With some changes to its financing structure, the Healthy Howard Health Plan could emerge as a viable option for Americans who will not be able to afford to buy insurance should the ACA be struck down. Initiated in October 2008, Healthy Howard provides comprehensive, affordable healthcare to working-class families and individuals who have incomes higher than the eligibility level for entitlement programs like Medicaid, but still too low to afford private health insurance. Based on the primary care "medical home" model, with an emphasis on wellness and preventive services, Healthy Howard uses a local, federally qualified health center as our primary care home.
Highmark fired Dr. Kenneth Melani for "gross and willful misconduct" on April 1 because of another high-profile fight that went public. The sudden downfall of Melani, who earned $4.3 million last year, left healthcare industry experts reeling. The future of financially struggling West Penn Allegheny Health System and its 11,000 employees hangs in the balance. Highmark's fortune will be at risk if it loses subscribers to UPMC Health Plan or other insurers that will offer in-network access to UPMC hospitals and doctors when the UPMC-Highmark contract expires in 2013.
New Hampshire lawmakers are considering a variety of proposals that would affect how the state implements the controversial healthcare law or prevent participation. One bill would include New Hampshire in the federal lawsuit over the healthcare reform bill, which was heard last month in the Supreme Court, while another proposal would prohibit the state from implementing a state health care exchange. Beyond these bills, however, yet another proposal, HB 1560, would allow New Hampshire to bypass the Affordable Care Act and other federal healthcare programs. HB 1560 could allow New Hampshire to join an interstate Health Care Compact, which would enable members to enact regulations that supersede federal healthcare law.
California's prescription drug monitoring program is a real-time online database that displays a patient's prescription drug history. As attorney general, Gov. Jerry Brown promoted the online database in 2009 as a new solution to the prescription drug abuse epidemic. More than 40 states are using similar systems to help curb prescription drug abuse. But in California, the system has not put a dent in prescription drug abuse because enrollment in the drug-monitoring database program is optional. Of more than 30,000 doctors and pharmacists in the Bay Area, only 86 are signed up to use the system, according to records obtained by The Bay Citizen.
A contract impasse between Anthem Blue Cross Blue Shield and the emergency-room doctors at Augusta Health is not close to being resolved and could have a financial impact on area clients of the insurance company after May 1. Anthem says that if there is no contract, it will reimburse its members for a contracted rate. But that rate could be less than what ER physicians charge patients. The president of Shenandoah Emergency Medicine Specialists said the group attempted to renew its contract with Anthem six months ago for a more reasonable rate. Dr. Scott Just said that, after months of negotiation, "it became evident that Anthem had no intention of reaching an acceptable contractual agreement with the group."
Paul Hawks, an electrician for the Florida Department of Transportation, was one of more than 4,500 people in the United States in the past 25 years who have donated a section of their liver while still alive. Death is rare—besides Paul, three other donors have died since 1999. The relatives of the other donors—they died in 1999, 2002 and 2010 —have gone public, but this is the first time Lorraine has discussed her husband's death. The Department of Public Health report gives a rare and gruesome picture of a surgical procedure gone horribly wrong. The department's account is based on medical records, operating room communications and two days of interviews with the attending transplant surgeon and other doctors, nurses and administrators.