News from Tallahassee for 7/31/14

State corrects errors in its lawsuit against VA posted on 7/23/14

by staff | tampa bay times

The state has filed an amended lawsuit against the Department of Veterans Affairs that deletes several significant errors about a patient offered as an example of the poor care veterans receive in agency hospitals.

The Tampa Bay Times reported earlier this month that the suit made several errors in the case of veteran Roland "Dale" Dickerson, a Largo resident who believes the VA failed to treat his serious coronary blockages in a timely manner.

The suit said Dickerson tried to get care at St. Petersburg General Hospital and had a procedure showing he had a minimal narrowing of his coronary arteries when, in fact, he had a 69 percent blockage. It noted Dickerson had to get pricey private health insurance to pay for heart surgery at a non-VA hospital.

None of these assertions are true, though a Times review of Dickerson's medical file appeared to support the veteran's belief that the VA delayed critical heart tests for more than two years.

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Court Deals Setback to Health Care Law posted on 7/22/14

by ROBERT PEAR | NY Times

Affordable Care ActWASHINGTON — In a ruling that could upend President Obama’s health care law, a federal appeals court ruled Tuesday that the government could not subsidize premiums for people in three dozen states that use the federal insurance exchange. The 2-to-1 ruling could cut off financial assistance for more than 4.5 million people who were found eligible for subsidized insurance in the federal exchange, or marketplace.

Under the Affordable Care Act, the court said, subsidies are available only to people who obtained insurance through exchanges established by states.

The law “does not authorize the Internal Revenue Service to provide tax credits for insurance purchased on federal exchanges,” said the ruling, by a three-judge panel of the United States Court of Appeals for the District of Columbia Circuit. The law, it said, “plainly makes subsidies available only on exchanges established by states.”

Their share of premiums could then increase sharply, making insurance unaffordable for many.

However, the decision is the not the last word, as other courts are weighing the same issue. And the ruling could be reviewed by the full appeals court here.

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FL Mosquitoes Spreading Virus posted on 7/18/14

by Mary Shedden | Health News Florida

Health officials say a mosquito-borne illness that had afflicted Floridians who traveled to the Caribbean has now been transmitted within the state.

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Lawyers, Patients Fight Cost of Records posted on 7/10/14

by Carol Gentry | Health News Florida

Doctors used to give patients a copy of their medical records for free. But that service is waning, as today's large group practices shed the hassle and risk by outsourcing the record-handling.

For-profit companies in the new "release of information" or "disclosure-management" industry include HealthPort Technologies LLC in suburban Atlanta and Bactes Imaging Solutions LLC in San Diego.

They say it is costly to process record requests in compliance with patient privacy laws. In Florida, they get $1-a-page for hospital records, whether the copies are on paper or digital.

For doctors' records, the price is likewise $1 a page in most cases. The only price breaks are for patients, who pay a quarter a page after 25 pages, and government agencies.

The Florida Board of Medicine has been debating whether to do away with the exceptions and have a $1-a-page maximum charge for everyone. A hearing is now scheduled for October in South Florida.

HealthPort Technologies' General Counsel Jan McDavid says most people don't understand why the industry wants the charge to be the same for copies in electronic and paper format; they think a download should be less expensive. But what's costly isn't the paper, she said, it's the personnel.

"There are about 32 steps involved" in processing a document-copy request," she said. "It takes a lot of training; it's a very highly regulated environment."

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Demand that hospitals repay Medicaid funds latest sign of D.C.-Tallahassee rift posted on 7/7/14

by Tia Mitchell | Times/Herald Tallahassee Bureau

caduceusTALLAHASSEE — The federal government wants to recover $267 million from Florida hospitals it says were paid too much to care for the poor. And it wants the entire amount this year — a demand that is hitting safety-net hospitals like Jackson Memorial in Miami and Tampa General hard.

"Essentially it wipes out any profit we would have next year, so that's kind of why we're struggling with it," said Jackson Health System chief financial officer Mark Knight, noting the state's largest public hospital had operated in the red for years before turning things around.

Jackson stands to lose $47 million in Medicaid funding with this one issue. Tampa General would be out $13.3 million.

The federal demand is the latest incident highlighting tensions between Washington and Tallahassee over how to provide health care to the poor. Republican legislators rejected President Barack Obama's Medicaid expansion that would have provided health coverage for 764,000 uninsured Floridians.

But Tallahassee leaders wanted to continue receiving $1 billion a year in Medicaid Low Income Pool payments to hospitals. They even asked Washington for more from that program.

It's not unusual for health care funding to be audited and adjustments required. Justin Senior, director of the state Medicaid program, noted that $267 million, a figure accrued over the past eight years, pales compared with the $1 billion annual appropriation.

But the one-year repayment is a sticker shock. Hospital and state officials have asked for three years instead, and assurances that the audits are final.

But its holdout position on Medicaid expansion means Florida lacks leverage, Knight said.

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