A legislative watchdog group agreed Monday to delve deeper into the state Department of Correction’s awarding of a $200 million-plus contract to handle inmate health care to a relative newcomer despite its $6.4 million higher bid, reports the Chattanooga TFP. Fiscal Review Committee members want the winner of the contract, Centurion LLC, to come before the panel in September.
Correction Department officials went before Fiscal Review for approval of their request to extend the current contract of Brentwood, Tenn.-based Corizon until Sept. 30 to provide Centurion additional time to prepare taking over the service.
While the business at hand was the 90-day extension of Corizon’s existing contract, committee members devoted most of their time questioning Centurion’s winning of the new three-year contract.
Corizon, which had the existing contract, lost the competition to Centurion on the new three-year contract. Corizon protested but two state panels upheld the award to Centurion, the most recent coming in a June 6 ruling.
Recently, Correction Department officials said, Corizon indicated it would not push the protest further by going to court.
Lawmakers criticized the request-for-proposal process and raised concerns about the higher cost and what they see as the recently created Centurion’s relative lack of experience.
Rep. Tim Wirgau, R-Buchanan, said it raises “red flags” for him.
“Give me some reasons why you decided to spend $6.4 million more,” he told Wes Landers, chief financial officer for the Correction Department.
Rep. Jeremy Faison, R-Cosby, was highly critical of Centurion’s experience.
“That seems a little shady there,” Faison said, adding that the state either had standards or not in awarding points in the request-for-proposal process for experience.
In remarks both during the committee and afterward, Wes Landers, the Correction Department’s chief financial officer, defended the decision to go with Centurion.
COLLEGEDALE, Tenn. (AP) — An East Tennessee city of fewer than 7,000 residents is poised to become the first municipality in the state to grant health care benefits to domestic partners.
According to the Chattanooga Times Free Press (http://bit.ly/12shZN7 ), Collegedale City Commission members last week passed on first reading a plan to extend the same benefits married city workers receive to heterosexual and same-sex partners of city employees.
A consultant with the University of Tennessee’s Municipal Technical Advisory Service said that, if the commissioners approve the proposal again, Collegedale would become the first among Tennessee’s 346 cities to cover domestic partnerships.
Consultant Bonnie Jones said she is surprised one of the larger cities might not be the first.
“Collegedale is kind of on the cutting edge,” Jones said.
By Eric Schelzig, Associated Press
NASHVILLE, Tenn. — The growing demand for medical care that is expected to accompany the full implementation of the federal health care law in January is adding urgency to a Tennessee debate over whether nurses should be allowed to provide more independent care to patients.
Nurses currently see patients in a variety of settings ranging from private practices to retail clinics, but they want to remove a layer of supervision from physicians. Doctors’ groups oppose giving nurses more independence. A legislative fight is on the horizon.
“We’re in the ring,” said Gary Zelizer, who lobbies on behalf of doctors for the Tennessee Medical Association. “We’re warming up, but it’s coming.”
Sharon Adkins, the executive director of the Tennessee Nurses Association, said in an email that her group is “in full support of removing practice barriers and support full practice authority for all health care professionals.”
Adkins said advance practice registered nurses, or APRNs, “give as good or in some cases better care than physicians.”
Enhancing criminal penalties has long been a favored pursuit of lawmakers, the major restraint on this inclination being the cost to taxpayers of locking up the wrongdoers and provisions of state law and legislative rules that say the enhanced spending must be covered in the state budget.
An interesting debate back in the 2013 legislative session, worthy of more attention than it received as us media types focused on stuff deemed more interesting in the fast-action session, concerned what may be seen an evolution of compromise in this inherent conflict.
That is, enhance the punishment, but only when the victim is a member of a chosen profession.
The chosen professional victims in this year’s session were doctors, nurses and other health care providers in one bill (HB306) and firefighters and emergency workers in another (SB66). Starting July 1, the effective date of both new laws, if you, for example, punch an on-the-job paramedic (covered by both laws), the maximum penalty upon conviction of assault will be more severe than if you punched a preacher, a retired grandmother or a newspaper reporter.
A group that advocates expanding TennCare to more of the state’s poor delivered a petition and stated its case to an aide to Gov. Bill Haslam on Wednesday, reports The Tennessean. A coalition that includes the Tennessee Nurses Association, Tennessee League of Women Voters, Tennessee Health Care Campaign and the Tennessee Justice Center said it has gathered more than 4,500 signatures for an online petition calling on Haslam to offer TennCare services to everyone making 138 percent of the federal poverty level or less.
The cost would be paid in full by the federal government through 2016 and in large measure until at least 2020.
Haslam put off a decision on TennCare expansion in March, saying he wanted to continue negotiating with the federal government for a plan that would let the state offer private insurance to new enrollees. He has said he expects to know whether those negotiations will pay off by the end of summer.
Don Johnson, Haslam’s assistant director for constituent services, accepted the petition on the governor’s behalf and met with several advocates. They argued that expanding TennCare would help those who currently do not have coverage as well as rural hospitals that face service cuts or closure.
Note: News release below.
News release from National Governors Association:
WASHINGTON–As lawmakers at both state and federal levels of government look for ways to improve the quality of health care and reduce the costs of public programs, governors are developing innovative Medicaid programs and must retain flexibility to implement these measures.
To assist in these efforts, the National Governors Association (NGA) today announced the members of a new Health Care Sustainability Task Force (Task Force). Oregon Gov. John Kitzhaber and Tennessee Gov. Bill Haslam will serve as co-chairs of the Task Force.
Other governors serving include Alabama Gov. Robert Bentley, Arkansas Gov. Mike Beebe, California Gov. Jerry Brown, New Mexico Gov. Susana Martinez, New York Gov. Andrew Cuomo, South Dakota Gov. Dennis Daugaard, Utah Gov. Gary Herbert and Vermont Gov. Peter Shumlin. NGA Health and Homeland Security Chair Maryland Gov. Martin O’Malley and Vice Chair Nevada Gov. Brian Sandoval will serve as ex-officio members.
“Right now states are looking to change how they do business in order to more effectively serve their constituents,” said Gov. Kitzhaber. “This Task Force will help states sit down together to figure out what’s working and what isn’t and identify how the federal government can best support these efforts.”
“Governors are working in their states to find ways to cut costs when it comes to health care,” said Gov. Haslam. “It is our responsibility to examine every possible option in an effort to make sure promising new initiatives can be fully utilized.”
The Task Force will focus on state innovations that require the redesign of health care delivery and payment systems with the objectives of improving quality and controlling costs. Through the sharing of state experiences and best practices, the Task Force will work to identify areas where federal legislative or regulatory action is necessary to reduce barriers and further support state initiatives.
Republican Gov. Bill Haslam’s refusal so far to expand Medicaid under federal health reform could mean that Tennessee’s poorest residents won’t have access to health coverage in 2014 but some lawful immigrants will, according to the Chattanooga TFP. That’s because legal immigrants with incomes below 100 percent of the poverty level — $11,170 for a single person or $23,050 for a family of four — will be eligible for federal subsidies to buy private coverage through health insurance exchanges.
American citizens with the same income levels, however, can’t participate in the exchange because the law envisioned those with incomes up to 138 percent of the poverty level would be covered through the Medicaid expansion.
The politically ticklish contrast came about as a result of last year’s U.S. Supreme Court ruling on the 2010 Affordable Care Act.
The act aims to provide coverage to millions of lower-income people in two ways. One is to mandate that most people have health insurance and to help those who can’t afford it by subsidizing purchase of private coverage on new state health insurance exchanges. People with incomes up to 400 percent of the federal poverty level could get subsidies.
The other is by expanding state Medicaid programs, which now cover mostly low-income pregnant mothers, children and some disabled people, to everyone whose income is up to 138 percent of the federal poverty level.
The court upheld the law but made Medicaid expansion optional rather than mandatory for states. Georgia, Alabama and many other Republican-led states have ruled out the expansion.
The prospect that legal immigrants, such as workers and refugees, will be insured but not the state’s poorest residents is “quite an irony,” said Ron Pollack, executive director of the Washington-based health advocacy group Families USA.
He said Arizona’s Republican governor, Jan Brewer, cited that fact among others when she recommended her state expand Medicaid.
Matt Salo, executive director of the National Association of Medicaid Directors, said the Supreme Court ruling sets up a political dilemma.
“If you’re a state that doesn’t do the expansion, there will be two groups of people below 100 percent of the poverty level: citizens, who will likely get nothing, [and] legal immigrants, who get fully subsidized coverage in the exchange. … That’s not going to sit well with folks.”
Tennessee’s biggest health insurer helped ensure its own fiscal health last year by boosting net income by more than 26 percent and swelling its reserves to more than 50 percent above what is legally required, reports the Chattanooga TFP. BlueCross BlueShield of Tennessee, the state’s biggest nonprofit corporation with $5.6 billion in annual revenues, said Monday it earned record profits of $221.5 million during 2012. Even with its income gain last year, BlueCross officials said the 4 percent profit margin was still the lowest among the major health insurers operating in Tennessee.
“As a tax-paying, not-for-profit company we can operate on a lower profit margin than the investor-owned companies in our industry, but we still try to maintain a small profit margin to ensure we can continue to serve our customers and remain financially strong,” BlueCross Vice President Roy Vaughn said. “I think our customers want us to be strong financially and to do well so that they know they can depend upon our services.”
Bills approved by both chambers Tuesday will increase the penalty for criminal assaults if the victim is either a firefighter, emergency worker or a health care professional.
The bills touched off considerable debate in the Senate as Republican Sens. Stacey Campfield of Knoxville and Brian Kelsey of Germantown questioned the wisdom of putting some victims on a higher level than others.
Campfield said the legislation violates the principle of “equal protection under the law” and questioned why a person assaulting a pregnant woman should face a lesser penalty than someone assaulting a doctor or fireman.
Proponents noted current law already makes the penalty higher when the victim is a law enforcement officer and said firefighters, emergency personel and doctors or nurses face greater risk of assault than others.
Both bills now go to the governor. The bill on health care provider assaults (HB306) passed 31-1 in the Senate and 63-31 in the House. The bill on firefighters and emergency workers (SB66) was approved 24-2 in the Senate; 93-3 in the House.
After winning approval in a House committee, legislation to prohibit Tennessee insurance companies from participating in health care exchanges set under the Affordable Care Act has failed in the Senate.
The bill (SB666) got only one vote in the Senate Commerce Committee — that of the sponsor, Sen. Dolores Gresham, R-Somerville — after critical commentary from insurance company representatives and state officials. Gov. Bill Haslam said after the House vote that he opposes the bill.
The measure earlier won 6-2 approval in a House panel where sponsor Rep. Vance Dennis, R-Savannah, said it would exploit “the Achilles’ heel of Obamacare.” Since states control insurance companies, sponsors argued legislators can block the federal law by prohibiting state-licensed insurance firms from participating in the program.
Critics said that the result would likely be authorization from the federal government for out-of-state companies to sell insurance within Tennessee instead.
The two Democratic senators on the Commerce Committee voted against the bill. All Republicans on the panel — except Gresham — either abstained or were not present when the vote was taken.