Tuesday, May 6, 2014

Tuesday, May 6, 2014

Senate rejects amendment to protect home-care services; Legislators weigh in on hospital financing fiasco; Legislature eyes new amnesty program for tax scofflaws; and Study: Health insurance can be a lifesaver. $265.8 million — Amount of advance lease payments provided by six private operators as part of the state’s hospital privatization deals. The payments are now being questioned by federal health care authorities.

Senate rejects amendment to protect home-care services
An effort to protect the Medicaid dollars that flow to providers of home- and community-based services for the elderly and people with disabilities died on the Senate floor Monday. Senate Bill 355 by Sen. Fred Mills, R-New Iberia, sailed through the Senate Finance Committee last week but received only 13 votes in the 39-member Senate after lobbyists for the nursing home industry urged lawmakers to reject the constitutional change. The amendment was filed in reaction to similar ballot measures that were approved last year which seek to protect funding for hospitals, nursing homes and pharmacies. “Mills said advocates for the community-based services as well as those in need of hospice care and home health care want a chance to take their case to voters too,” The Advocate reports.  “He said they will be exposed more to the budget axe even if constitutional amendments aimed at protecting nursing homes and hospitals are approved.”

Opponents of the measure said it would lock up too much state revenue, making other parts of the budget even more vulnerable during financial downturns. But those arguments didn’t hold sway in the House, where members approved a separate constitutional amendment that protects financing for higher education.

Legislators weigh in on hospital financing fiasco
Gov. Bobby Jindal’s top administrators faced heavy questioning from two legislative committees Monday, when Lawmakers in the House and Senate got their first chance to ask questions about the federal government’s rejection of the state’s financing plans for its charity hospital partnerships. Commissioner of Administration Kristy Nichols said the state plans an aggressive appeal of the ruling from the federal Centers for Medicare and Medicaid Services (CMS) and that the worst-case scenario would require the state to repay about $200 million to Uncle Sam starting in September 2015. Legislators quizzed the administrators on why they weren’t notified sooner about the financing problem, and pressed to get the matter resolved as quickly as possible.

The problem stems from the state’s decision to plug a 2012 budget gap using up-front lease payments from the private hospitals that took over the operations of six state-owned charity hospitals.

There is, of course, a simple solution to financing charity care in Louisiana: Instead of relying on an antiquated safety-net model, the state could simply accept federal dollars and extend Medicaid coverage to low-income adults.   But an effort to do just that died Monday on the Senate floor on a 15-22 vote.

Legislature eyes new amnesty program for tax scofflaws
Louisiana’s ongoing budget problems have given rise to yet another attempt to convince tax deadbeats to settle their accounts with the state. As Jeremy Alford reports in Lapolitics, the state hopes to raise $100 million through its latest tax amnesty program, which cleared its first committee hurdle on Monday. The latest deal involves giving even more generous terms than the state offered last year to entice corporations to pay what they owe. “While the Department of Revenue has not yet scheduled the 2014 tax amnesty program, it’s expected to be slated for the fall. Unlike last year’s two-month program, this year’s incarnation will be only one month. Still, there’s a great deal in the legislation to convince taxpayers to address their late and overdue payments. Rather than sticking with the 15 percent waiver for penalties, [Rep. Joel] Robideaux’s bill increases the threshold to 67 percent for penalties and 33 percent for interest.”

Study: Health insurance can be a lifesaver
A new study looking at the effects of the 2006 health insurance reforms in Massachusetts found that covering the uninsured leads to lower rates of death. The Massachusetts law, which provided near-universal coverage in that state by requiring most adults to carry health insurance, was the model for the federal Affordable Care Act.  “The study tallied deaths in Massachusetts from 2001 to 2010 and found that the mortality rate — the number of deaths per 100,000 people — fell by about 3 percent in the four years after the law went into effect. The decline was steepest in counties with the highest proportions of poor and previously uninsured people. In contrast, the mortality rate in a control group of counties similar to Massachusetts in other states was largely unchanged. A national 3 percent decline in mortality among adults under 65 would mean about 17,000 fewer deaths a year.”

$265.8 million — Amount of advance lease payments provided by six private operators as part of the state’s hospital privatization deals. The payments are now being questioned by federal health care authorities.