News from Tallahassee for 7/28/14

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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Alzheimer's, Cancer Bills Signed posted on 6/19/14

by News Service of Florida

Gov. Rick Scott signed health care-related bills Wednesday that affect research on Alzheimer's disease and cancer.

One (combined HB 711 and HB 709) creates the Ed and Ethel Moore Alzheimer’s Disease Research Program within the Department of Health to decide on grants aimed toward prevention of, or a cure for, Alzheimer’s disease. The Moores were the grandparents of Rep. Matt Hudson, R-Naples, chair of the subcommittee on health care appropriations. The state's $77 billion budget includes $3 million for the Ed and Ethel Moore program.

Another bill (HB 5203) sets up a program at the Department of Health to help the University of Florida and University of Miami win designation as National Cancer Institute centers. Currently the state has only one -- H. Lee Moffitt Cancer Center and Research Institute in Tampa -- yet the population is large enough to warrant three. And given the demographics of Florida, with its large retiree population, cancer has a larger-than-usual footprint.

Both bills go into effect July 1.

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Verdict in Lab Battle: $15M posted on 6/17/14

by Carol Gentry | Health News Florida

Millennium Laboratories, a San Diego company that specializes in urine testing nationwide, should pay its major competitor almost $15 million in damages for unfair business practices and violations of federal anti-kickback laws, a Tampa federal jury announced late Monday.

That competitor is Ameritox Ltd., which has headquarters in Baltimore. Ameritox brought the civil case against Millennium Labs in 2012 after state and federal authorities did not intervene, its attorneys said during the two-week trial.

Most of the damages -- $12 million of the total award of $14.755 million -- were punitive. The harm that Millennium's actions inflicted on Ameritox took place in three states, the jury said: Florida, Tennessee and Texas. Florida was the site of the most damage, the jury decided.

The jury assessed $8.7 million in damages for Millennium's sales practices in Florida, of which $7 million was punitive. Damages for the other two states were about $3 million apiece, most of it punitive.

What the jury regarded as illegal kickbacks -- violations of the federal Stark Law -- were free plastic urine specimen cups that had test strips built into them. Millennium Labs gave the $5 cups to doctors as a marketing tool, attorneys said during the trial. The idea was that doctors who got the cups might switch from Ameritox to Millennium for the confirmatory tests, for which Medicare and insurance companies often pay more than $100. And the cup giveaway appeared to work, judging from sales charts.

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