Princess Health and Nurse anesthetists no longer need to be supervised in Ky..Princessiccia

Princess Health and Nurse anesthetists no longer need to be supervised in Ky..Princessiccia

anesthesia doctors health care access physicians rural health state government

Gusty 15:19 Add Comment

Kentucky will be the 17th state to opt out of a federal requirement that requires nurse anesthetists to be supervised by a physician, a move that Gov. Steve Beshear said will increase flexibility and efficiency in operating rooms.

The Kentucky Hospital Association applauded the effort. "Certified registered nurse anesthetists are an extremely important part of health-care delivery in Kentucky, particularly in the rural areas of the state," said Mike Rust, KHA president. "This opt-out will ensure patient access to quality anesthesia care."

"We've consulted with the Cabinet for Health and Family Services and health care providers, and this is clearly a change we need to make to improve access to critical medical care," Beshear said. "In cases like this, where the federal requirement is an obstacle to some of the best options for delivery of high-quality health care, we're pleased to take this step to opt out."

A 2010 report that analyzed Medicare data for 1999 to 2005 and published in the journal Health Affairs found no evidence opting out of the oversight requirement resulted in more patient deaths or complications. (Read more)

Princess Health and Neat app shows how education, income affect a county's health.Princessiccia

Princess Health and Neat app shows how education, income affect a county's health.Princessiccia

county health diabetes education health rankings income

Gusty 13:18 Add Comment

Based on the premise that much of what influences health happens outside the doctor's office, the 2012 County Health Calculator uses education and income to illustrate how these factors can affect one's health any county. 

The app estimates how many cases of diabetes would be prevented, how many lives would be saved and how many diabetes costs would be eliminated if income or education levels improved by specific amounts in a specific area. For example, the Pulaski County page shows, "If 5 percent more people attended some college and 4 percent more had an income higher than twice the federal poverty level, we could expect to save 17 lives, prevent 175 cases of diabetes, and eliminate $12 million in diabetes costs every year."

The application also shows which counties have the highest and lowest education levels (best: Fayette County, worst: Clay County) and income levels (best: Oldham County, worst: McCreary County).

The interactive app was developed by the Robert Wood Johnson Foundation and Virginia Commonwealth University's Center on Human Needs and renders "ballpark estimates" of avertable deaths, diabetes and diabetes cost. Researchers obtained education and income data from the U.S Census Bureau and county death rates and estimates of the prevalence of diabetes from the U.S. Department of Health and Human Services. Estimates of diabetes prevalence were based on self-reports by people who responded to the Behavioral Risk Factor Surveillance System. Data on medical spending on diabetes derived from The Dartmouth Atlas of Health Care. (Read more)

Princess Health and Beshear says he will create state health insurance exchange if federal health reform law is upheld.Princessiccia

Princess Health and Beshear says he will create state health insurance exchange if federal health reform law is upheld.Princessiccia

Affordable Care Act Cabinet for Health and Family Services health insurance health reform insurance exchange state government

Gusty 08:59 Add Comment

Gov. Steve Beshear said today that he will wait on creating a health insurance exchange under federal health reform until the U.S. Supreme Court rules on the constitutionality of the reform law, which is expected to happen in late June. He said in a press release, �The steps we have taken to date, and the planning process we are putting in place helps ensure the state is able and ready to follow the law.�

The exchange, a requirement of the Patient Protection and Affordable Care Act, would be a market for individual health-insurance policies. It would help small employers insure their employees in health plans and "enable individuals to receive premium tax credits and premium subsidies, and qualify small businesses for tax credits," the release said.

"The state has a $57.8 million federal grant to plan and implement of programs and systems required by the law, including "building an end-to-end eligibility and enrollment system to serve both Medicaid and exchange participants," the release said. "Kentucky previously received two federal health insurance exchange planning grants totaling $8.6 million." (Read more)

With time running short, why wait to issue an order? The court's decision "may impact the nature of the executive action," said Jill Midkiff, spokeswoman for the state Cabinet for Health and Family Services. "The timing of issuance of the executive order will not impact the current work or future work that is being completed to establish a state exchange. There is nothing that we need to accomplish at this point that requires an executive order to be in place."

Princess Health and State tells Coventry Cares to keep covering ARH patients; managed-care firm says it will drop Ashland hospital.Princessiccia

Princess Health and State tells Coventry Cares to keep covering ARH patients; managed-care firm says it will drop Ashland hospital.Princessiccia

Appalachia courts hospitals managed care state government

Gusty 05:46 Add Comment

The state has ordered Medicaid managed-care firm Coventry Cares to keep paying for its members to be treated at Appalachian Regional Healthcare hospitals for at least 30 days, rather than stopping tomorrow -- when a federal judge will hold a hearing in ARH's lawsuit against Coventry, after having ordered negotiations between the parties. For more from ARH, click here.

Meanwhile, the Lexington Herald-Leader reports that Coventry plans to stop paying for services at King's Daughters Memorial Hospital in Ashland, one of the largest health-care facilities in the region. Hospital spokesman Tom Dearing told the newspaper, "Coventry's obvious lack of commitment to the people of Eastern Kentucky, putting profits ahead of lives, will potentially leave thousands of Medicaid recipients without adequate health care options." He said the hospital had 29,000 cases covered by Coventry from Nov. 1 to March 31. (Read more)

Read more here: http://www.kentucky.com/2012/05/02/2172494/judge-orders-hospital-chain-medicaid.html#storylink=cpy

Princess Health and Appalachian Regional Healthcare asks federal judge to make managed-care firm keep it under contract.Princessiccia

Princess Health and Appalachian Regional Healthcare asks federal judge to make managed-care firm keep it under contract.Princessiccia

Appalachia health insurance hospitals jobs Medicaid politics poverty rural health state budget state government

Gusty 12:45 Add Comment

Appalachian Regional Healthcare, a hospital chain in Eastern Kentucky and southern West Virginia, is seeking an emergency injunction by a federal judge ordering Coventry Cares to let its Kentucky members continue receiving services from the hospitals, and to avoid widespread layoffs the chain says will happen if the judge doesn't intervene, reports Bill Estep of the Lexington Herald-Leader. Coventry Cares is one of three state-approved companies to provide managed care services through Medicaid. It said it would cancel its ARH contract after Friday, which would affect about 25,000 Medicaid recipients.

With a few exceptions, Coventry members would lose access to treatment or have to travel long distances to get to other facilities approved by the company, which ARH and officials in affected counties say would be difficult for most because they don't have money or reliable transportation to make the trip. Coventry spokesman Matthew Eyles said the company would continue paying for some services at ARH hospitals, including ob-gyn services to women who are more than 12 weeks pregnant and have a relationship with an ARH doctor.

The state switched to managed-care last year as a way to save money, but as Estep reports, the move has been "rocky." Providers have complained about delayed payments from the companies and their cumbersome pre-approval processes for treatments. ARH sued Coventry and Kentucky Spirit, another provider, claiming the companies owed more than $18 million for services ARH had provided.  Estep notes, "The state allowed another managed care provider not to include ARH in its network, which meant a lot of higher-risk, higher-cost patients ended up covered by Coventry, the company said." The company also said the state failed to implement a method to assess risks that would adequately compensate managed-care providers who have more high-risk patients."

ARH and its Coventry patients think the company is trying to get more money out of the state. Many of ARH's patients are covered by Coventry, and ARH spokeswoman said about 300 to 400 jobs would be cut if Coventry cancels its contract. State officials are encouraging continues negotiation between ARH and Coventry. (Read more)

Meanwhile, Bardstown pediatrician and Passport Health Plan board member James Hendrick wrote a letter to the editor of The Courier-Journal offering Passport's services to "help the state get Medicaid back on track." He said he's been very impressed with the nonprofit's "strong and engaged provider network, and an intense focus on delivering services at a cost that doesn�t diminish quality," adding that because Passport is a nonprofit, it's not concerned with appeasing shareholders. Passport has been managing Medicaid in the Louisville region for several years.

Princess Health and Meds-for-meth bill drew record lobbying expenses, not even including radio and newspaper ad campaigns.Princessiccia

Princess Health and Meds-for-meth bill drew record lobbying expenses, not even including radio and newspaper ad campaigns.Princessiccia

advertising allergies drug abuse drug companies drugs legislation legislature meth methamphetamine pharmaceuticals pharmacies pharmacists pseudoephedrine state government

Gusty 05:14 Add Comment

Makers of over-the-counter drugs spent more than any lobbying interest ever had during a single Kentucky legislative session in their effort to defeat a bill requiring prescriptions for the key ingredient in methamphetamine, Bill Estep reports for the Lexington Herald-Leader.

"The Consumer Healthcare Products Association spent $457,053 on lobbying activities in the first three months of this year's legislative session, according to reports filed with the state Legislative Ethics Commission," Estep writes. "The group's lobbying effort was so dominant that it spent more than the next five groups combined in that period, January through March, according to spending reports."

And the figure doesn't even included hundreds of thousands of dollars that the trade group spent on radio and newspaper campaigns, because the lobby-reporting requirements do not apply to messages aimed only at the general public. The group did report spending on "a phone-bank operation to put people in contact with legislators to voice concerns about legislation to require a prescription for medicine containing pseudoephedrine, which is now available over the counter," Estep writes.

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

The efforts, dating back to 2010, were partly successful. The legislature passed a bill "that will require a doctor's prescription for pseudoephedrine, but only after someone has bought 24 grams of the medicine a year," Estep notes. "A 48-count box of the generic medicine with 30-milligram pills contains 1.44 grams of pseudoephedrine. The bill excludes limits on gel caps and liquid pseudoephedrine." (Read more)

The lobbying effort wasn't only about Kentucky. The makers of Sudafed and other pseudoephedrine preparations are trying to stave off similar efforts in other states, and viewed Kentucky as a sort of firewall after seeing prescription-only laws pass in Oregon and Mississippi.

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/04/30/2170495/makers-of-cold-medicines-set-new.html#storylink=cpy

Princess Health and Managed-care firm blames state for problems leading to impending end of contract with ARH hospitals.Princessiccia

Princess Health and Managed-care firm blames state for problems leading to impending end of contract with ARH hospitals.Princessiccia

Appalachia courts managed care poverty state government

Gusty 04:44 Add Comment

In the face of a lawsuit that alleges it did not pay claims promptly, Coventry Health and Life Insurance Co. blamed the state for problems that have surfaced since managed care was implemented. Coventry has canceled its contract with Appalachian Regional Healthcare, which has sued the company as well as Kentucky Spirit Health Plan Inc., reports Nola Sizemore for the Harlan Daily Enterprise.

"The current crisis would have never occurred except for the commonwealth's failure to make timely and reasonable decisions on three major issues," Coventry Executive Vice President Timothy Nolan said in a letter to ARH President Jerry W. Haynes. The issues are "a failure to implement a risk adjustment methodology, failure to find a solution to the supplemental hospital payment issue and errors in the original data book and failure to ensure all MCOs meet the same robust standards for network adequacy," Sizemore reports. MCOs are managed-care organizations.

Conventry Health and Kentucky Spirit are two of three MCOs chosen to manage the state's Medicaid program. Since they took over Nov. 1, there have been repeated complaints about delayed payments, as well as burdensome rules requiring doctors to get pre-authorization from the companies before they can provide care.

ARH treats about 25,000 Medicaid patients at its eight hospitals. In the past six months, nearly 11,000 Medicaid visits have been made at the Harlan facility alone, with 7,800 of them covered by Coventry, said Mark Bell, community and patient advocate. This will "present a complex and serious crisis for everyone," he said. (Read more)