Saturday, 20 June 2015

Princess Health and Merger mania: Aetna bids for Humana; Cigna may want it too; Anthem has bid for Cigna; UnitedHealth makes a play for Aetna.Princessiccia

Princess Health and Merger mania: Aetna bids for Humana; Cigna may want it too; Anthem has bid for Cigna; UnitedHealth makes a play for Aetna.Princessiccia

Aetna Inc. has made a bid to buy Louisville-based Humana Inc.,"one of a number of recent moves by big health insurers to find merger partners," Dana Mattioli and Liz Hoffman report for The Wall Street Journal.

The proposal was made in "the last few days," the Journal reports. "It isn�t clear how much Aetna indicated it would pay. Humana has a market value of $30 billion. The company hired Goldman Sachs Group Inc. to help it field takeover interest, people familiar with the matter have said."

Meanwhile, Aetna has been approached by another big insurer, UnitedHealth Group. "It isn�t clear what, if any, Aetna�s response was," the Journal reports. "News of the Aetna proposal comes the same day Anthem Inc.another of the five big managed-care companies, said it boosted its takeover offer for Cigna Corp.,"offering $47.5 billion. "Anthem went public with the bid after the two sides failed to reach agreement, and is seeking to put pressure on Cigna through Cigna shareholders."

"Cigna itself is eyeing Humana, people familiar with the matter have said. The five big managed-care companies are jockeying for deals that will enable them to get more efficient and better respond to changes in the health care landscape in the U.S.," the Journal reports.

"Humana, which has an estimated 12,000 employees and roughly 2,000 contractors in Louisville and the immediate region, has been seen as an attractive target in the health-insurance industry because of its well-run business running Medicare Advantage programs," Grace Schneider reports for The Courier-Journal. The company is valued at $30 billion.

"The company's membership rolls have surged to more than 3 million in the last year," Schneider writes. "That growth comes when health care reform has forced providers � hospitals, doctors, pharmacies, among them � to consolidate to increase their leverage and clout in an increasingly competitive health care segment. For the same reason, health insurers are now looking to consolidate."
Princess Health and Biotech firm buys UK professor's anti-overdose nasal spray.Princessiccia

Princess Health and Biotech firm buys UK professor's anti-overdose nasal spray.Princessiccia

Pharmacy Professor Daniel Wermeling at the University of Kentucky invented a nasal spray to fight heroin overdoses, and a biotech firm has bought the product, which may be on the market within six months, pending approval by the U.S. Food and Drug Administration. The device "contains a single dose of a mist form of naloxone and delivers the drug in a way similar to how Flonase is used to treat allergies," Mary Meehan reports for the Lexington Herald-Leader.

The product is on a fast track for approval because of the rising rates of heroin overdoses across the country, said UK Provost Tim Tracy, former dean of UK's pharmacy school. Wermeling doesn't know exactly when his product will be on the market, but he said the FDA approved another fast-track, anti-overdose therapy after only 14 weeks. The fast-track program speeds development of drugs to treat serious or life-threatening conditions. "Last year, 233 people [in Kentucky] died with heroin in their systems, according to the state medical examiner's office," Meehan notes.

Wermeling has been developing the project at UK since 2009 with the help of more than $5 million in federal and state tax dollars. Tracy said Indivior PLC, the spinoff pharmaceutical company that bought the nasal spray, will be able to manufacture, market and distribute the product. Right now, emergency responders and hospitals must draw naloxone, branded as Narcan, in a syringe to provide the correct dose.

Princess Health and Three doctors, nine others in western half of Kentucky are indicted in the largest-ever federal 'takedown' of Medicaid fraud.Princessiccia

Former Dr. Fred Gott of Bowling Green was arrested.
(Photo: Miranda Pederson, Bowling Green Daily News)
Twelve people in the western half of Kentucky, including three doctors, have been charged with Medicaid fraud in what the federal government calls its biggest-ever "takedown" of the problem, Andrew Wolfson of The Courier-Journal reports.

The indictments allege "a half-dozen schemes involving nearly $8 million in alleged fraudulent billings," Wolfson writes. "The offenses include $5 million in false billings for muscle-relaxant injections that were never delivered to patients, as well as a staged car wreck in which three people allegedly conspired to get controlled substances and fraudulent reimbursements."

In another case, Wolfson reports, "a medical practice that treated car wreck patients is accused of using the DEA numbers of nurse practitioners to order hydrocodone for herself and falsely billing it to an insurance company. Nationally, the sweep resulted in charges against 243 people, including 46 doctors, nurses and other licensed medical professionals."

John Kuhn, acting U.S. attorney for the Western District of Kentucky, told Wolfson that about $1 billion of annual Medicare and Medicaid expenses are fraudulent. Medicare is the federal health-insurance program for people over 65; Medicaid is the federal-state program for the poor and disabled.

Former Dr. Fred Gott of Bowling Green, a 63-year-old cardiologist, was charged with "conspiracy to dispense controlled substances, health care fraud and money laundering," Deborah Highland reports for the Bowling Green Daily News. "The Bowling Green-Warren County Drug Task Force opened an investigation into Gott�s practices after Warren County Coroner Kevin Kirby alerted the task force about drug overdose deaths involving Gott�s patients, task force director Tommy Loving said."

Friday, 19 June 2015

Princess Health and Trimble County parents protest 'humiliating' treatment of students whose school lunchroom accounts are in the red.Princessiccia

Princess Health and Trimble County parents protest 'humiliating' treatment of students whose school lunchroom accounts are in the red.Princessiccia

Parents in Trimble County are demanding that the county schools stop serving cheese sandwiches to students whose lunchroom accounts are in the red, Kayla Vanover of WAVE-TV in Louisville reports.

"Embarrassing, humiliating and 'flat out wrong' is how parents described the school's policy to take a student's lunch right off the lunch table and toss it because the child's parents had not replenished their account to cover the meal," Vanover reports.

On May 20, Lori Ritchie's daughter "sat down to eat, but her hot meal was thrown away and she was given a cheese sandwich with a side," Vanover reports. "Ritchie said she doesn't blame the workers, but she said the policy needed to be changed a long time ago. Wednesday, a special called public meeting with the school board allowed other parents and community members to voice their opinions on the current policy, in hopes an agreement could be made."

Doug Joyce, grandfather of a student, told the board, "It is bullying. We throw kids out of school or reprimand them for bulling, so why should we let grown-ups bully kids like that?" A board member, unidentified in Vanover's story, said "We don't want any child to be embarrassed or receive an alternative meal, so we are really going to beef up the communication."

Princess Health and Food Reward Friday. Princessiccia

This week's lucky winner... the Pizza Hut Hot Dog Bites pizza!!!


Read more �

Princess Health and Republican legislators question cabinet's figures on managed-care payments and cost projections for Medicaid expansion.Princessiccia

Audrey Haynes (cn|2 image)
"When Audrey Haynes sat down before the legislature�s Medicaid Oversight and Advisory Committee Wednesday, she expected the data she brought would persuade lawmakers that Kentucky�s expansion of Medicaid has been good for the state," Ronnie Ellis reports for CNHI News Service. "The secretary of the Cabinet for Health and Family Services, which administers the Medicaid program also may have expected her statistics to ease unhappiness with the state�s move to managed care for most Medicaid services."

"It didn�t happen," Ellis writes. "At least she didn�t persuade Republican members who openly questioned the validity of the cabinet�s data, a couple stopping just short of saying the cabinet is making up the numbers" about payments to providers by managed-care organizations, which it says are 99 percent on time. �The numbers do not appear to represent the reality on the ground,� Rep. Richard Benvenuti, R-Lexington, said after the meeting.

Sen. Ralph Alvarado
�I think those are false,� Sen. Ralph Alvarado, R-Winchester, said after the meeting. �I don�t know if they�re lying, but somebody is providing bad information.�

During the meeting, Alvarado read "segments of letters from providers who have not received full reimbursements from managed care organizations," reports Kevin Wheatley of cable channel cn|2's "Pure Politics."

"Haynes referenced a report from CHFS which showed that over 90 percent of Medicaid claims are being paid in a timely manner," reports the blog of the Kentucky Chamber of Commerce. "Sen. Alvarado replied that this statistic does not match what he is hearing from his constituents and medical providers." Haynes addressed the managed-care issue in her PowerPoint presentation, downloadable here.

Rep. David Watkins, D-Henderson, a retired physician and co-chair of the committee, "urged the panel to find ways to improve managed care."

Watkins said the managed-care organizations, which are insurance companies or their subsidiaries, should come before the committee to answer questions. �I�m not totally satisfied that they�re doing quite as good a job as your report here would portray,� he told Haynes. �I think they need to be more accountable. I think they need to be more responsive to the providers who actually are doing work in the field.�

The MCOs will appear before the joint House-Senate committee Aug. 19, Brad Bowman reports for The State Journal in Frankfort. For cn|2's three-minute clip of the discussion between Haynes and Alvarado, via YouTubeclick here.

The Republican lawmakers also voiced skepticism, but offered no contrary evidence, about the cost of expanding Medicaid to households with incomes up to 138 percent of the federal poverty level, from the previous limit of 69 percent. Under the Patient Protection and Affordable Care Act, the federal government is paying the entire cost of the expansion until next year, when the state will begin paying a small part, rising to the law's cap of 10 percent in 2020.

Haynes noted projections for Democratic Gov. Steve Beshear's administration that the expansion would add $30.1 billion to the state's economy through 2021, and would pay for itself until then, even after the state starts picking up part of the cost. The numbers were not new; they were part of a study by Deloitte Consulting and the University of Louisville that Beshear released in February.

Republicans focused on the prediction that the expansion would cost the state a net $45 million in 2021. "I know that seems like a way long ways off and some of you may no longer even be in the position to deal with it, but some of us probably will and the taxpayers will," said Alvarado, a physician.

Haynes "stated that she believed with the financial boost to the economy through jobs, the costs will be offset," the blog of the Kentucky Chamber of Commerce reports.

�Now that we�re seeing the lowest unemployment that we�ve seen in our state in quite a number of years, I�m sure each of you are amazed at how that we�ve had all 120 counties in our state where the unemployment rate has gone down,� Haynes said. �As this state continues to generate revenue and hopefully, as is planned, this is a bridge program for people who basically are hard-working people, but their employer does not provide insurance or they have children and therefore that qualifies them from an income basis for Medicaid.�


Thursday, 18 June 2015

Princess Health and Health department urges Kentuckians to walk regularly; state ranks high in obesity, low in physical activity.Princessiccia

Princess Health and Health department urges Kentuckians to walk regularly; state ranks high in obesity, low in physical activity.Princessiccia

With summer here, the state health department is urging Kentuckians to adopt a regular walking schedule to connect with friends and neighbors and improve health and fitness in a state that ranks high in obesity and low in physical activity.

�Summer is the perfect time to renew your commitment to get outdoors and take a walk,� Health Commissioner Stephanie Mayfield, said in a news release. �We all know walking is healthy, but it�s also fun, relaxing, and a great way to connect with others. You can invite a friend or loved one out for a nightly walk after dinner, take care of weekend errands on foot, or invite neighbors or co-workers to start a regular walking group. The more you walk, the more you�ll connect and be part of building a stronger, healthier community.�

In Kentucky, 31.3 percent of adults are obese. �Obesity is linked to multiple chronic conditions, including diabetes, heart disease and stroke � and is one of the major chronic conditions affecting the health of Kentuckians,� said Elaine Russell, the Department for Public Health's obesity-prevention coordinator. �Regular walking could greatly reduce our state�s obesity burden.�

Russell's program and the Partnership for a Fit Kentucky have created a guide for obesity prevention and health policy for Kentucky communities, at http://www.fitky.org/wp-content/uploads/sites/2/2015/04/PA-Vision-Slidedoc.pdf. ). Kentucky is one of four states that will get technical assistance from America Walks to improve walkable community design, such as complete streets, lower traffic speeds, livable communities and economic benefits.

�We�re also working directly with communities and funding projects through a public health grant program to help cities and towns across Kentucky develop pedestrian plans,� Russell said. The department selected 11 communities for funding to start work on a pedestrian plan.

�We�re very excited about recent developments in obesity prevention and increasing physical activity in the commonwealth,� Russell said. �We hope everyone will not only become more physically active, but take some time to learn more about our vision and support our communities in their work to become more active, healthier places to live, work and play.�