Category Archives: Health Care

Lamar says Republicans need to make a deal on Obamacare

U.S. Sen. Lamar Alexander says that his work with Democrats in an overhaul of the federal No Child Left Behind law could be a model for an overhaul of the Affordable Care Act, better known as Obamacare, and that’s something Republicans need to address next year. So reports Politico.
“Whoever the president is in January, we’re going to have to take a good, hard look at Obamacare,” Alexander told Politico. “I don’t think Republicans can go another four years, whether we have a Republican president or not, and say, ‘Just give us a couple more Republicans and we’ll repeal Obamacare.’ ”

The Republican lawmaker says his own committee’s bipartisan work on the No Child Left Behind education bill created a clear template for finding common ground on health care. That sweeping overhaul of a 14-year-old education law passed with bipartisan support last year. President Barack Obama himself called it a “Christmas miracle.”

“One reason I’ve enjoyed working with Patty Murray, the senior Democrat on the (Senate Health, Education, Labor and Pensions) Committee is that she’s results-oriented,” Alexander says. “We can focus on the 80 percent we agree with and fight about the 20 percent another day.”

But Obama hasn’t proved to be a good partner on health care, Alexander maintained. He’s hoping that the next president — whoever he or she may be — will be more receptive.

“Hillary Clinton is married to a fellow who made a lot of deals as president,” Alexander said. “And if she shows an aptitude for taking a position, listening to other people and looking for the 80 percent instead of the 20 — or if Mr. Trump does, if he’s the president — then we can improve the health care system.”

Alexander ready to deal with Democrats on Obamacare

Sen. Lamar Alexander says he’s more than happy to strike deals with Democrats — even on Obamacare. So reports Politico.

“Whoever the president is in January, we’re going to have to take a good, hard look at Obamacare,” the powerful chairman of the Senate HELP committee told POLITICO’s “Pulse Check” podcast. “It can’t continue the way it is.”

“I don’t think Republicans can go another four years, whether we have a Republican president or not, and say just give us a couple more Republicans and we’ll repeal Obamacare,” he added.

Alexander laid out several changes that he’d like to see in health care: Less government “management,” more support of private sector innovation and more flexibility for states on Medicaid. He also credited House Speaker Paul Ryan’s recent white paper that summarized Republican health care proposals as a “helpful” starting point, though he didn’t explicitly endorse the House GOP’s insistence on replacing the whole law

The Republican lawmaker says his own committee’s bipartisan work on the No Child Left Behind education bill created a clear template for finding common ground on health care. That sweeping overhaul of a 14-year-old education law passed with bipartisan support last year. President Barack Obama himself called it a “Christmas miracle.”

“One reason I’ve enjoyed working with Patty Murray, the senior Democrat on the [HELP] Committee is that she’s results-oriented,” Alexander says. “We can focus on the 80 percent we agree with and fight about the 20 percent another day.”

But Obama hasn’t proved to be a good partner on health care, Alexander maintained. He’s hoping that the next president — whoever he or she may be — will be more receptive.

“Hillary Clinton is married to a fellow who made a lot of deals as president,” Alexander said. “And if she shows an aptitude for taking a position, listening to other people and looking for the 80 percent instead of the 20 — or if Mr. Trump does, if he’s the president — then we can improve the health care system.”

Harwell task force: Medicaid for veterans, those with behavioral disorder

By Eric Schelzig, Associated Press
NASHVILLE, Tenn. — GOP lawmakers on Thursday for the first time presented details of a more limited approach to Medicaid expansion than was envisioned by Republican Gov. Bill Haslam’s failed Insure Tennessee proposal.

Members of a task force appointed by Republican House Speaker Beth Harwell said the 3-Star Health proposal would first focus on extending coverage to uninsured people with behavioral health problems and to veterans. The program would include health savings accounts, incentives for healthy living and penalties for improper use of emergencies.

Republican Rep. Cameron Sexton of Crossville said the task force has presented its plan to Centers for Medicare and Medicaid Services but acknowledged that no other state has been approved for a similar approach.

“We’re looking for a measured approach, where we can have a phased-in approach to work toward closing the gap,” he said. Continue reading

Harwell task force presents Medicaid plan to feds (press release)

News release from House Republican Caucus
(NASHVILLE) — Earlier today, members of the ‘3-Star Healthy Taskforce’ and TennCare met with representatives from the Centers for Medicare and Medicaid Services (CMS) to discuss the Taskforce’s proposal to close the insurance coverage gap in Tennessee.

“We feel that today’s meeting was a significant step forward in achieving the Taskforce’s stated goal of presenting a plan to the legislature that improves access to healthcare and closes the insurance coverage gap,” said Representative Matthew Hill.

“This conservative and measured approach of focusing on behavioral health, mental illness and substance abuse, and uninsured veterans is one of the most significant steps forward for healthcare in Tennessee,” continued Chairman Cameron Sexton. “This patient population has been underserved in the State of Tennessee for generations.”

The grey paper presented to CMS pursues a different direction than Insure Tennessee and details a two-phase approach the Taskforce is seeking for approval. Continue reading

State Dept. of Health has a new chief lobbyist

News release from the state Department of Health
NASHVILLE, Tenn. – Jeremy Davis has been appointed assistant commissioner for legislative affairs for the Tennessee Department of Health. In this role, Davis will direct and oversee the department’s legislative efforts and initiatives. He will also coordinate with and assist legislators in public health-related issues and departmental legislative proposals. Davis comes to this new role after serving as a legislative liaison for TDH since 2011. He succeeds Valerie Nagoshiner, who has been promoted from assistant commissioner to chief of staff at TDH.

“Jeremy has extensive experience in public policy and in working with our legislators, and has served us well during his time with our legislative affairs team,” said TDH Commissioner John Dreyzehner. “I am excited to have him take on the additional responsibilities of leading our legislative projects.”

As assistant commissioner for legislative affairs, Davis will develop the department’s annual legislative package and work with key members of the Tennessee General Assembly to ensure passage of key departmental initiatives. He will coordinate all TDH reports mandated by the legislature and facilitate departmental advisory committee appointments.

Davis joined TDH after serving as executive assistant for policy and research for Senate Majority Leader Mark Norris. He has also served as research analyst with the Tennessee General Assembly’s Senate Environment, Conservation and Tourism Committee and as an executive staff member for Sen. Ward Crutchfield.

“I am honored to have this opportunity to continue working with the Department of Health to protect, promote and improve the health and prosperity of Tennesseans, and look forward to advocating and promoting healthy living across the state of Tennessee,” said Davis.

Davis holds a Bachelor of Science degree from Tennessee Technological University in Cookeville. He serves on the advisory board for Franklin Community House in Franklin. Davis resides with his wife and son in Fairview.

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. TDH has facilities in all 95 counties and provides direct services for more than one in five Tennesseans annually as well as indirect services for everyone in the state, including emergency response to health threats, licensure of health professionals, regulation of health care facilities and inspection of food service establishments.

Sen. Yager: State law not followed in closing Scott County hospital

News release via Senate Republican Caucus
(NASHVILLE) – State Senator Ken Yager (R-Kingston) said today he has contacted the Tennessee Department of Labor and Workforce Development, the Tennessee Health Licensure and Regulation Office, and the Health Services and Development Agency in regards to enforcing state law and licensure requirements regarding the notification of closure of Pioneer Community Hospital of Scott. The action came after Pioneer employees found out on June 16 that their jobs would end in ten days when the facility is closed. Yager said this runs afoul of state law and licensing requirements.

“I have contacted Ann Rutherford Reed, who is Director of Licensure Division of Health Licensure and Regulation Office of Health Care Facilities; so that our state law is followed,” said Senator Yager. The state of Tennessee and these employees were not given proper notice. It is hard enough to find out about losing your job. Not having adequate notice makes that loss even more difficult. My focus right now is to see that these employees are treated fairly.”

Under the state’s Certificate of Need (CON) requirements, Yager said notice is required before any critical access hospital can be closed. He requested Director Reed enforce this provision against Pioneer, telling her “a 10-day notice is totally inadequate and contrary to your policy.”
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Scott County’s only hospital files notice of closing

Pioneer Health Services has notified the State of Tennessee that it could potentially close its Scott County hospital although local administrators remain hopeful that the worst-case scenario will not pan out, reports the Oneida Independent Herald.

The Magee, Miss.-based corporation filed its 30-day notice with the state last week, as required by law. Tony Taylor, CEO of Pioneer Community Hospital of Scott, said his managers learned of the development Tuesday morning.

…Taylor, who has been chief administrator at the local hospital since Pioneer opened the facility in 2012, said the notice is not a guarantee that the the hospital will close.

“This is just a way of them fulfilling their obligation of notice,” Taylor said. “After June 26, they could close the hospital, if they chose to do so.”

PHS is currently restructuring, two months after filing for Chapter 11 bankruptcy protection. As part of that bankruptcy filing, PHS closed its MedSurge program at the Scott County facility, ending inpatient services while keeping all outpatient services — including surgery, physical therapy and diagnostics, among others — along with its emergency room.

Reportedly, PHS has been willing to entertain offers to sell the Scott County hospital. It is not known whether the corporation has been able to attract potential suitors.

Taylor said Pioneer has put no timeline on the hospital’s future.

…If the hospital closed, ownership of the real estate would revert to Scott County. The county is currently in the midst of a 10-year contract with Pioneer that requires the facility — ownership of which was transferred to Pioneer in 2012 at no cost — to be operated as a hospital or be returned to the county.

However, that, too, could be complicated. First National Bank currently has a lien on the property after Pioneer borrowed $400,000 for improvements in 2015. The Internal Revenue Service has also filed a separate $500,000 tax lien on the property due to back taxes owed by the corporation.

Some reporting from HarwellCare task force, meeting 6

Excerpts from some reporting on the sixth meeting of House Speaker Beth Harwell’s “3-Star Healthy Project” task force, held Tuesday in Nashville and to be followed by at least one more session with federal health care officials:

WPLN says the group “seems to favor giving more support to clinics over offering poor Tennesseans government insurance through Medicaid.”

That’s somewhat encouraging to Mary Bufwack, the president and chief executive of United Neighborhood Health Services, a network of nonprofit clinics around Nashville that provide primary and OB/GYN care. Bufwack agrees getting low-income people in to see doctors would be a good thing, but who pays for what happens after that, when those doctors discover medical problems that need more treatment?

“Expanding primary health care actually sometimes uncovers and identifies problems that need more specialists,” Bufwack says. “My concern is we make sure the people have the access needed to specialty, hospital and other kinds of services that are absolutely vital.”

Plus, Bufwack says, Tennessee’s clinics are nowhere close to being big enough to handle the number of people who need coverage.

From The Tennessean:

The five lawmakers who attended Tuesday’s meeting — Sexton, Reps. Matthew Hill, R-Jonesborough; Roger Kane, R-Knoxville; Steve McManus, R-Cordova; and Karen Camper, D-Memphis — reached no conclusions, but a variety of government officials offered ideas to consider as the group moves forward.

During his presentation, Douglas Varney, commissioner of the Department of Mental Health and Substance Abuse Services, made a variety of recommendations to the group, including suggesting that providing primary care providers with more education on substance abuse can help address the needs of those struggling with the problem.

Beyond Varney, the task force also heard testimony from Raquel Hatter, commissioner of the Department of Human Services, and Valerie Nagoshiner, chief of staff for the Department of Health. Hatter fielded several questions about the various programs that provide temporary financial assistance to Tennesseans, while Nagoshiner focused her comments on a variety of health care safety nets the state has.

With significant talks about mental health and substance abuse throughout the day, Sexton ultimately concluded the issue probably would be included in the task force’s final recommendations.

“If we’re looking at starting at some point, I’d say there’s a good chance that we would be starting at the behavioral health side,” he said after the meeting.

From Nashville Post Politics:

In comments after the almost three-hour meeting, committee member Rep. Roger Kane (said) that whatever the task force comes up with won’t be a whitewashed version of Gov. Bill Haslam’s plan to expand insurance coverage.

“We’re not going to be able to get Insure Tennessee 2.0 through the House,” Kane said bluntly. When asked if legislators, once safely re-elected in November, might change their minds, Kane shook his head. “I’m going to say the answer is still no. It wasn’t an election year last year, and we couldn’t get it passed then.”

It remains unclear whether the task force created by House Speaker Beth Harwell to come up with a conservative alternative to Insure Tennessee actually has the wherewithal or the political capital to get anything done.

… Beyond an expansion of low-cost community health clinics, which task force chair Rep. Cameron Sexton has endorsed, nothing in today’s presentations indicated what other ideas might make it into an official proposal — although a few moments were revealing of the panel’s general lack of knowledge surrounding some of the issues.

Appeals court backs TennCare applicants in lawsuit

By Travis Loller, Associated Press
NASHVILLE, Tenn. — Tennessee’s Medicaid program has to provide applicants with a fair hearing if it cannot process their requests on time, under an order that’s been upheld by a federal appeals court.

Applications for most forms of Medicaid should be processed within 45 days, by law. Applications based on disability are allowed 90 days.

Applicants for TennCare — Tennessee’s version of Medicaid — sued in July 2014, complaining that their applications had been pending for months, and the state had refused to provide hearings.

A federal judge in Nashville issued a preliminary injunction in September 2014 requiring hearings for those whose applications were not timely processed. The injunction is a temporary ruling in effect while the case works its way through the courts. The judge also granted the lawsuit class-action status, meaning anyone in a similar situation to the original plaintiffs could be considered a plaintiff.

The state appealed, asking the 6th U.S. Circuit Court of Appeals to dismiss the lawsuit on technical grounds.

On Monday, a 6th Circuit panel ruled 2-1 in favor of the TennCare applicants.
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On TN prison problems with hepatitis C

As initially reported by the Tennessean in the first of a series of articles, Only eight of the 3,487 inmates known to have hepatitis C in Tennessee prisons are receiving medicine that can cure the disease, caused by a virus that can lead to fatal liver damage. Nearly one in two inmates the state did test in 2015 showed signs of having hepatitis C.

On Monday, Rep. John Mark Windle, D-Livingston, whose district includes one of the state’s biggest prisons in Morgan County, held a news conference to declare the situation poses a danger to the public at large. Excerpt from WPLN’s report:

“Ninety percent of all inmates are released back into the general population,” he says. “And if you’ve got 10,000 people that have got hepatitis C that are going to re-enter the population, the chance for the spread of that disease is phenomenal. And we need to take steps to try to address that immediately.”

But Windle says that 10,000 figure is conjecture, because prison officials don’t know for sure exactly how many inmates are carrying hepatitis C. It’s based on a screening of 900 inmates, roughly half of whom came up positive for hepatitis C.

Prison officials do know that more than 3,000 have the disease, which is spread through dirty needles, tattoos and bodily fluids.

Windle would like the state to give every inmate blood tests for hepatitis C — or at least develop a protocol for figuring out those most at risk for the disease. For the good of the public as much as the good of prisoners.

“If the correctional officers and the counselors are subject to being in the same personal space as those inmates … it’s not uncommon to be subjected to bodily fluids, urine, feces tossed on them,” he says. “At the very minimum, we should provide a safe workplace.”

Wider testing would be expensive, Windle admits. And treatment for hepatitis C could cost more than $80,000 per patient. Prison officials have cited that price — as well as the high likelihood that inmates will contract the disease again after they’re cured — as major barriers to eradicating the disease.

But, says Windle, the cost to the state if the disease spreads beyond the prison walls would be far greater.

“I just think it’s time to address (what) may be an epidemic,” he says.

A spokeswoman for the Department of Correction responds that Tennessee prisons already have safety protocols in place to protect employees from exposure to hepatitis C.

She adds that testing positive for hepatitis C does not necessarily mean an inmate is carrying the virus because antibodies remain in the bloodstream even after they’ve recovered. She says doctors weigh factors such as virus type, the patient’s liver condition and other health conditions before determining treatment.