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  • Conn. Exchange Chief To Run Healthcare.gov

    Federal officials tap Kevin Counihan, who helped launch Connecticut's successful online health insurance marketplace, to oversee the federal exchange, which is used by residents of three dozen states, and to prevent the problems that plagued it last fall.

    Connecticut Mirror: Access Health's Counihan To Run Federal Obamacare Marketplace
    Kevin Counihan is resigning as the chief executive of Connecticut's health insurance exchange to lead the once-troubled federal Obamacare marketplace, officials announced Tuesday. As CEO of the federal exchange, Counihan will assume responsibility for the HealthCare.gov insurance marketplace, a crucial piece of the Affordable Care Act that is used to enroll people in coverage in nearly three dozen states. The federal exchange's launch last fall was considered disastrous, and Counihan's appointment comes less than three months before the Nov. 15 start of the second open enrollment period for private insurance (Levin Becker, 8/26).

    The New York Times: Leader Of Connecticut's Health Marketplace Is Named To Run Federal Program
    Mr. Counihan will start on Sept. 8, a little more than two months before the next sign-up period for health insurance begins on Nov. 15. Sylvia Mathews Burwell, the secretary of Health and Human Services, hired Mr. Counihan for the new position of chief executive as part of an effort to improve management of the federal marketplace and to avoid the technological failures that paralyzed its website, HealthCare.gov, last fall (Goodnough, 8/26).

    Kaiser Health News: New Head Of Healthcare.gov Is Connecticut's Counihan
    Kevin Counihan, the head of Connecticut's health insurance marketplace, will be the new CEO of healthcare.gov, the website that 36 states use to sell insurance under the Affordable Care Act, the administration announced Tuesday. Department of Health and Human Services Secretary Sylvia Burwell tapped Counihan to lead the site as part of a revamped management structure that aims to have the second year of Obamacare run more smoothly than the first (Cohen and Webber, 8/26).

    The Wall Street Journal: Connecticut Exchange CEO To Run HealthCare.gov
    The health law called for the setting up of online exchanges where consumers can compare insurance plans and apply for tax credits toward the cost of coverage. HealthCare.gov is the platform the federal government uses to run exchanges on behalf of more than 30 states unable or unwilling to run their own. … HHS said Tuesday that as well as being in charge of the federally run exchanges, Mr. Counihan's responsibilities would include working with the states that run their own exchanges, and running the Center for Consumer Information and Insurance Oversight, the unit in charge of regulating health plans under the 2010 health law (Radnofsky, 8/26).

    The Washington Post's Wonkblog: There's Finally Someone In Charge Of Healthcare.gov
    The idea of a single point person to oversee the law's implementation originally generated interest among some of the law's advocates in early 2010 and top administration officials. More talk resurfaced after the failed launch of HealthCare.gov last year, when it became clear there was a management problem at the Centers for Medicare and Medicaid Services, the agency overseeing the law's implementation. It's easy to see why CMS saw Counihan as the right person to run the enrollment Web site serving 36 states (Millman, 8/26).

    San Francisco Chronicle: Health Exchange Head Named To Federal Post
    The head of the state's health insurance exchange is leaving the post to head the federal and state marketplace in Washington. While he predicts the impact of his departure will be "minimal," some advocates aren't so sure. On Tuesday, Access Health CT CEO Kevin Counihan announced he had accepted a position as the federal marketplace CEO. Counihan will be responsible for leading the federal marketplace, managing relationships with state marketplaces and running the Center for Consumer Information and Insurance Oversight, which regulates health insurance at the federal level. During open enrollment this year, the federal marketplace website, healthcare.gov, was plagued with glitches and shutdown (Cuda, 8/26).

    NBC News: Connecticut Health Honcho Named Healthcare.gov CEO
    Kevin Counihan, who headed up Connecticut’s successful health insurance exchange, has been named CEO of Healthcare.gov. It’s a new job, one that the new Health and Human Services Secretary Sylvia Matthews Burwell promised to create when she was named earlier this year (Fox, 8/26).

    Politico also notes an interim appointment for another job.

    Politico: Connecticut Exchange Leader Named CEO Of Healthcare.Gov
    HHS is still looking for a permanent chief technology officer for HealthCare.gov, but the agency announced Tuesday that Tim Hughey of Accenture will effectively fill that role in the interim. Accenture is the lead contractor on the federal exchange now, having replaced CGI, which was fired in January. Hughey will provide technology support to CMS through the next open enrollment season, which kicks off Nov. 15, federal health officials said (Wheaton, 8/26).



  • Federal Investigators Request Firms' Documents On Troubled Md. Exchange

    The head of Noridian Healthcare Solutions says the HHS inspector general's office sought documents related to the company's work on Maryland's online health insurance marketplace.

    The Washington Post: Federal Auditors Sought Documents Related To Troubled Md. Health Exchange Launch
    Noridian Healthcare Solutions, the company fired by Maryland officials after the disastrous launch of the state's health insurance exchange, received a request from federal auditors last month to turn over documents related to the troubled project, chief executive Tom McGraw said Tuesday. McGraw said in a statement that Noridian was "cooperating fully" with the July 30 request by the inspector general's office for the Department of Health and Human Services, which has been auditing the use of federal funds in creating the Maryland Health Benefit Exchange (Johnson and Flaherty, 8/26).

    The Baltimore Sun: Subpoenas Issued In Maryland Health Exchange Probe
    Federal auditors looking into Maryland's flawed health insurance exchange are subpoenaing documents as part of their probe and have sought information from the lead contractor hired by the state to build the site. North Dakota-based Noridian Healthcare Solutions, the former prime contractor with a multimillion-dollar deal to design Maryland's online insurance marketplace, received a request for documents related to the project from the inspector general of the U.S. Department of Health and Human Services on July 30, the company's president said Tuesday (Fritze and Cohn, 8/26).



  • Open Payments Website Plagued By Delays, Difficulties

    The site, which is supposed to make transparent payments between drugmakers and physicians, is slated to be made public by Sept. 30. But as the deadline nears, the pharmaceutical industry is pressing the Centers for Medicare & Medicaid Services to be more transparent in explaining what's going on with the database. 

    Fox News: Another Obamacare Website Suffers Delays, Glitches Ahead Of Launch Date
    Thought HealthCare.gov had problems? Another federal government-run website created under ObamaCare is suffering the same symptoms as the troubled federal health care exchange -- grappling with delays, data problems and other hiccups as the deadline to take it public nears. At issue is a database known as the Open Payments website. It was created under the Affordable Care Act to shed light on the financial ties between doctors and pharmaceutical companies as well as device manufacturers (8/26).

    The Wall Street Journal's Pharmalot: Pharma Tells The Federal Government: Transparency Works Both Ways
    File this under "how ironic." Drug makers are asking for more transparency from the government agency that is requiring them to be more transparent about how much they pay doctors. The Pharmaceutical Research and Manufacturers of America, or PhRMA, is calling on the Centers for Medicare and Medicaid Services to further explain why the agency has removed one-third of the payment information from an online database that is due to be made public by Sept. 30 (Loftus, 8/26).



  • Futile Medical Care Crowds Out Other Patients

    Also, one insurer and one business have end-of-life conversations with patients by phone.

    WBUR: When Medical Care Is Futile, Other Patients Pay The Hidden Price
    Every day in intensive care units across the country, patients get aggressive, expensive treatment their caregivers know is not going to save their lives or make them better. California researchers now report this so-called “futile” care has a hidden price: It’s crowding out other patients who could otherwise survive, recover and get back to living their lives. Their study, in Critical Care Medicine, shows that patients who could benefit from intensive care in UCLA’s teaching hospital are having to wait hours and even days in the emergency room and in nearby community hospitals because ICU beds are occupied by patients receiving futile care. Some patients die waiting (Knox, 8/26).

    Kaiser Health News: Operator? Business, Insurer Take On End-of-Life Issues By Phone
    Imagine you're at home. Maybe that's in Florida, Wisconsin, Rhode Island, wherever. You have cancer. You just had another round of chemo, and the phone rings. "My name is Kate. I'm a health care counselor," the gentle voice says from her cubicle in Cherry Hill, N.J.. This is no telemarketing call … it’s about the end of your life. Kate Schleicher, 27, is a licensed clinical social worker, who knows almost as little about you as you do about her. Except she’s got your phone number, your insurance provider and that you are pretty sick (Gordon, 8/27).



  • Exchange Roundup: 2,000 Oregonians Must Switch Plans; Georgia Medicaid Applicants Still In Limbo

    Media outlets cover exchange and Medicaid developments in Oregon, Georgia and Florida.

    Oregonian: Cover Oregon: At Least 2,000 Oregonians Need To Change Coverage Due To Health Exchange Errors
    Cover Oregon will hold a special open enrollment period for 1,400 Oregonians who were incorrectly enrolled into the low-income Oregon Health Plan by the state's troubled health insurance exchange. Starting Aug. 31, the people affected will have no coverage through the OHP, the state's version of Medicaid. However, they will have the option to sign up for coverage from private insurers and to qualify for tax credits through Cover Oregon to bring down premiums. Meanwhile, Cover Oregon is contacting at least 700 people who should have been enrolled in the Oregon Health Plan, but were incorrectly enrolled in a commercial health plan instead (Budnick, 8/26).

    Atlanta Journal-Constitution: One-Third Of Medicaid Applicants Still In Limbo
    Roughly 27,000 poor Georgians, most of them children, still don’t know whether they’ll get health coverage months after applying for Medicaid through the Affordable Care Act’s health insurance marketplace (Anderson, 8/26).

    Health News Florida: Obamacare Sign-Ups To Rise 23%?
    The number of Floridians enrolled in individual health plans under the Affordable Care Act in June was 866,485, according to new state data compiled from insurers’ reports. The carriers expect enrollment to rise to 1.1 million next year, an increase of 23 percent (Gentry, 8/26).

    Fox News: How to Get Health Insurance Outside the Open Enrollment Window
    The first open enrollment season of the Affordable Care Act has come and gone and the next one doesn’t start until Nov. 15, but that doesn’t mean uninsured individuals can’t get coverage until then. “Under the Affordable Care Act, people who experience certain life changes may be eligible to enroll in a new health plan before the next open enrollment period begins,” says Michael Mahoney, senior vice president, consumer marketing at GoHealth www.gohealthinsurance.com. “Those who qualify for a special enrollment period generally have 60 days from the qualifying event to shop for coverage” (Fuscaldo, 8/26).



  • Nonprofit Hospitals' Financial Woes Detailed In Report By Moody's
    Income for these hospitals declines as the government and insurers change the way they pay them. 

    The New York Times: Nonprofit Hospitals' 2013 Revenue Lowest Since Recession, Report Says
    Nonprofit hospitals last year had their worst financial performance since the Great Recession, according to a report released on Wednesday. The poor operating performance of many hospitals underscored some of the changes in the health care system as the federal government and private health plans became less willing to pay for hospital care and changed the way they paid hospitals in an effort to reduce costs (Abelson, 8/27).

    The Wall Street Journal: Nonprofit Hospitals' Earnings Fall As Costs Outrun Revenue
    Nonprofit hospitals' income declined for a second straight year in 2013 and their median rate of revenue growth fell to an all-time low, Moody's Investors Service said, a trend the credit rater's analysts say likely will continue this year. The nonprofit hospitals' performance contrasts with the rising profits and patient volumes reported by publicly traded hospital operators in recent weeks (Weaver, 8/27).



  • Obama Vows Better Health Care, Other Initiatives, For Vets, Military

    Addressing the American Legion’s national convention, the president announced steps to expand access to mental health care and an initiative to lower home loan costs for military families. He also promised a new "culture of accountability' at the Department of Veterans Affairs.

    The New York Times: Obama Tells Veterans He Will Fix Health System, As New Report Lists Lapses
    President Obama on Tuesday promised several thousand military veterans that he would fulfill his “sacred trust” to those returning from America’s wars by overhauling a dysfunctional health care system, even as a new report documented “unacceptable and troubling lapses” in medical treatment (Baker and Philipps, 8/26).

    Los Angeles Times: Obama Tells American Legion He's Working To Regain Veterans' Trust
    The list included seemingly straightforward changes, such as making it easier for veterans to earn commercial driver's licenses, and new funding for complex research. The Pentagon and the National Institutes of Health have launched a study on early detection of suicide risk, post-traumatic stress disorder and traumatic brain disorder, while the VA will invest $34.4 million in a national clinical trial on suicide prevention involving 1,800 veterans at 29 hospitals, the White House said (Hennessey, 8/26).

    The Washington Post: Obama Pledges Better Mental Health Services, Other Initiatives For Military, Vets
    Heralding a new "culture of accountability" at the Department of Veterans Affairs, President Obama Tuesday announced a number of executive actions to help active-duty military members, their families and veterans, ranging from strengthening access to mental health care to making it easier for troops to reduce mortgage payments. Speaking at the American Legion’s annual convention in the wake of a scandal involving falsified records and long wait times at VA facilities, Obama reaffirmed his support for America's veterans and said his administration will do all it can to ensure current and former members of the military receive the full benefits they deserve (Zezima, 8/26).

    Reuters: Obama Tells Veterans Better Mental Health Care On The Way
    President Barack Obama sought to make amends with veterans on Tuesday, announcing steps to expand their access to mental health care and an initiative with financial companies to lower home loan costs for military families. The president was embarrassed earlier this year when it was revealed that the Department of Veterans Affairs (VA) had been covering up lengthy delays in providing health care to former military personnel (8/26).

    The Associated Press: Obama Defends Handling Of Veterans Affairs Issues
    His standing with veterans damaged by scandal, President Barack Obama on Tuesday defended his administration’s response to Veterans Affairs lapses that delayed health care for thousands of former service members, but conceded more needed to be done to regain their trust. His appearance also had deep political overtones in a state where the Democratic senator, Kay Hagan, is facing a difficult re-election and has sought to distance herself from Obama’s policies, declaring as recently as Friday that his administration had not “done enough to earn the lasting trust of our veterans” (8/26).



  • State Highlights: Calif. Hospital Chain Sues Union; Texas Sues Xerox Again

    A selection of health policy stories from California, Texas, Louisiana, North Carolina and Colorado.

    San Jose Mercury News: Hospital Bidder Sues Union, Alleging Extortion
    In a surprising move, an anti-union Southern California hospital chain hoping to buy the struggling Daughters of Charity Health Care System is suing employee unions under the federal RICO Act, saying the unions are trying to thwart that deal and others by using extortionist tactics aimed at forcing it to cave into union demands. The lawsuit filed Monday in U.S. District Court in San Francisco by Prime Healthcare Services accuses Service Employees International Union and SEIU-United Healthcare Workers West; the union federation Change to Win; and three union leaders of conspiring to "target and attack Prime with the ultimate objective of either unionizing Prime, thereby altering its cost structure and business model, or eliminating Prime from the market altogether'' (Seipel, 8/26).

    Dallas Morning News: Janek Accuses Xerox Of “Reckless” Misuse Of Medicaid Data
    Texas Medicaid officials, already in a legal battle with Xerox Corp. over the company’s alleged failure to prevent widespread dental fraud, filed another lawsuit Tuesday accusing Xerox of improperly taking large quantities of medical records and not protecting patients’ confidentiality. The state Health and Human Services Commission said it filed a lawsuit in state district court in Austin seeking return of the patient data. ... Xerox spokesman Kevin Lightfoot, though, said in an email that “the data represents proprietary Xerox information and was retained with the state’s knowledge” (Garrett, 8/26).

    The Texas Tribune: Texas Files Second Lawsuit Against Xerox
    The state of Texas on Tuesday announced a second lawsuit against former contractor Xerox, alleging the company failed to turn over client health records relating to its operation of the state Medicaid program. The announcement comes three months after the state announced it was suing the company over allegedly misspent money, after thousands of requests for medically unnecessary braces were approved (Walters, 8/26).

    The Associated Press: Health Benefits Changes Planned for Louisiana State Workers
    Louisiana's state government employees and retirees face increased out-of-pocket costs, higher deductibles and new health service limitations as Gov. Bobby Jindal's administration reworks state insurance plans to keep the program from financial disaster. Financial analysts say those in the insurance program in many instances will be paying more and getting less. Critics of the changes say workers and retirees are being held responsible for the Jindal administration's mismanagement of their program (8/26).

    Raleigh News & Observer: DHHS Medicaid Planner Leaves Highly Paid Job
    A woman state health officials hired a year ago to work on Medicaid alternatives -- a new position that paid $95,000 annually despite her thin resume -- is resigning. Margaret “Mardy” Peal will leave Sept. 19, to take advantage of an opportunity that will allow her, a single mother, to be at home with her children more often, according to her resignation letter. ... Her hiring at DHHS drew criticism because it fit into a pattern of controversial personnel decisions by Secretary Aldona Wos, including high pay for young, inexperienced officials, and a contract with someone who works for her husband’s company (Jarvis, 8/26).

    The Denver Post: Colorado Not Monitoring Psychotropics For Imprisoned Youths
    Colorado has poor controls over the administration of powerful psychotropic medication to youths in corrections facilities, with state officials unable to show they are doing enough to monitor for harmful side effects, according to a state report released Tuesday. The report, which focused on the state's Division of Youth Corrections, sampled the medical records of 60 youth offenders, 57 of whom were prescribed psychotropic medication (Osher, 8/26).



  • Ariz. GOP Primary For Governor Won By Treasurer

    Doug Ducey defeated former Mesa Mayor Scott Smith. Smith had the backing of Gov. Jan Brewer after supporting her Medicaid expansion proposal. Also, other Arizona Republicans who backed the Medicaid expansion there withstand challenges from more conservative candidates. Elsewhere, former GOP Florida Gov. Charlie Crist won a Democratic primary to challenge Republican Gov. Rick Scott.

    The New York Times: Arizona Treasurer Wins G.O.P. Primary For Governor
    With 83 percent of the precincts reporting, Mr. [Doug] Ducey was ahead with 37.3 percent of the vote, or about 59,000 more votes than his closest rival, Scott Smith, who had 22.4 percent. Mr. Smith, the former mayor of Mesa, was considered the most moderate among the Republicans running for governor. He focused his campaign less on border security, a prime theme for his opponents, and more on the economy, which is still suffering from the aftereffects of the recession. Gov. Jan Brewer, a Republican, lent him her endorsement and financial support, in part because he backed her decision to expand Medicaid coverage, a move opposed by most Republicans in the state because of its perceived connection to President Obama’s health care overhaul (Santos, 8/26).

    The Wall Street Journal: Charlie Crist Wins Democratic Primary In Florida Governor's Race
    Former Florida Gov. Charlie Crist won his first race as a Democrat Tuesday night, securing the party's nomination to challenge current Republican Gov. Rick Scott in what will be one of the nation's premier gubernatorial contests this fall. … In Arizona, Republican Doug Ducey won his party's primary and will face Democrat Fred DuVal this fall in the race to succeed Republican Gov. Jan Brewer, who isn't seeking a third term. Mr. Ducey, Arizona's state treasurer, was endorsed by Texas Sen. Ted Cruz, who called his plan for addressing illegal immigration "the most serious and credible plan to address the border crisis." … The former CEO of ice-cream chain Cold Stone Creamery, Mr. Ducey has … pledged to rein in the costs of Medicaid expansion -- a law signed by Ms. Brewer that has proved controversial among Republican state legislators and has been a hallmark of her tenure. Ms. Brewer had endorsed another candidate, former Mesa, Ariz., Mayor Scott Smith, in the race (Ballhaus, 8/27).

    Arizona Republic: Incumbents Withstand Pro-Medicaid Vote
    The Legislature's vote in 2013 to expand Arizona's Medicaid program got a welcoming reception from voters Tuesday, as most of the Republican incumbents who supported it appeared to be withstanding challengers on their right. That issue, combined with a contentious decision to adopt Common Core standards for Arizona's schools, drew sharply defined battle lines in the Republican primaries. The policy moves also served as a referendum on Gov. Jan Brewer's legacy. She supported both initiatives and candidates who said they would defend the decisions (Pitzl and Lee, 8/27).



  • Minn. Home Health Care Workers Vote To Unionize

    The Service Employees International Union will represent about 27,000 home health care workers -- many of whom care for relatives -- who are paid through Medicaid.

    The Wall Street Journal: Minnesota Home-Care Workers Say Yes To Union
    The Service Employees International Union scored a victory Tuesday as home health care workers in Minnesota voted to be represented by the labor group, even as it faces a legal challenge from opponents who say the 27,000 workers involved shouldn't be forced to join a union. The SEIU is slated to represent Minnesota home health-care workers who are paid through Medicaid. Many of them care for their own relatives (Maher, 8/26).

    Pioneer Press: Minnesota Home Care Workers Approve Union
    Thousands of Minnesota home care workers have voted to create their own union, the state said Tuesday after counting results. The union will represent about 27,000 workers who are paid by the state to care for disabled or elderly patients (Snowbeck, 8/26).

    Minneapolis Star-Tribune: In Historic Vote, Minnesota Home Health Care Workers Unionize
    In one of Minnesota’s largest labor organizing efforts since the Depression, home care workers across the state on Tuesday voted to join the Service Employees International Union, giving that organization the power to bargain on their behalf. The vote is the culmination of one of the most sweeping union expansion efforts in Minnesota history and represents a victory for Gov. Mark Dayton and the DFL-controlled Legislature, who pushed through legislation that enabled the certification vote (Simons, 8/27).

    Minnesota Public Radio: Minnesota Personal Care Aides Back Statewide Union
    Government-subsidized personal care assistants -- people who work with the elderly and disabled in their homes -- have voted to form a union. Labor organizers billed it as the largest union vote in Minnesota history, though only 22 percent of the nearly 27,000 eligible home health workers mailed in their ballots this month, according to data released Tuesday by the state Bureau of Mediation Services (Pugmire, 8/26).