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Friday
Jul252008

Pennsylvania Gov. Rendell Law Requiring Private Health Insurers To Cover Treatment for Autism

 A bill recently signed by Pennsylvania Gov. Ed Rendell (D) will require private health insurance companies in the state to provide diagnosis and treatment coverage of up to $36,000 per year for residents under age 21 with autism spectrum disorder, the Philadelphia Inquirer reports. The law, which is scheduled to take effect in July 2009, also requires insurers to provide coverage for applied behavioral analysis therapy that experts say is a key element in treatment of the disorder.Patients needing treatments that exceed the $36,000 limit will be eligible for state Medicaid reimbursements to cover the extra expense. Health plans that provide coverage to businesses with fewer than 50 employees will be exempt from the new law.
Currently, children with autism can enroll in the state's Medicaid program, which is managed by the Department of Public Welfare and spends about $185 million annually on medical-assistance programs for residents under age 21 with autism, the Inquirer reports. Under the new law, those children would be transferred from the Medicaid program into private health plans that could reduce state spending by about $13 million in the first year after it is implemented, according to the Inquirer.

read_more: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=53513
Friday
Jul252008

Presumptive Republican Presidential Nominee McCain Discusses Cancer Issues at Ohio Event

Presumptive Republican presidential nominee Sen. John McCain (Ariz.) on Thursday discussed issues related to cancer at a town hall meeting in Columbus, Ohio, hosted by cyclist and testicular cancer survivor Lance Armstrong, the Los Angeles Times reports.
During the event, McCain, a melanoma survivor, said, "I was in a battle with melanoma. And I know ... somewhat, at least to a small degree, how tough that battle can be. And yes, I've become a fanatic. Yes, I admit it. When I see a woman with a child in the sun, I go over and say, 'Get sunscreen on that child, please.'" McCain, a former smoker, also criticized tobacco industry lobbyists.
According to the Times, "McCain's appearance at the summit was widely panned by liberal groups that have criticized his health insurance plan, which some independent analysts say could make it more difficult for people with health problems to find coverage." McCain has proposed to replace a tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families to purchase private coverage, and critics maintain that the plan "might impose hardships on cancer survivors, for example, because insurance companies might balk at covering people with pre-existing conditions," the Times reports.

read_more: http://www.kaisernetwork.org/daily_reports/health2008dr.cfm?DR_ID=53511
Thursday
Jul242008

Community Efforts to Expand Dental Services for Low-income People

Poor oral health among low-income people is gaining attention as a significant health care problem. Key barriers to dental services include low rates of dental insurance coverage, limited dental benefits available through public insurance programs, and a lack of dentists willing to serve low-income patients, according to findings from the Center for Studying Health System Change’s (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Communities are attempting to provide more dental services to low-income residents. Along with state efforts to increase dentists’ participation in Medicaid and the State Children’s Health Insurance Program (SCHIP), hospitals, community health centers, health departments, dental schools and others are working to expand dental services, with some focusing on basic preventive services and others pursuing more comprehensive dental care. Many community efforts rely on increasing the number of dental professionals available to treat low-income people.

read_more:http://www.hschange.com/CONTENT/1000/?words=community+efforts+to+expand+dental+services+for+low+income+people
Wednesday
Jul232008

Amerigroup Settles Medicaid Lawsuit Over Denial of Coverage to Pregnant Women for $225M

Amerigroup on Tuesday said it will enter a $225 million settlement agreement with Illinois and the federal government over allegations that it denied coverage to eligible pregnant women, the Baltimore Sun reports (Baltimore Sun, 7/23).

Cleveland Tyson, former vice president of government relations at Amerigroup's Illinois subsidiary, in 2002 filed a whistle-blower lawsuit that claimed the company cherry-picked the healthiest patients to reduce spending. The U.S. attorney in Chicago and the Illinois attorney general later joined the lawsuit as plaintiffs. Illinois paid Amerigroup a flat fee per beneficiary that took into account that some people require more costly treatment than others. In March 2007, a federal judge in Chicago ruled against Amerigroup and awarded $334 million in the lawsuit.

read_more: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=53457
Wednesday
Jul232008

Why Not the Best? Results from the National Scorecard on U.S Health System Performance,2008

Prepared for the Commonwealth Fund Commission on a High Performance Health System, the National Scorecard on U.S. Health System Performance, 2008, updates the 2006 Scorecard, the first comprehensive means of measuring and monitoring health care outcomes, quality, access, efficiency, and equity in the United States. The 2008 Scorecard, which presents trends for each dimension of health system performance and for individual indicators, confirms that the U.S. health system continues to fall far short of what is attainable, especially given the resources invested. Across 37 core indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with U.S. and international performance benchmarks. Overall, performance did not improve from 2006 to 2008. Access to health care significantly declined, while health system efficiency remained low.

read_more: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=692682