Residents and town officials of the Boothbay peninsula in Maine are outraged at the announcement that they will lose their emergency room and hospital of St. Andrews hospital, and that this was presented by Lincoln County Healthcare (LCH) as a fait accompli, with no discussion with the community. The selectmen from the towns and state Representative Bruce MacDonald have put together a task force to explore alternatives to closing the region’s emergency room. Their efforts are being stymied by the lack of transparency from LCH, with their withholding data from the community task force as well as recommendations from their consultants, but especially by time constraints.
Saying there are "troubling indications" of abuse in the way hospitals use electronic records to bill for Medicare and Medicaid reimbursement, the Obama administration warned on Monday that it would not tolerate what it called attempts to "game the system" and vowed to vigorously prosecute doctors and hospitals implicated in fraud. The strongly worded letter, signed by the attorney general, Eric H. Holder Jr., and the secretary of health and human services, Kathleen Sebelius, said that "electronic health records have the potential to save money and save lives." But the letter continued: "There are troubling indications that some providers are using this technology to game the system, possibly to obtain payments to which they are not entitled."
Mitt Romney suggested Sunday that Americans who lack insurance can find the care they need in emergency rooms—a position that contradicts the rationale behind his Massachusetts healthcare law. In an interview on CBS, the former governor was asked whether the government should provide healthcare for the uninsured. The GOP presidential nominee replied by saying that "we do provide care for people who don't have insurance"—emergency care. "If someone has a heart attack," Romney said, "they don't sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care."
Seven of the top 10 Medicare prescription drug plans (PDPs) saw a double-digit increase in premiums for 2013, according to an analysis by Avalere Health. The increases mean that several of the top 10 PDPs will lose eligibility for low-income subsidy beneficiaries in some U.S. regions, the study found. The release comes not long after the Kaiser Family Foundation found that health insurance premiums rose by a modest 4 percent this year on average, down from a 9-percent increase in 2011. Analysts attributed the drop to the slow economy.
After a summer of disappointing economic news, the recent Census report on the uninsured was a rare bit of sunshine. The number of uninsured Americans declined by about 3 percent, or 1.34 million, to 48.6 million in 2011. This was the largest one-year numerical decline in twelve years. There were "only" about 1.7 million more uninsured in 2011 than there were in 2006, before the devastating recession. The search for policy fingerprints on these findings points directly to Medicaid. For all the controversy over this program, the safety net did its job.
The Obama administration on Monday began requiring health insurers to provide user-friendly guides to patients that explain their benefits, aiming to make buying insurance nearly as easy as scanning packages of food for nutrition facts. Under President Barack Obama's healthcare reform law, employers and insurers must provide a summary of benefits and coverage in a clearly worded, standardized format that allows the private insurance market's 163 million beneficiaries to make side-by-side comparisons of plan offerings. The benefit guides will also factor into the creation of new state-based health insurance markets due to begin offering subsidized, private coverage to moderate-income consumers in January 2014.