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As 2018 comes to a close, NAHU would like to wish its members, partners and other industry professionals a safe and happy holiday season.|
Our final NAHU Newswire for 2018 will run on Friday, Dec. 21, before taking a short hiatus during the holidays. Our regular publication will resume Thursday, Jan. 3, 2019.
The three red states — Idaho, Nebraska and Utah — that bucked their own Republican legislatures last month and approved Medicaid expansion under the Affordable Care Act are likely to proceed, despite Friday's ruling by a federal judge in Texas that the entire federal health care law is unconstitutional.
Even in Montana, where voters last month defeated an extension of the temporary Medicaid expansion approved in 2015, legislative leaders predict that lawmakers will make the expansion permanent, since it is politically unpopular to take coverage away from people once it has been extended.
The Roanoke Times
Kara Murdock camped out on Halloween night so she would be the first person in Prince William County to enroll in Virginia's newly expanded Medicaid program.
The 27-year-old, whose right arm was amputated below the elbow as the result of a blood clot when she was 23, has been uninsured since she was dropped from her parents' insurance coverage when she turned 26.
But on Jan. 1, Murdock will be one of the more than 180,000 uninsured people to gain Medicaid coverage under the program's new qualification rules.
KUER 90.1, NPR Utah
A familiar health program known as work requirements will be returning in the upcoming legislative session after Utahns' voted to fully expand Medicaid in November.
Work requirements are the rules that say if an individual gets low-income health insurance through the state's Medicaid program, they also have to fulfill a requirement like taking classes, doing job training or volunteering.
"You either have to be employed or you have to be looking for work, or preparing yourself so that you're qualified to go to work if you are able," said Utah State Senator Allen Christensen, R-Ogden.
Enrollment in health insurance plans for 2019 under the Affordable Care Act has slipped about four percent from the signup period last year, according to federal data, after a late surge prevented the decline from reaching double digits.
Nearly 8.5 million people in states that use the federal HealthCare.gov marketplace signed up for 2019 coverage by the Dec. 15 deadline, the federal Centers for Medicare and Medicaid Services reported, off from about 8.8 million last year. Still, this year's decline had measured 13 percent, compared to last year, after the initial four weeks of open enrollment that began Nov. 1, signaling a pickup in the final stretch.
National Law Review
In another change to U.S. state breach notice laws in 2019, South Carolina will have new breach notice requirements for insurance companies. The requirements follow the National Association of Insurance Commissioners' Insurance Data Security Model Law. South Carolina was the first to adopt the model text into law, and it is this law that is going into effect on Jan. 1, 2019. South Carolina joins others states, including Connecticut and New York, to have breach notice requirements for insurance companies.
Providers and insurers want the CMS to put some real teeth — including financial penalties — into any plan requiring greater price transparency from drugmakers.
In comments on a proposed rule to require drugmakers to list a drug's wholesale price in TV ads, several provider and insurers groups told the agency that a stick is needed to ensure pharmaceutical companies follow through.
Kaiser Permanente, which said it would prefer to see HHS and Congress curtail direct-to-consumer ads, suggested imposing a fine of one percent of Medicare and Medicaid payments on drugmakers that violate the rule, should it become final.
Health Leaders Media
A study released recently showed that just 30 percent of self-pay accounts, comprised primarily of patients who are uninsured, have generated 80 percent of self-pay revenue for hospitals.
That's certainly a lopsided statistic, one made especially significant by the ballooning uninsured rate.
But what should revenue cycle executives do — in a practical sense — with that finding?
Gov. Pete Ricketts' administration has taken a step forward on expanding Medicaid to some 90,000 low-income Nebraskans.
State officials recently unveiled a website aimed at informing citizens about progress in carrying out the Medicaid expansion measure passed by voters in November.
The measure, known as Initiative 427, became law last week. It requires the Department of Health and Human Services to file a Medicaid plan amendment with the federal government by April 1.
A new study from independent nonprofit FAIR Health analyzed individual procedures or services covered by private insurance companies from 2007 to 2017. In that decade, use of services for behavioral health, which includes substance abuse and mental-health conditions, went up 320 percent. Treatment related to use and dependence on amphetamines climbed more than 3,000 percent, while use of treatment for anxiety diagnoses spiked more than 240 percent.
Alice Chen, Ph.D., M.B.A., from the University of Southern California in Los Angeles, and colleagues conducted a cross-sectional study to examine the characteristics of physicians excluded from Medicare and state public insurance programs for fraud, health crimes, or unlawful prescribing of controlled substances between 2007 and 2017.
The researchers found that 2,222 physicians (0.29 percent) were temporarily or permanently excluded from Medicare and state public insurance programs during 2007 to 2017.
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NAHU Newswire is a daily brief featuring the latest news of interest to healthcare agents and brokers, selected from thousands of sources by the editors of MultiView. NAHU personnel, in accordance with internal policies, do not approve all stories selected. Any comments regarding content of this publication should be emailed to NAHU. It should not be understood or inferred from the presence of advertisements that NAHU endorses any products or services advertised. Similarly, NAHU is not responsible for the quality of journalism reflected in the articles: it should not be understood or inferred that NAHU supports the information provided. MultiView and NAHU are not liable, for any delays or inaccuracies in the information contained in this brief, nor for any actions taken or outcomes resulting from relying on the information provided herein.
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