September 3

Wisconsin Has Rejected $550 Million in Federal Dollars for Health Care

With its new two-year budget in place, Wisconsin now has passed up more than $550 million in federal money available under the Affordable Care Act. The state previously rejected roughly $200 million in federal money available starting in January 2014, according to the Legislative Fiscal Bureau. The new budget turned away another $360 million — far more than the $250 million in cuts the same budget made to the University of Wisconsin System. Yet accepting the federal money was never seriously considered by the Republican-controlled Legislature. The state has remained committed to Gov. Scott Walker’s approach to the law. Walker is the only governor in the country who has used the law to expand access to health insurance while turning down the additional federal dollars available to pay for it. Most Republican governors have opted not to expand their Medicaid programs through the law. In contrast, Walker did expand Wisconsin’s Medicaid program, and 145,000 people have gained coverage as a result. The governor just did it in a way that costs state taxpayers — though not federal taxpayers — more money.

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August 31

Congress Overwhelmingly Approves Bill Bolstering Medicare Patients’ Hospital Rights

The U.S. Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care, but have not been admitted to the hospital. It’s a distinction that’s easy to miss until patients are hit with big medical bills after a short stay. The vote follows overwhelming approval in the U. S. House of Representatives in March. The legislation is expected to be signed into law by President Barack Obama, said its House sponsor, Texas Democratic Rep. Lloyd Doggett. It’s called the NOTICE Act, short for “Notice of Observation Treatment and Implication for Care Eligibility.” The law would require hospitals to provide written notification to patients 24 hours after receiving observation care, explaining that they have not been admitted to the hospital, the reasons why, and the potential financial implications. Meanwhile, the number of claims hospitals submitted for observation care continues to skyrocket. According to the most recently available data from CMS, total claims increased 91 percent since 2006, to 1.9 million in 2013. Long observation stays, lasting 48 hours or more, rose by 450 percent to 170,219 during the same period, according to a Kaiser Health News analysis. In 2013, Medicare officials attempted to control the use of observation care by issuing the so-called “two-midnight rule,” which would require hospitals to admit patients who doctors expect to stay at least two midnights. But Congress delayed its enforcement after hospitals said the rule was confusing and arbitrary.

For the article from Kaiser Health News, click here.

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August 27

Centers for Medicare and Medicaid Services Proposes New Regulation to Govern Nursing Home Arbitration Agreements

On July 16, 2015, Centers for Medicare and Medicaid Services (CMS) published in the Federal Register an exhaustive proposed rule on requirements for long-term care facilities. One of the proposed provisions concerns dispute resolution — specifically, binding arbitration agreements — at Sec. 483.70(n). The posted background on this topic provides, “We considered not proposing any requirements concerning binding arbitration agreements. We share stakeholders’ concern that some nursing homes may be requiring residents to sign agreements for binding arbitration as a requirement for admission into the facility. In addition, if the nursing home is not requiring the agreement as a condition of admission, some facilities may be requesting the resident to sign the agreement without fully explaining the rights the resident is waiving and the consequences of that waiver. We have proposed specific requirements if a nursing home chooses to request that a resident sign an agreement for binding arbitration. These requirements include, among other things, that the nursing home must explain the agreement to the resident in a form and manner that he or she understands, and that the resident acknowledge that they understand the agreement. We have also proposed specific requirements for the agreement, including that admission to the facility cannot be contingent upon the resident signing the agreement, the agreement must be entered into voluntarily, and the arbitration must be conducted by a neutral arbitrator in a venue convenient to both parties.

For the full text of the proposed regulations from the Federal Register, click here.

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August 10

Japan’s Elderly Cause More Crime than the Young

Japanese police took action against more pensioners than juveniles in the first six months of the year, underlining the dramatic changes in a society that is aging rapidly. A total of 23,656 people aged 65 or older were questioned in connection with a crime in the first half of 2015, according to the National Police Agency. In the same period, 19,670 youths between the ages of 14 and 19 were the subject of a police investigation. The number of young people coming to the attention of the police declined more than 15 percent, while the number of elderly getting into trouble with the law was up by 622 cases, or 2.7 percent. A growing proportion of the crimes by elderly perpetrators were listed as “violent” by police, with the total rising 10.8 percent on the previous year. Murders and robberies were up 11.8 percent, the police said. Crimes by elderly people appear to reflect the problems that beset Japanese society at the moment, including a widening gap between rich and poor.

For the article from The Telegraph, click here.

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August 6

Most Americans Want Medicare to Negotiate Drug Prices

A vast majority of Americans say the Medicare health program for the elderly should be able to negotiate with drug companies to set lower medication prices, a practice currently prohibited by law, according to a survey released on Friday. The poll conducted by the Kaiser Family Foundation found that 87 percent of people surveyed want Medicare to have the authority to press drug makers for greater discounts. The skyrocketing prices for crucial medicines have hit both health insurers and consumers, who are being asked to cover a higher proportion of their medications’ cost. Efforts to allow Medicare to negotiate drug prices have not been successful, due to opposition over government interference in the marketplace. Drug manufacturers say their prices reflect the billions of dollars they spend in research and development, both for treatments that are approved and the many more that fail. Previous Kaiser polls underlined other frustrations over drug costs. A top priority for Americans in April was making drugs affordable for people with chronic conditions like diabetes. In a June poll, 73 percent of participants thought prescription drug prices were unreasonable. Over three-quarters of those people said it was because manufacturers set prices too high.

For the article from Reuters, click here.

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