College campus birth control may become more inexpensive. The 2009 federal budget bill signed by President Obama may make this a reality. This, according to a report coming in from the Kansas City Star. There will be once again incentives for pharmaceutical companies to give discounts on contraceptives. These discounts were lost some time back under a deficit reduction law. Read more…
Only Eight states have been selected to participate in a new 4 year 15 million dollar initiative. The grant initiative aims to enroll more children and retain eligible children in Medicaid as well as ALLKids.
The PEAK project will be lead by the Alabama department of public health and the Alabama Medicaid agency. PEAK is an acronym for Perfecting Enrollment for Alabama’s kids. The funding and support for the grant is provided by the Robert Wood Johnson Foundation.
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A 50-23 vote approved a bill in Utah state house. The bill is HB171 and does away with the 5 year residency requirement for documented immigrant children. They can now receive Medicaid and CHIP coverage. After passing the preliminary vote, the bill needs to pass a second vote following which it will be be passed to Governor Jon Huntman Jr. for his signature.
28 mn in Medicaid payments were made to 20000 people who were getting benefits in other states in New York, it has been revealed. This has been revealed by New York Comptroller Thomas DiNapoli. According to him the onus was on the department to do a better job to make sure that counties checked properly the federal records. This would ensure that those getting benefits in New York were not getting them elsewhere.
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Inclusive engagement in health care reform is welcome. The March 5 Health Care Summit from President Obama’s camp is one such step. People with varying interests and stakes in health care reform can meet and discuss to arrive at a positive transformation of the health care system in America. This will hopefully result in Universal Affordable Health Care.
Health care reform discussions are ongoing and decisions are being made. In the middle of this the Center for Medicare Advocacy reminds how Medicare can teach the provision of Universal Health Care, affordably.
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Medicaid is to be extended in West Virginia. People with incomes up to 50 percent of the federal poverty level will benefit. Currently the eligibility threshold is up to 35 percent of the federal poverty level. Childless adults would be benefited as well. The aim may be to increase the income limit to 100 percent of the poverty level.
Still to be determined are the types of benefits to be provided, the cost of the expansion and the number of adults that would be eligible. CMS would probably not be asked for permission each time. The expansion would be funded by several sources including Medicaid, Supplemental Nutrition Assistance Program as well as other programs.
Although Diabetes patients who are in team based care do not save more in treatment costs under Medicare and Medicaid than other patients, they are healthier. This is the finding of a recent study. Patients, payers as well as employers have to face a high financial burden due to chronic conditions.
In the study Medicaid patients who recieved team based care were compared with patients who did not recieve team based care. The study tried to find out whether medical payments would reduce and whether quality of care would improve for patients. People with chronic conditions often suffered a loss of productivity. These patients only got 56 percent of recommended care according to the study.
Pharmacia, acquired by Pfizer in 2003 was responsible in inflation of medicine prices according to a ruling by a Wisconsin jury. The meds were sold to the Medicaid program of the state. As a result Pfizer has been fine $9 mn in total. Out of this $2 mn is for consumer protection law violation and $7 mn is for monetary losses.
Additionally state medicare law had been violated 1.4 mn times by Pharmacia. Each violation can attract a penalty of between $100 to $15,000. Pfizer is likely to appeal the verdict.
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The ACNM – American College of Nurse-Midwives applauded the bipartisan introduction of the Midwifery Care Access and Reimbursement Equity Act of 2009. The ACNM is the oldest womens health organization in the country. The legislation (H.R. 1101) will allow improved access to the health services for women which are offered by Certified Nurse Midwives and Certified Midwives.
This is to happen by a correction of the inequity of the reimbursement rate between midwives and Medicare program licenced health care professionals. The primary care services are of very high quality (the ones provided by CM’s and CNM’s) and therefore equitable reimbursement and making sure that their services are available to women is essential.
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Both the Biotechnology Industry Organization and American Academy of Physician Assistants are happy with the passage of SCHIP. Both Congress and President Obama have been applauded. BIO has applauded the passage of SCHIP because it supports universal healthcare. It is very essential for everyone to be insured. BIO and its associates look at expanding the fringes of available health care – bringing to life innovative therapies which patients can benefit from.
The opportunity to work with policy makers is welcomed by BIO so that access to innovative health therapies are made available. In addition the American Academy of Physician Assistants which represents almost seventy five thousand physician assistants in the US has applauded President Obama and Congress as well.
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Wednesday saw President Obama moving towards fulfilling another of his promises. He signed bill HR 2 into law. This bill expands the reach of SCHIP to 4 million additional children. This according to President Obama is the beginning of his goal of universal health coverage. The final bill was earlier cleared by the house 290 to 135 in favor of the bill.
In the absence of congressional action SCHIP was set to expire on March 31 this year. According to the provisions of the bill families with incomes of upto thrice the federal poverty level qualify for this program for their children. In New York and New Jersey even children from higher income families will be able to qualify for this program.
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The Prescription Advantage program in the state of Massachusetts has suffered a $11 million cut. Due to this cut, larger drug copayments will have to be made by more than 44,000 Massachusetts seniors. Seniors meeting a particular income eligibility requirement are provided copay assistance by the Prescription Advantage program.
There has been a $1bn state budget reduction by Governor Deval Patrick. As a result copays may double or triple for many seniors. Effective from Jan 1st, only if Medicare and the beneficiary combined have spent $2700 then state assistance for covered drugs is available.
Medicare beneficiary representing organizations expressed dismay at the release of the Medicare Advantage/Prescription Drug Plan Call Letter. Private insurance companies that want to contract with Medicare have been given instructions via this call letter if they want to provide drug and health coverage. The letter was released earlier than previous years. The early release may be to make sure leniency continues in the oversight of private plans for at least another year. There may also be a last ditch effort to promote private Medicare Advantage plans.
According to Judith Stein from the Center For Medicare Advocacy, this letter shows how Medicare has failed to oversee highly priced and low value private insurance plans. The problem is not addressed by this call letter and discriminatory pricing continues for more costly services.
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Medicare beneficiaries have been encouraged to review their presciption coverage and plans. The annual open enrollment period begins on 15 Nov and goes on till 31 Dec. For Medicare Advantage (MA) plans, one change in enrollment can be made by beneficiaries. The can cancel a plan, change a plan or enroll in a new plan. This period between Jan 1 and Mar 31 cannot be used to start or stop drug coverage. Neither can you enroll or disenroll in a Medicare Medical Savings Account Plan.
Meanwhile efforts to fight Medicare waste, fraud and abuse are being sought to be strengthened. CMS has announced that certain durable medical equipment suppliers will be needed to post a surety bond. Billing privileges of more than 1,100 medical equipment suppliers in Florida and Southern California have been revoked.
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Recent studies on health care have been reviewed and have given interesting information. If patients are not cost constrained and do not have limited accessibility to doctors then reports that are made public about health care quality could motivate patients to choose better plans.
Medical Care, Jan 2009 issue had these findings published. This clarifies to some extent the reason for people repeatedly wanting better care but not prioritizing it when choosing providers. When individuals choose health care plans less than 5 percent said that their choices were based on quality information about the plans.
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Health care reform options have been compared in a Congressional Budget Office report. The comparision shows that if Americans are allowed to buy into Medicare before they turn 65, more people would have health coverage with a lower payout than private insurance.
The effects of a limited buy in option for those between 62 and 64 years was studied by the CBO. According to this estimate a single coverage in 2011 would be about $7600 a year and a private policy would cost roughly double this figure. In 2006 about $10200 was spent per Medicare insured person by Medicare. This includes an older and sicker population than the one the buy in program is looking at.
The Obama administration that is coming into office is asking the people to help create the ideal health care policy. The people can do this by hosting a meeting and inviting intelligent people who can contribute their discussability. You get to check out the Obama team proposal and communicate with the transition team your ideas for the betterment of the proposal.
The West Virginia Medicaid Program may be sued by a public interest law firm. The firm is based in Charleston, W.Va. The lawsuit to be filed against the State’s Medicaid office is based on the allegation that federal law has been violated by the West virginia Medicaid Program. Benefits for children whose parents do not put pen to paper on a personal responsibility statement have been reduced.
Out of pocket expenses will increase for Medicare Part D cancer afflicted beneficiaries. There will also be increased restrictions on such patients. This comes out of research by Avalere Health and ACS CAN.
Brand name oral cancer drugs have been shifted to higher formulary tiers over the last four years. This means that every year the products have cost consumers more.
A new proposal unveiled that proposes universal health care has been praised by senator Kennedy. The proposal came from the health insurance industry. America’s Health Insurance Plans or AHIP has offered this proposal. This proposal follows the proposal by Max Baucus on these lines as well. Sen Ted Kennedy, D- Mass has pledged to move quickly on this issue the next year.
The focus of the AHIP health care plan is to reduce growth of health care expenses across America by 30 percent. If this target is achieved then expenditures would reduce by over 500 bn between 2010 and 2014. There is a greater sense of optimism after the announcement.
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More than 75 advocacy groups for the disabled as well as lawmakers have started to lobby for the wait time for the disabled to qualify for Medicare to be eliminated. This according to a report from the AP/ San Francisco Chronicle. According to the current rule, when the social security administration deems people ill or disabled then they are eligible for Medicare benefits after only a two year waiting period.
Congressional activity has heightened on comprehensive health reform. The various committees – Finance, Pension and Labor, Health, Congress have started making efforts toward drafting comprehensive health reform legislation. There is a united Democratic effort to pass legislation based on President Elect Barack Obama’s health care plan.
Based on the plan, health care would be expanded to include more US citizens. There have been roundtable talks involving Democratic lawmakers, but meetings with Republicans would begin soon. There is emphasis on a “One Bill” approach which many feel is the best and perhaps the only way to do things. Read more…
Last week a proposal was sent to Governor Charlie Crist by the Florida Agency for Health Care Administration. The proposal recommended and expansion of the Medicare Managed Care Pilot Program to 20 more counties. This pilot program is currently operational in 5 counties. It requires that beneficiaries sign up for managed care plans. The plans are mostly HMO’s that offer some additional benefits but can also be limited by choice.
Part of the request is an increase in Medicaid payment to specialist. This is likely to increase access to beneficiaries. At the same time as the proposal, there is also a request from Governor Crist that staff be reduced by ten percent. The agency has agreed to comply with this proposal.
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The Utah Health System Reform Task Force is in preparation to make it’s recommendations. The aim is to overhaul the state’s health care system. This, according to the Salt Lake Tribune. According to Mark Bair, Chair of the work group of health care providers, all uninsured people would need to obtain coverage to work. This will need affordable and portable health plans which will be issued on a modified community rating. Residents who already have health issues will have to be provided coverage.
According to Bair, shopping for health insurance needs to be made easy via a website that gives information on all the available choices. Also tax advantages and choices would need to be maximized. The medical malpractice system needs an overhaul. There have to be incentives for people to live healthy.
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Health insurance coverage has not expanded in Pennysylvania or other states due to the weakening economy. California, Illinois and New Mexico are with Pennysylvania on this, lawmakers could not agree on how the plans were to be funded. According to Diane Rowland, Executive VP, Kaiser Foundation, it is not easy to reform health laws at the state level.
This job is easier when the economy is good and difficult when the economy is not healthy. Massachusetts is the state with the greatest degree of success in health care reform and reducing the ranks of the uninsured.
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