THE GAZETTE ONLINE AND PRINTABLE VERSIONS AVAILABLE AT HTTP://AHCA.BULLETINNEWS.COM

DATE: MONDAY, JUNE 9, 2014 8:00 AM EDT

TODAY’S EDITION AHCA/NCAL in the News Clinton White House Faced Backlash For Failed Health Reform Iowa Care Center Receives Commitment To Quality Award...... 1 Push...... 6 PHCA President: Senior Care Payments Need To Keep Up Commentary Considers ACA...... 6 With Inflation...... 1 News /Health Reform Implementation Medicare Savings Seen By Switching To Cheaper Eye Burwell Expected To Be Sworn In As HHS Secretary Monday. ... 2 Medicine...... 6 Gulf Opening Between States That Expanded And Doctor Details His Own Medicare Reimbursements...... 6 Those That Did Not...... 2 Medicaid News Obama Administration Working To Revamp HealthCare.gov...... 3 Officials Questioned About School Medicaid Program. 6 Cantor’s July Policy Memo Offers Few ACA-Related Details...... 3 Despite Medicaid Coverage, Chicago Homeless Man Faces Judge Blocks Expansion Of Discount Drug Program Set Up Unique Healthcare Challenges...... 7 Under ACA...... 3 Michigan Officials Using Assessments To Incentivize Healthier Some Insurance Companies Opting Out Of ACA Program For Living...... 7 Small Businesses...... 3 ACA Creating Opportunities For States To Experiment With Industry News Healthcare...... 3 CMS Seeks IDR Reviewer...... 7 Many States Report Significant Medicaid Backlogs...... 4 Study: Coordinated Care Saves Millions Of Dollars...... 7 State Premium Proposals “A Mixed Picture.” ...... 4 LTC Provider Pursuing Supreme Court Ruling In Wrongful Employee Responsible For Access Health CT Data Breach Death Case...... 7 Placed On Administrative Leave...... 4 Florida LTC Facility Fined After Violating Do-Not-Resuscitate Health Exchange Upgrade Delayed A Second Time. .... 4 Order...... 7 Exchange Board Seeking New Director...... 5 Study: Patients Indicating Desired End-Of-Life Care Tend To Weighing Whether To Charge Carrier Assessment To Receive It...... 7 Fund Exchange...... 5 Blog: Cutting Public Retirement Benefits Could Actually Help. .... 7 Success Of Exchange Examined...... 5 NNU President: Health IT Not The Answer To All Our Problems. 8 Report: ACA Leading To Uptick In Emergency Room Use...... 5 Study: Off-Exchange Plans More Costly For Customers...... 5 Assisted Living News Catholic Benefits Association Gets “Temporary Reprieve” From United Methodist To Construct New ALF...... 8 Employer Mandate...... 5

the lives of residents through quality care.” The award was AHCA/NCAL IN THE NEWS presented by AHCA/NCAL and “honors centers across the nation that have demonstrated their commitment to improving Iowa Care Center Receives Commitment To quality care for seniors and individuals with disabilities.” Quality Award. The Spencer (IA) Daily Reporter (6/7, PHCA President: Senior Care Payments Need 10K) wrote in its “Business Briefs” section that the Ruthven To Keep Up With Inflation. The Harrisburg (PA) Community Care Center in Iowa received a 2014 bronze Patriot-News (6/7, 397K) reprinted Health Care “Commitment to Quality Award for its dedication to improving Association President and CEO Stuart H. Shapiro’s op-ed that “Pennsylvania’s 700-plus skilled-nursing facilities...have researchers and those who work with the poor expect very gone from the bedrock of our state’s long-term care few Americans to move between states to take advantage of continuum to a profession on life support.” He cites one study the law.” noting that state nursing home operating margins have fallen Medicaid Expansion Debate Continues Across 63% from 2007 to 2012, meaning “nursing centers are losing Country. The Post (6/9, Vozzella, 4.22M) money, when adjusted for inflation, or returning margins so reports that Virginia Republicans “appear to have low that they can’t afford what they need to ensure quality outmaneuvered” Gov. Terry McAuliffe (D) in the state’s care.” A second study “showed that Pennsylvania reimburses budget standoff “by persuading a Democratic senator to nursing facilities an average of $26 a day less per resident on resign his seat, at least temporarily giving the GOP control of Medicaid than the true cost of care, meaning nursing homes the chamber and possibly dooming the governor’s push to today lose $9,500 annually for each Medicaid resident in their expand” Medicaid under the ACA. The Post says State Sen. care.” He closes by stating, “Unless payments for senior care Phillip Puckett (D) will announced his resignation on Monday, keep pace with cost increases facing all providers, the skilled “paving the way to appoint his daughter to a judgeship and nursing center profession is not going to be able to meet the Puckett to the job of deputy director of the state tobacco needs of current residents – let alone the growing demand for commission.” According to the Post, the “news prompted care as baby boomers age.” outrage among Democrats,” along with “accusations” that the GOP is “trying to buy the Senate with job offers in order to AFFORDABLE CARE ACT/HEALTH thwart McAuliffe’s proposal” to expand Medicaid. Ryan Grim in the Huffington Post (6/9, Grim, 11.54M) REFORM IMPLEMENTATION says Virginia Republicans have “resorted to what appears to be outright bribery in its ongoing effort to deny low-income Burwell Expected To Be Sworn In As HHS residents in the state access to the Medicaid expansion Secretary Monday. Politico (6/6, Cunningham, 637K) authorized by Obamacare.” reported that Sylvia Mathews Burwell “is expected to be In a post for Vox (6/9), Sarah Kliff says “the whole fight sworn into her new job as HHS secretary on Monday.” is coming to a head right now because by the end of the The National Journal (6/6, Novack, Baker, Subscription month the Virginia government needs to pass a new budget.” Publication, 561K) added that “she’ll take over the Kliff says “the House budget doesn’t fund the Medicaid department just as officials are working through some 2 expansion,” but “the Senate budget does,” and “negotiations million discrepancies in consumers’ Obamacare applications are gridlocked.” According to Kliff, McAuliffe “is and selecting new contractors to ensure HealthCare.gov will exploring...us[ing] an executive order to expand Medicaid.” work when the next open enrollment period begins.” The Virginia Gazette (6/7, 50K), the Bristol (TN/VA) Herald Finally, Fierce Healthcare (6/6, Budryk, 147K) detailed Courier (6/9, 81K) and the Prince William (VA) Times (6/9) how newly-confirmed HHS Secretary Burwell “cruised” also have reports on the debate over Medicaid expansion in through her confirmation process. Virginia. Alexander’s Primary Opponent Criticizes His Arkansas Business (6/9, 42K) reports that Arkansas Support Of Burwell. The Hill (6/6, Viebeck, 237K) reported State Rep. John Burris “was among the most vocal that Sen. Lamar Alexander’s (R-TN) primary challenger, state opponents of the federal health care overhaul among the Rep. Joe Carr, “is criticizing his support for President Republicans in the state House,” but now that he is “running Obama’s new Health and Human Services Secretary.” Carr for a north Arkansas state Senate seat...he finds himself says “Alexander’s vote to confirm Sylvia Burwell on Thursday being portrayed as a cheerleader for the law he derides as shows that the senator is not sufficiently opposed to ‘Obamacare.’” According to Arkansas Business, there is “an ObamaCare.” effort by opponents of Arkansas’ compromise Medicaid expansion to make an example of Burris, one of the Gulf Opening Between States That Expanded architects of the ‘private option.’” Arkansas Business notes Medicaid And Those That Did Not. On its front that the state “uses federal Medicaid funds to purchase page, the Times (6/9, A1, Lowrey, Subscription insurance for the poor,” which “has been touted as a way for Publication, 9.65M) reports that in Texarkana, the state line Republican-leaning states to implement a key part of the between Texas and Arkansas is a serious healthcare divide, health care law.” Northwest Arkansas Online (6/9) reports as Arkansas has expanded Medicaid and Texas has not. The that Burris is running against “private-option opposer Scott Times says that “none of the low-income Texarkana residents Flippo.” interviewed realized that moving to the other side of town Sioux Falls (SD) Argus Leader (6/9, 116K) reports that might mean a Medicaid card.” The Times says that “health Sen. Tim Johnson “and other colleagues in the Senate have asked Republican governors in states such as South Dakota 2 to ‘put politics aside and do the right thing’ by expanding Judge Blocks Expansion Of Discount Drug Medicaid coverage under the Affordable Care Act.” Program Set Up Under ACA. The New York Times Commentary Considers Medicaid Expansion (6/9, Pear, Subscription Publication, 9.65M) reports that US Debate. The Pittsburgh Post-Gazette (6/9, 677K), in an District Judge Rudolph Contreras in Washington, DC “has editorial, writes, “Even some members of Gov. Tom Corbett’s struck down a new rule requiring drug companies to offer own Republican Party have come to the conclusion that certain drugs at discounted prices, saying the Obama expanding” Medicaid “is the best way to help working administration had no authority to issue the rule.” Pennsylvanians.” The Post-Gazette notes that last Administration officials “said the decision could provide a Wednesday, three Republicans on the state House Human windfall to drug makers,” but the pharmaceutical industry Services committee “voted with nine Democrats to advance a “said that the administration was stretching the Affordable Medicaid expansion bill.” According to the PPG, “That’s not Care Act to provide discounts on more drugs for more people, the tectonic shift necessary...to turn odds in favor of the and that the rule was ‘inconsistent with the plain language of measure in the full House, but it’s a start.” The paper the statute.’” In his ruling, released in late May, Judge concludes, “It’s time for Pennsylvanians to let their elected Contreras “said the administration had ‘acted beyond the representatives on both sides of the aisle know they won’t bounds of its statutory authority,’” and he issued an injunction take no for an answer.” blocking the rule. Administration officials say they are Obama Administration Working To Revamp reviewing the ruling and have not decided whether to appeal. HealthCare.gov. CBS News (6/6, 5.21M) offered Some Insurance Companies Opting Out Of continuing coverage of the report that “the Obama ACA Program For Small Businesses. The administration is moving to overhaul HealthCare.gov to Washington Times (6/8, Howell, 455K) reports that the ACA’s prevent a return of the glitches that plagued the federal small-business exchanges “were supposed to be an easy insurance website’s debut last October.” The piece noted that way for employers of 50 or fewer full-time workers to gain while the “front end of the website” may be more operational, leverage in the insurance market and provide coverage “the back end of the website that coordinates customer options to their employees.” However, their full information and insurance payments with health insurance implementation was delayed last year, so now “some companies continues to struggle.” insurance companies” in states that use the Federal Cantor’s July Policy Memo Offers Few ACA- exchange “are opting out of the employee-choice model for the 2015 plan year too, because they fear the small-business Related Details. On Friday, House Majority Leader risk pool will be imbalanced.” Currently, employers in states Cantor released his June policy memo, which notably lacked using the Federal exchange “must go through an agent, details about the Affordable Care Act, The Hill (6/6, Viebeck, broker or insurer that offers a certified SHOP plan.” 237K) reported. The memo casts “further doubt on whether” lawmakers will “endorse” any ACA replacement proposal ACA Creating Opportunities For States To “before the August recess.” Experiment With Healthcare. Under the headline ACA Ties Proving A Political Liability For Arkansas “Some States See In The Health Law A Chance To Pursue Legislator. Facing a tough runoff election with an opponent Unique Solutions,” the Wall Street Journal (6/9, Radnofsky, who is emphasizing his ties to the Affordable Care Act, Subscription Publication, 5.51M) examines how the ACA has Arkansas Republican legislator John Burris is finding that his created opportunities for experimentation in the healthcare role in engineering the state’s private option alternative is sector across the country. For example, Vermont is taking the proving to be a political liability in his bid for a state Senate opportunity to move closer to a single-payer system, while seat, the Wall Street Journal (6/7, Campoy, Subscription more conservative states like Wisconsin are crafting reforms Publication, 5.51M) reported. that appeal to Republicans. Democrats Embrace The Affordable Care Act At ACA Funds Used To Help Hospitals Employee Missouri Event. The St. Louis Post-Dispatch (6/9, 1.02M) “Patient Advocates.” The Wall Street Journal (6/9, reports, “Sounding unmistakably like a candidate for Johnson, Subscription Publication, 5.51M) details the role of governor, Democratic Missouri Attorney General Chris Koster the “patient advocate,” an employee many hospitals enlist to took Republican legislators to task Saturday on a range of help patients navigate the confusing and overwhelming world issues including Medicaid expansion” at the Missouri of medical care expenses. The article notes that many states Democratic Party’s annual Jefferson-Jackson Dinner, while are helping to fund such advocates using money allotted Sen. Richard Durbin (D-IL) “gave a full-throated defense of through the Affordable Care Act. the federal Affordable Care Act, also known as Obamacare.”

3 In a separate story, the Wall Street Journal (6/9, Beck, 60,000 people who purchased commercial health insurance Subscription Publication, 5.51M) reports that hospitals are through are receiving discounted turning toward bundled care payments, in which a bill would premiums, according to figures from the Department of be for all the care provided during a stay as opposed to Vermont Health Access.” itemized billing, which could make the process easier. Employee Responsible For Access Health CT Many States Report Significant Medicaid Data Breach Placed On Administrative Leave. Backlogs. According to officials in 15 large states, of the On Friday, Access Health CT CEO Kevin Counihan “unprecedented” six million people who “have gained acknowledged “that the personal information of some Medicaid coverage since September,” more than 1.7 million enrollees may have been compromised.,” The Hill (6/6, “are still waiting for their applications to be processed – with Viebeck, 237K) reported. In a statement, “Counihan said that some stuck in limbo for as long as eight months,” the an individual discovered a backpack on a Hartford street Washington Post (6/8, Galewitz, 4.22M) reported. Estimates containing the personal information of about 400 people.” reveal that “the scope of the problem varies widely.” The Centers for Medicare and Medicaid Services spokesman backlogs are attributed to “technological glitches” that Aaron Albright stated: “This situation does not involve prevented the Federal exchange “from transferring data on consumers who have used HealthCare.gov. We are in applicants to state Medicaid agencies and many states’ contact with Connecticut and the state is providing updates inability to handle an enrollment surge” due to various issues. on this incident.” The Connecticut Mirror (6/9, Becker) reports that the State Premium Proposals “A Mixed Picture.” data breach “has been traced to an employee of the company Over the weekend, several outlets reported on the insurance that runs the agency’s call center, according to the rate proposals for plans to be sold on the Affordable Care exchange.” On a Hartford street Friday, a backpack belonging Act’s exchanges. The proposals show a mix of increases and to an employee of Maximus, which runs the call center, “was decreases. found to contain four notepads with handwritten names, From , the Washington Post (6/7, Sun, 4.22M) Social Security Numbers and birth dates for about 400 reported on the 2015 insurance rate proposals posted on the people, as well as paperwork from Access Health CT.” state’s Insurance Administration website on Friday, which The AP (6/9) reports that the employee has been “paint a mixed picture.” According to the filing, CareFirst, “placed on administrative leave.” “Maryland’s dominant insurance company,” is seeking “hefty Finally, the Hartford (CT) Courant (6/7, Dowling, 599K) premium increases of 23 to 30 percent for consumers buying reported that Access Health COO Peter Van Loon said in a individual plans next year under the federal health-care law.” statement over the weekend, “Access Health CT has begun While Kaiser Foundation Health Plan and Evergreen Health calling individuals whose names were handwritten on the Cooperative “are proposing to lower rates for next year, by 12 work papers to inform them of this potential breach. percent and about 10 percent, respectively.” Cigna and Consumers will be offered the following remedies … at no United Healthcare “are offering plans for the first time in the cost: credit monitoring, fraud resolution, identity theft state’s individual market.” The Hill (6/6, Viebeck, 237K) and insurance, and security freezes of credit reports.” the Baltimore (MD) Sun (6/9, Hopkins, 925K) also reported on Additional coverage, most of it out of Connecticut, was Maryland’s rate proposals. offered by the Norwich (CT) Bulletin (6/7, Barry, 47K), CNBC From Connecticut, the Motley Fool (6/7, Williams, (6/6, Mangan, 1.75M), the Danbury (CT) News Times (6/7, 1.11M) explored whether the proposed 2015 premiums on Cuda, 137K), the Daily Caller (6/6, Hurtubise, 408K), and the the state’s exchange are really decreasing “by an average of Norwich (CT) Bulletin (6/6, Benson, 47K). 8.9%, although the magnitude of the drop varies by plan.” From Colorado, the Denver Post (6/7, Draper, 940K) Vermont Health Exchange Upgrade Delayed A reported that insurers selling coverage on the state’s Second Time. The AP (6/8) reports that the “plan to exchange had to submit their plans by Friday. Though no upgrade the Vermont Health Connect website to allow users information on the rates is available, the Division of to make small changes to their health insurance accounts” Insurance, will now begin reviewing the filings. has again been delayed “while officials try to make sure it will Subsidies Will Likely Offset Rate Hikes For Many In work properly.” The article notes that “there is a backlog of Vermont. The VTDigger (6/6, True, 1K) reports that while 10,000 applications awaiting changes,” and the state “is insurers in Vermont have requested rate increases to sell planning to bring in another contractor to help clear up the plans through Vermont Health Connect, many consumers in backlog.” the state will likely not see a premium “spike.” That is because “about 37,200, or 62 percent, of the more than 4 Vermont Public Radio (6/7, Kinzel, 1K) reported that Connecticut’s state-based exchange, “arguably had one of Mark Larson, the commissioner of the Vermont Department the most successful open enrollment seasons of any of Health Access, explained the latest delay saying, “So that Obamacare marketplace this year.” The piece features an when we deploy new functionalities, that we are very interview with Access Health CT chief executive Kevin confident that it is going to serve Vermonters well.” Counihan, describing why the website was so successful the Also reporting are the Burlington (VT) Free Press (6/6, software behind it is being sold to other states. Remsen, 116K) and the VTDigger (6/7, True, 1K), Rules It Can Pick Up Legal Bills For Report: ACA Leading To Uptick In Emergency Troubled Exchange Employees. The AP (6/7) reports that Room Use. The Detroit Free Press (6/9, Ungar, 1.02M) Oregon has decided it can “pick up legal bills for current and reports that hospitals across the country are experiencing an former employees who face a criminal investigation over the influx in emergency room patients following the launch of the failure of the state’s health insurance enrollment website, Affordable Care Act, despite the fact that “that’s just the .” This follows the announcement last month opposite of what many people expected under Obamacare.” that “a federal grand jury has issued a subpoena for records Among the reasons cited: “A long-standing shortage of related to the botched health insurance website.” primary-care doctors leaves too few to handle all the newly Maryland Gubernatorial Candidate Facing Criticism insured patients. Some doctors won’t accept Medicaid. And Because Of Link To Troubled Exchange. The AP (6/7) poor people often can’t take time from work when most reported that although he has received several key primary care offices are open, while ERs operate round-the- endorsements and has the support of many of the state’s clock and by law must at least stabilize patients.” leaders, Maryland Lt. Gov. Anthony Brown is facing “criticism about his role in leading health care reform in the state.” The Study: Off-Exchange Plans More Costly For contention stems from troubles with Maryland’s exchange, Customers. According to a HealthPocket study release which “was so flawed it is being revamped with new this week, “four major healthcare companies offer plans technology for the next enrollment period in November.” separate from ObamaCare marketplaces that are more costly The St. Cloud (MN) Times (6/8, Sommerhauser, 77K) than similar plans on the exchanges,” The Hill (6/7, Al- carries an additional account of troubles with a state-based Faruque, 237K) reported. The study found that off-exchange exchange, this time in . plans offered by United Healthcare, Aetna, Cigna, and Assurant are, on average, “40 percent more expensive” than Hawaii Exchange Board Seeking New Director. similar bronze, silver, and gold plans the insurers sell on the The AP (6/9, Bussewitz) reports that the Board of Directors of exchange. According to researchers, price transparency on the is launching “its search for a the exchanges may have forced insurers to drop “their permanent executive director,” and hoping to have one in premium prices substantially to show they are cheaper than place by October 1. Tom Matsuda “has been leading the off-exchange plans.” health exchange as interim executive director since Shift To Private Exchanges Detailed. The Motley December,” when former Executive Director Coral Andrews Fool (6/7, Japsen, 1.11M) detailed “America’s private health resigned. care revolution,” noting that “employers and insurance The Honolulu Star-Advertiser (6/7, Consillio, 402K) companies are aggressively moving employees, their reports that, in addition to seeking a new director, “almost half dependents and retirees to” private exchanges “in droves.” of the board of directors for the Hawaii Health Connector will The shift “is becoming a boon to employee benefits change at the end of the month.” This, the article says, leaves consultancies,” such as Aon Hewitt, Mercer, and Towers “uncertain the future of the state’s troubled health insurance Watson. Further, “giant health insurance companies” like exchange.” Cigna, Aetna, and Blue Cross and Blue Shield “want to form Colorado Weighing Whether To Charge Carrier exchanges and are in the early stages of exchange development.” Assessment To Fund Exchange. The Denver Post (6/9, Draper, 940K) reports that the board of Connect for Catholic Benefits Association Gets Health Colorado will decide Monday whether it will again “Temporary Reprieve” From Employer charge insurers offering plans in the state $1.25 a month for Mandate. McKnight’s Long-Term Care News (6/7, each policy sold. This fee, known as the “carrier assessment,” Mullaney, 921) reported a Federal judge ruled the Olathe, KS, would be used to fund the state’s exchange, CoverColorado. Villa St. Francis skilled nursing facility “and other members of Success Of Connecticut Exchange Examined. the nationwide Catholic Benefits Association do not have to Vox (6/9, Kliff) examines why Access Health CT, offer health plans covering contraception while they pursue 5 litigation against the government.” The March class-action suit it filed was “the first to include three different types of MEDICARE NEWS plaintiffs: houses of worship; ‘ministries’ such as Catholic Medicare Savings Seen By Switching To nursing homes and other healthcare facilities; and Catholic- owned for-profit businesses.” While the case is being Cheaper Eye Medicine. Vox (6/9) reported how litigated, all CBA members have been granted “a temporary Medicare Part B could save $18 billion and patients could reprieve from the so-called employer mandate.” save $5 billion over the next decade if the healthcare system switched to Roche’s cheaper Avastin (bevacizumab) instead Clinton White House Faced Backlash For of the company’s Lucentis (ranibizumab injection), both of Failed Health Reform Push. The Hill (6/6, Jaffe, which are used to treat “conditions that lead to blindness in 237K) “Blog Briefing Room” reported that “newly released elderly adults.” Vox cited several hurdles, including the fact private documents show” that the Clinton White House “was Avastin, a cancer treatment, is considered off-label use when painfully aware of the political damage done to former used for preventing onset of blindness, and Roche unit President Clinton’s agenda after his failed push for healthcare Genentech won’t seek FDA approval for the eye treatment. In reform in the mid-1990s.” Throughout much of the addition, doctors get reimbursed more under Medicare for documents, the experience is referred to as the “health care Lucentis compared with Avastin. “Consciously or not, doctors debacle.” might be more likely to recommend the more profitable treatment, especially because Medicare picks up most of the Commentary Considers ACA. Over the weekend tab,” Vox noted. through Monday, several outlets carried opinion pieces weighing in on various aspects of the Affordable Care Act. In Doctor Details His Own Medicare an editorial, the New York Times (6/9, Board, Subscription Reimbursements. In an online piece for NPR (6/9, Publication, 9.65M) explains how the Supreme Court, by Schumann, 519K), John Henning Schuman, a primary care rendering the Affordable Care Act’s Medicaid expansion doctor who teaches at the University of Oklahoma School of optional, created “gaps” in the funding for “hospitals that have Community Medicine, notes that in Arpil, “after decades of provided a lot of free charity care to poor and uninsured fighting to keep how much Medicare pays individual doctors a patients.” The paper offers solutions to address this issue, secret, the federal government bowed to pressure...and including universal expansion of Medicaid, hospitals released...information” regarding “who is getting paid by increasing their involvement in getting the poor insured, and, Medicare for what.” Schumann says he was “curious to learn finally, Federal health officials opting to “review regularly what I could about my own Medicare billing from the public whether health plan co-payments are actually affordable to data,” and so he checked “The New York Times’ Medicare those living on very modest incomes.” database tool and ProPublica’s Medicare Treatment Tracker.” The Week (6/6, 1.85M) reporter John Aziz highlighted a Schumann goes on to describe what he found and how that graph, which “shows that after a difficult rollout the [Affordable data reflects the changing nature of his practice. Care Act] is working.” The graph indicates that “the number of uninsured people is the lowest it has been since Obama MEDICAID NEWS became president in 2009.” Further, even though “many have predicted soaring medical costs as a result of the law, Arkansas Officials Questioned About School medical costs are actually rising at a lower rate than they Medicaid Program. Arkansas education and human were in 2013 or 2012.” services officials appeared before a legislative panel on Mark Trahant, the Atwood Chair of Journalism at the Friday to answer questions about a state Division of University of Alaska Anchorage and a member of the Legislative Audit, which “found Arkansas school districts Shoshone-Bannock Tribes, described for the Indian Country participating in the Medicaid in the Schools Program have not Today Media Network (6/6, 45K) how the Affordable Care Act complied with all Medicaid rules,” the Pine Bluff (AR) will affect how the Indian Health Service delivers care. He Commercial (6/7, Lyon, 36K) reported. State Education said that to make it work “there will have to be action from Department attorney Courtney Salas-Ford and State tribes, Alaska Native corporations, and hundreds of Department of Human Services chief attorney Mike White thousands of individuals.” were questioned by state Rep. Kim Hammer (R-Benton) and state Sen. Linda Chesterfield (D-Little Rock) about the Medicaid in the Schools Program, which is administered by the Southeast Arkansas Education Service Cooperative (SEARK). 6 Despite Medicaid Coverage, Chicago Homeless reports that some experts question whether or not the Man Faces Unique Healthcare Challenges. The savings rates can be sustained over time. Chicago Sun-Times (6/7, 1.1M) columnist Mark Brown LTC Provider Pursuing Supreme Court Ruling profiled Eugene Bochenek, a homeless man who signed up McKnight’s Long-Term Care for Affordable Care Act “coverage through Cook County’s In Wrongful Death Case. expanded Medicaid program.” Bochenek lauds his News (6/7, Mullaney, 921) reported that on May 23, experience with CountyCare. Steven Glass, executive Extendicare Homes Inc. began pursuing “a Supreme Court director of managed care for Cook County Health and ruling on the reach of nursing home arbitration agreements, Hospitals, details some of the struggles that healthcare according news reports.” After resident Vincent Pisano died in officials face when caring for the transient population. one of their facilities in 2011, the company “sought to have the lawsuit dismissed and to compel arbitration, arguing that Michigan Officials Using Assessments To Pisano’s daughter signed an arbitration agreement when her Incentivize Healthier Living. USA Today (6/7, 5.82M) father was admitted,” while the Pennsylvania Superior Court carries a Kaiser Health News report on the Michigan officials determined an existing state wrongful death statute creates in who want “to make the state among the first in the nation to this situation “an independent cause of action.” add a heavy dose of ‘personal responsibility’ to” Medicaid. Florida LTC Facility Fined After Violating Do- Kaiser Health News notes that Michigan “became the second after Iowa to offer lower premiums and cost sharing to Not-Resuscitate Order. McKnight’s Long-Term Care recipients who agree to do a health risk assessment with their News (6/7, Mullaney, 921) reported Florida state authorities doctor every year and to commit to improve their health by have fined the St. Petersburg Jacaranda Manor $16,000 after taking steps such as quitting smoking or losing weight.” “reviving a resident with a do-not-resuscitate order, according Michigan Medicaid Director Stephen Fitton is quoted as to news reports.” According to the AP, after administering saying, “There is a heavy consumer engagement piece in CPR to a patient who stopped breathing in the dining room, a this, both in terms of finances and skin in the game, but also nurse found the do-not-resuscitate order. Since then, “the in terms of healthy behaviors and really trying to find ways in facility reportedly has retrained its staff.” which we can make the population of Michigan healthier.” Study: Patients Indicating Desired End-Of-Life Care Tend To Receive It. The Wall Street Journal (6/9, INDUSTRY NEWS A3, Landro, Subscription Publication, 5.51M) reports a recent study published in the Journal of the American Geriatrics CMS Seeks IDR Reviewer. Modern Healthcare (6/7, Society indicates patients documenting end-of-life Dickson, Subscription Publication, 224K) reported the CMS is preferences in a special medical form tend to receive they seeking “a consultant to review an appeals process it has for care they hope for in their last days. Researchers arrived at nursing homes that have been hit with fines for quality or that conclusion after examining death records of people who safety issues.” The organization wants this consultant to passed from natural causes, 30% of whom had completed independently review the informal dispute review (IDR) the Physician Orders for Life-Sustaining Treatment form at process in situations where “a facility feels the process has the time. failed, according to a solicitation notice,” and specifically calls for what the article describes as “an experienced physician or Blog: Cutting Public Retirement Benefits Could nurse practitioner who is an expert in issues of geriatric care, Actually Help. John O’Connor wrote in the McKnight’s as well as expertise in the long-term-care regulations.” Long-Term Care News (6/7, 921) “Daily Editors’ Notes” blog Study: Coordinated Care Saves Millions Of that legislators “recently approved a plan to deal with massive pension obligations by trimming cost of living Dollars. The Los Angeles Times (6/9, Terhune, 3.46M) adjustments for eligible retirees.” However, a statute in the reports that a study released Friday demonstrated that state Constitution calls state public retirement system accountable care organizations (ACOs) were able to yield big membership “an enforceable contractual relationship, the savings in a Southern -based program between benefits of which shall not be diminished or impaired.” He Anthem Blue Cross and HealthCare Partners. The stated, however, that “the move would appear to be a no- collaboration helped the partners cut costs by “reducing brainer. After all, the result would be many people hospital admissions, emergency-room visits and lab tests.” contributing to the program for more years, and depleting it Dr. Michael Belman, Anthem’s medical doctor, lauded the for fewer. And the funds that are not removed from the coffers partnership’s ability to reduce costs in the PPO system where care is “relatively unmanaged, uncoordinated.” The paper 7 might be used to help pay for much-needed services. Like, for example, long-term care.” NNU President: Health IT Not The Answer To All Our Problems. National Nurses United Co-President Deborah Burger responded in a McKnight’s Long-Term Care News (6/7, 921) op-ed to Editorial Director John O’Connor’s post titled, “These nurses are picking a fight they’ll be hard- pressed to win.” She argues that health information technology does not necessarily represent “the answer to our biggest healthcare troubles.” Noting what she calls “the rapid spread of unproven medical technology and the untested implications for patients,” she asserts that “the proliferation of health IT and the restrictions it places on caregivers is another reminder of how misguided the priorities of our broken healthcare system have become.” She calls for “a comprehensive, humane, single standard of care system for everyone based on individual patient need.” ASSISTED LIVING NEWS United Methodist To Construct New ALF. The Heritage Newspapers (MI) (6/9, Pruitt, 1K) reports the United Methodist Retirement Communities, Inc. plan to construct a new assisted living facility at its Chelsea, MI, Glazier Commons campus. The name is meant to honor “Frank Porter Glazier, a Chelsea stove manufacturer who donated 33 acres from a former county fairgrounds in 1906 to offer a new way of caring for Michigan seniors that eventually became the UMRC.”

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