Lawmakers last year called for reducing poor patients' use of emergency rooms to save Medicaid $72 million, but state officials' first try at a three-visit limit on "nonemergency" visits to the ER was criticized by doctors and hospitals and struck down by a judge over procedural flaws. The state now has a new plan with a stricter limit: Medicaid will cover zero ER visits if treatment in an emergency room is "not medically necessary" for a health condition.
A teenager accused of bluffing his way into an Osceola County hospital emergency room last year says it's not his fault. The state attorney's office released interviews with Matthew Scheidt, 18, who is being held on no bond after he was accused of impersonating a physicians assistant and a police officer. Scheidt faced two counts of impersonating a physician's assistant and four counts of practicing medicine without a license in October.
HCA Holdings Inc, the largest U.S. hospital operator, on Monday reported better-than-expected fourth-quarter earnings as it admitted more patients to its facilities and recorded a one-time gain from an investment, sending its shares up 6 percent. A focus on controlling operating expenses and a reduction in bad debts helped offset lower surgical volumes, the company said. Cardiovascular surgery volumes were down for the third consecutive quarter, though the rate of decline slowed, company officials said on a conference call. Managed-care admissions, which slumped during the economic downturn as workers lost jobs and insurance, rose slightly for the second quarter in a row.
State regulators are examining a $1.5 million proposal by an Oregon insurer to take over a portion of Montana's third-largest health insurance company as part of a government anti-trust settlement. Commissioner of Securities and Insurance Monica Lindeen has scheduled a hearing Tuesday on the proposal by PacificSource Health Plans to buy New West Health Service's commercial business. The hearing will examine whether the deal is fair and protects the estimated 9,000 New West policyholders who will be affected, said Lindeen spokesman Lucas Hamilton. The hearing will include a public comment period.
The Obama administration blocked an effort by California to charge Medicaid patients for emergency room visits and hospital stays and allow healthcare providers to turn away those who couldn't pay. A law signed by Democratic Governor Jerry Brown in March would have assessed co-payments in Medicaid for a variety of medical services, including prescription drugs. The co-payments were expected to save California $575 million in the fiscal year that begins July 1, said H.D. Palmer, a spokesman for the Department of Finance. The administration was "unable to identify the legal and policy support" for California's request, Marilyn Tavenner, acting administrator of the Centers for Medicare and Medicaid Services, wrote in a letter today to Toby Douglas, chief deputy director of health-care programs for the California Department of Health and Care Services.
Vermont Gov. Peter Shumlin and legislative leaders said Monday they wanted to make it possible for more of the state's small businesses to offer lower premium health insurance plans sometimes known as "bronze plans" until the state can implement its single payer health care system. Speaking Monday in Montpelier, Shumlin and leaders from the House and Senate, all Democrats, said they would also allow businesses with more than 50 employees to remain outside the federally-mandated health care exchange until 2016. "We feel strongly that the exchange is not the answer to all Vermont's health care problems," Shumlin said at a news conference in the Montpelier Statehouse.