed,” said Kevin J. Counihan, the chief executive of the federal insurance marketplace.
Medicare and Medicaid officials have found similar problems in the directories of insurance companies that manage care for beneficiaries of those programs. In December, federal investigators said that more than a third of doctors listed as participating in Medicaid plans could not be found at the locations listed.
The Obama administration recently adopted stricter standards stating that each insurer in the federal marketplace “must publish an up-to-date, accurate and complete provider directory, including information on which providers are accepting new patients, the provider’s location, contact information, specialty, medical group and any institutional affiliations.”
In addition, Mr. Counihan said, the administration will require insurers to provide physician information in a format that software developers can use to create tools to help consumers find health plans in which their doctors participate. Consumer advocates like Robert M. Krughoff, the president of the Center for the Study of Services, also known as Consumers’ Checkbook, said such tools could be a boon to consumers.

New study gives more evidence of Obamacare gains for millions

New study gives more evidence of Obamacare gains for millions - LA Times

As congressional Republicans move toward another vote on repealing the Affordable Care Act, new evidence was published Wednesday about the dramatic expansion of insurance coverage made possible by the law.
Nearly 17 million more people in the U.S. have gained health insurance since the law's major coverage expansion began, according to a study from the Rand Corp., a Santa Monica nonprofit research firm.
That tally takes into account 22.8 million newly insured people and 5.9 million who lost coverage in the last year and a half.
Researchers found gains across all types of insurance, including employer-provided coverage, government Medicaid programs and policies offered through state insurance marketplaces created by the law.
At the same time, the vast majority of Americans have seen no change in the source of their coverage, with 80% remaining in the same insurance, researchers found.
“The ACA has greatly expanded health insurance coverage in the United States with little change in the source of coverage for those who were insured before the major provisions of the law took effect,” concluded the authors of the study, published online by the journal Health Affairs.
The Rand study, based on surveys of 1,589 working-age adults, is not as large as other polls. But the findings are consistent with national surveys by Gallup, as well as with data from the federal government, which have all shown a dramatic decrease in the nation's uninsured rate since the health law's coverage expansion began.
Importantly, Rand's survey, which has tracked a panel of the same people since 2013, provides an early snapshot of where the coverage is expanding.
The biggest growth has been in the marketplaces created by the law, which now have about 11 million adult customers, about a third of whom were uninsured in 2013, according to the study.

Medicaid, another pillar of the health law, has seen enrollment grow by nearly 10 million adults since 2013.

Report alleges cover-up of impending Health Connector failure

By Felice J. Freyer GLOBE STAFF  

A report scheduled for release Monday by a conservative-leaning think tank accuses state officials of misleading the federal government and the public about the Massachusetts Health Connector’s readiness to launch its new website in October 2013.
The report from the Pioneer Institute draws on public audit reports and interviews with anonymous people described as “whistle-blowers” to detail what they characterize as a bungled effort by the University of Massachusetts Medical School, software developer CGI, and the Connector to upgrade the Connector’s software in 2012 and 2013.
The Connector — designed to link people with health insurance when they don’t have another source — eventually ended its relationships with UMass and CGI.
Asserting that state officials knew at least a year ahead of time that website development was off track, the report describes two communications with the federal government in March and May 2013 in which state officials allegedly covered up the site’s poor condition.
Joshua Archambault, a senior fellow at the institute and the report’s author, said he did not know whether the Pioneer Institute’s allegations led to a federal subpoena issued in January seeking Connector records dating to 2010. But the Pioneer Institute had written to federal authorities last October, accusing the state of multiple violations of federal antifraud statutes, alleging that state officials had failed to properly conduct a required test and had overstated progress on the software.
Elizabeth Guyton, press secretary for Governor Charlie Baker, who took office in January, said the administration was cooperating with the subpoena.
Otherwise, she said in an e-mail Sunday, “When it comes to the Health Connector, the Baker-Polito administration’s sole focus is fixing the broken system it inherited so that people can access the health care they need.”


Federal Cuts Would Be Major Blow to New York City’s Public Hospitals, Comptroller Says

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New York City’s public hospital system is looking at a major cash squeeze within four years if federal cuts to hospitals serving large numbers of poor and uninsured patients take place as scheduled, according to a report by the city comptroller, Scott M. Stringer, to be released on Monday.
Beginning in 2017, the federal government will begin cutting subsidies to those hospitals, based on the theory that since the passage of the Affordable Care Act, which has insured millions of Americans, hospitals will no longer need the same level of subsidies for uncompensated care.
But Mr. Stringer’s report says that the city’s hospital system will not benefit as much as expected from the Affordable Care Act insurance plans because the system continues to serve a high proportion of undocumented immigrants, who are not eligible for coverage under the act.
In the health law’s first year, the number of uninsured patients the system treated dropped by only 1.3 percent, the report said; another decrease of 7.2 percent is projected by 2019.
More strikingly, the city’s hospital system has not attracted enough newly insured patients to give it the revenue increase it would need to make up for the loss of federal funds, the report says.
“We have a solemn commitment to fund H.H.C. so that it can serve everyone who walks through the door, regardless of their immigration status or ability to pay,” Mr. Stringer said in a statement, referring to the Health and Hospitals Corporation, which runs the public hospitals. “That’s why we need to find a real cure for these cuts, not just apply a Band-Aid.”

Hepatitis C Drugs Added to W.H.O. List of Essential Medicines

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The World Health Organization put five new hepatitis Cdrugs on its essential medicines list for the first time on Friday, including drugs that cost $1,000 a pill or more in wealthy countries. The new drugs are ground-breaking because they usually cure quickly with minimal side effects.
Inclusion on the list, which the W.H.O. considers “the minimum medicine needs for a basic health‐care system,” carries no legal weight but indicates to governments, regulators and drug companies that those medicines should be made available to poor countries at low prices. The list includes the generic ingredients of Sovaldi and Harvoni, which cost $84,000 or more per treatment in the United States.
The W.H.O. also added four antibiotics to fight drug-resistant tuberculosis and 16 new cancer drugs to the list.
As more residents of poor countries survive into middle and old age, diseases that kill later in life, including tuberculosis, hepatitis and cancer, are growing in importance as cause of death.
Advocates for the world’s poor praised the W.H.O.’s decision. “This is huge,” said Ellen ‘t Hoen, an expert in medicine law and former director of the Medicines Patent Pool.

Mexico: Vaccinations Suspended After Infant Deaths

By THE ASSOCIATED PRESS


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