Tag Archives: care

Bill Increases Penalty for Assaulting Heath Care Professionals

The House has approved, 64-31, legislation that increases the penalty for assault when the victim is a health engaged in his or her professional duties.
The bill by Rep. JoAnn Favors, D-Chattanooga, was roundly criticized by some making health care providers a separate and special class of citizen. Favors and others noted that there is already a law making the punishment for assault on a law enforcement officer harsher than for others.
Favors, a nurse, said the bill (HB306) is needed because there has been an increase in workplace violence against doctors, nurses and other health care workers. Nevada has such a law, she said, and such attacks have declined since enactment.

Legislator Finds ‘Achilles Heel of Obamacare,’ House Sub Approves

Tennessee insurance companies would be prohibited from participating in the state’s federal health care exchange that will provide federally-subsidized medical insurance under a bill approved Wednesday by a House subcommittee.
Rep. Vance Dennis, R-Savannah, said he had found “the Achilles heel of Obamacare” with his bill (HB476) and, once Tennessee approves it, other states are likely to follow and doom the federal health care program.
“With this bill, I bring you the opportunity for your children and grandchildren and my children and grandchildren to save billions and billions of dollars of money being borrowed against them by the federal government,” said Dennis.
The “Achilles heel,” Dennis said, is that the federal law still allows states to control insurance companies. Thus, by declaring a state’s insurance companies cannot use the health care exchanges set up under Obamacare, the law can be negated, he said.
Dennis also contended that Obamacare would take business away from state insurance agencies writing policies for private insurance that is not subsidized by Obamacare.

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Ramsey: Florida Medicaid Expansion Could be a Model

State Senate Speaker Ron Ramsey said Thursday that if Tennessee expands its Medicaid program to cover more uninsured working poor, it should follow Florida Gov. Rick Scott’s example and put stipulations into law requiring cuts if federal funding is reduced.
Further from Richard Locker:
Ramsey, R-Blountville, said he expects Gov. Bill Haslam to announce his decision on whether to seek expansion of Medicaid/TennCare in Tennessee — and for the state legislature to act on Haslam’s request — before the General Assembly adjourns this spring. But he said he’s not sure whether lawmakers would go along with an expansion or not.
I’ve not polled members but it won’t be easy and that’s why I’ve told him (Haslam) that you need to be able to convince legislators it’s the right thing to do. And we need to be able to see that we, quote, got something for it or that there are statutory requirements that come into place if the federal funding changes and things of that nature,” Ramsey told reporters in his weekly media briefing.
Ramsey said he was surprised that Scott — a conservative elected with Tea Party backing — announced Wednesday that he will ask the Florida legislature to expand its Medicaid program, a key provision of President Barack Obama’s Affordable Care Act that Scott had vowed to oppose. Scott is the latest Republican governor to propose his state expand Medicaid and is seen as the most conservative on the list to do so.
Under “Obamacare,” the federal government will pay 100 percent of the costs of expanding Medicaid to people with incomes up to 138 percent of the poverty level for three years, then drop to 90 percent over the following two years, with the state paying the rest.
Ramsey appears to have softened his stance on the issue. Last summer when the U.S. Supreme Court upheld key provisions of the Affordable Care Act — but made it optional for states to expand Medicaid — the Senate speaker and lieutenant governor called Obamacare “a disaster” and a “usurpation of our liberty … that must be resisted.”

Health Care Compact Bill Fails in House Committee

Legislation setting the stage for a state take over of Medicare and other health care programs from the federal government failed in a House committee Tuesday with four Republicans joining Democrats to vote against it.
The vote on the Health Care Compact Act (HB536) came out as a 9-9 tie in the House Insurance and Banking Committe, which means the bill was defeated under House rules. A similar measure failed on the House floor in the last hour of the 2012 legislative, getting 45 of the necessary 50 votes with several Republicans absent or abstaining.
Last year, no Republican voted against the bill. On Wednesday, however, House Finance Committee Chairman Charles Sargent, R-Franklin, led a round of critical questioning of the measure and its sponsor, Rep. Mark Pody, R-Lebanon.
“This scares me to death,” said Sargent at one point, contending the measure opens the door for Tennessee to lose funding from the federal government for TennCare and Cover Kids, a program providing health insurance for children in low-income families.
Both those programs are operated by the state with most the funding coming from the federal government, which also imposes many rules. The bill envisions the federal government turning over other programs as well – including Medicare but not including veterans health care – and nonetheless giving states federal funds along with all management responsibilities.
Sargent asked Pody what the federal matching rate for those two programs is currently and whether it would change. Pody did not know, but the bill makes no policy decisions and separate enabling legislation would be adopted in future years if Tennessee moves to a takeover.
Sargent said the state now gets $3 federal for each state dollar in Cover Kids, a rate more favorable than most states, and roughly a $2 for $1 match in TennCare.
“If it does nothing like you say, why are we putting something on the books?” said Sargent, saying the state could simply send a letter to federal officials or adopt a legislative resolution petitioning. “We’re going open-ended into something not knowing what we’re doing.”
Pody said passage of the bill would give the state “as many options as possible” for dealing with health care in the future. He repeatedly stressed that specifics would be left to further legislation and the state could withdraw from the compact later. Nine states have passed legislation to join a Health Care Compact.

Note: This updates and replaces previous post.

On the Flood of TN Legislation to Assert States’ Rights

Tennessee legislators this year are calling for a broad array of limitations on federal government authority within the state, a movement that the speakers of the House and Senate say reflects growing concern within the Republican supermajority.
“The number of bills (filed) indicates that this is a Legislature that firmly believes in states’ rights,” said House Speaker Beth Harwell. “The federal government is not running properly and state government is. … That is the driving force.”
But she and Senate Speaker Ron Ramsey, who ran for governor in 2010 under the theme “Give Washington the boot,” say they are still studying the pile of bills asserting states’ rights in one way or another and are not ready to declare support — or opposition — to specific proposals.
Ramsey said he has misgivings about some measures declaring that federal laws violating the Constitution are void in Tennessee. The threshold question, he said, is who decides what is unconstitutional.
“The last thing you want is some rogue sheriff out here deciding what’s unconstitutional,” he said.
Some proposals call for the Legislature to decide, notably including the Tennessee Balance of Powers Act (SB1158) proposed by Sen. Mae Beavers, R-Mount Juliet, and Rep. Judd Matheny, R-Tullahoma. It would create a joint House-Senate committee to review federal laws and executive orders and recommend to the full House and Senate those that exceed the federal government’s constitutional authority. If the full House and Senate agree, the bill declares that those laws will be null and void within the state.

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Haslam Letter Says ‘No’ to Health Care Exchange Partnership

By Eric Schelzig, Associated Press
NASHVILLE, Tenn. — Tennessee won’t participate in a partnership with the federal government in establishing a health insurance exchange, Gov. Bill Haslam announced Friday.
The Republican governor said in a letter to U.S. Health and Human Resources Secretary Kathleen Sebelius that the partnership model doesn’t address his concerns over what he called “aggressive federal timelines, a lack of true flexibility for states, and misguided federal policies.”
Exchanges are online markets required under President Barack Obama’s health care law where consumers will be able to buy individual private policies and apply for government subsidies to help pay their premiums.
Haslam noted that he had the same complaints when he rejected a state-based exchange in December. His deadline decision means Tennesseans will participate in an exchange completely run by the federal government.
About 982,000 people lack health insurance in Tennessee. The state projects that about 300,000 people will participate in the exchange, through some estimates put that number as high as 600,000.

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AP Roundup of GOP Governors on ‘Obamacare’ (TN gets just a mention)

ATLANTA (AP) — Florida Gov. Rick Scott, who made a fortune as a health care executive, long opposed President Barack Obama’s remake of the health insurance market. After the Democratic president won re-election, the Republican governor softened his tone. He said he wanted to “have a conversation” with the administration about implementing the 2010 law. With a federal deadline approaching, he also said while Florida won’t set up the exchange for individuals to buy private insurance policies, the feds can do it.
In New Jersey, Gov. Chris Christie held his cards before saying he won’t set up his own exchange, but he’s avoided absolute language and says he could change his mind. He’s also leaving his options open to accept federal money to expand Medicaid insurance for people who aren’t covered. The caveat, Christie says, is whether Health Secretary Kathleen Sebelius can “answer my questions” about its operations and expense.
Both Republican governors face re-election in states that Obama won twice, Christie in 2013 and Scott in 2014. And both will encounter well-financed Democrats.
Their apparent struggles on the issue, along with other postures by their GOP colleagues elsewhere, suggest political uncertainty for Republicans as the Affordable Care Act starts to go into effect two years after clearing Congress without a single Republican vote. The risks also are acute for governors in Democratic-leaning or swing-voting states or who know their records will be parsed should they seek the presidency in 2016 or beyond.
“It’s a tough call for many Republican governors who want to do the best thing for their state but don’t want to be seen as advancing an overhaul that many Republicans continue to detest,” said Whit Ayers, a consultant in Virginia whose clients include Gov. Bill Haslam of Tennessee, a Republican who didn’t announce his rejection of a state exchange until days before Sebelius’s Dec. 14 deadline.

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Life Care Centers Investigated for Medicaid Fraud

CLEVELAND, Tenn. (AP) — Federal prosecutors claim a Medicare fraud scheme at Cleveland-based Life Care Centers of America was cooked up and enforced by management.
According to recently unsealed court records obtained by the Chattanooga Times Free Press (http://bit.ly/TkQ7wF) managers are accused of instructing therapists to assign patients to the highest level of therapy regardless of whether it was needed.
The “Ultra High” level and can pay a provider as much as $564, while the lowest rate of therapy pays $231.
The whistleblower lawsuits claim that employees who questioned the policies were often fired within weeks.
Company representatives declined comment to the newspaper, referring reporters to a letter stating that Life Care’s therapy programs improve patients’ conditions and quality of life.
If found guilty, Life Care could face hundreds of millions in fines.

On Being ‘Maggartized:’ The GOP Legislature’s Future?

Andrea Zelinski talks with Debra Maggart about the ramifications of the former House Republican Caucus chair’s defeat at the ballot box in the August GOP primary. Excerpts from a recommended read:
“You could argue that I took a lot of bullets, in my position as caucus leader, for the caucus. And that was my job, and I did it,” said Maggart.
“No pun intended on bullets.”
…”All the lobbyists, all the special interest groups, have learned that if you just marshal enough and want to take one person out, you can,” she said.
“They’ve coined a new word called ‘Maggartized,’ ” she said. “If you don’t do what they want, they’re going to Maggartize you.”
That fear reveals something of a crack in the legislative Republicans’ armor as the party grapples with satisfying large swaths of business leaders and small business owners, the philosophical tea party groups disinterested in going along with the GOP’s political strategy — and everyone in between.
“I always said I just didn’t believe that people send us down here for any lobbying group, whether it’s for — I don’t know — any group, to use fear and intimidation to get their way. That goes against the very thing the Tea Party says all the time they’re against. It was just really a strange situation how all of that played out, that the gun lobby would turn on their friends. And they did,” she said.
To Maggart, the political realities of keeping happy an ever-widening Republican base apply not just to the guns-in-lots bill. The opportunities are great for other Republicans thinking long-term on the Hill to lose their seats when those in the far-right wing of their party pin members in uncomfortable positions.
Take former Metro Councilman and state Rep. Jim Gotto. He narrowly lost his bid for re-election to the state House last month to Democrat Councilman Darren Jernigan, a defeat Maggart contends could have been avoided had he not been pressured to vote for a tea party-driven health care compact bill.
The legislation as written, which Maggart said “didn’t do anything,” would ask the federal government to let Tennessee build its own health care program with other states, sending a message to the feds that the state was rejecting the Affordable Care Act. While demanded by tea party groups, the legislation gave fodder for urban Democrats to accuse Gotto of endangering the health benefits of seniors.
“We kept telling that group, the tea partiers, this is what’s going to happen with this bill,” said Maggart. “At the end of the day we had it on the House floor, and it died. I voted for it, but it died. It is one of the reasons why Jim Gotto lost. We lost a good House member because of different factions not listening.”
The risk of interest groups leveraging their power to bend lawmakers to their will has other ripple effects throughout the caucus. Take the $155,000 her campaign shelled out trying to keep her, an incumbent, in office.
“I hate it that we spent so much money on me,” she said, “when we could have spent it to protect Jim Gotto or to have helped a [Goodlettsville Republican] Charles Williamson get elected, or [Nashville Republican] Ben Claybaker.”


UPDATE: Maggart continues her critique of the NRA in a video interview with the Huffington Post.

Poll Finds Tennesseans Prefer State-Operated Healthcare Exchange

NASHVILLE, Tenn. (AP) — A new Vanderbilt University poll shows a strong preference among Tennesseans for a state-run health insurance exchange over one run by the federal government.
The poll of 829 registered voters released Wednesday showed 53 percent favor the state-run exchange, while 33 percent prefer the federal approach.
The results contrast with Republican Gov. Bill Haslam’s decision earlier this week not to pursue a state-run exchange. Vanderbilt officials said the governor was not aware of the poll results before Wednesday’s release.
Haslam’s office did not immediately return a message seeking comment.
Meanwhile, a pending decision over whether to expand Medicaid was much more evenly divided among poll respondents: 47 percent said they support an expansion, while 46 oppose it.
Haslam has said he will decide the Medicaid issue sometime in the spring.
UPDATE: Here’s a quote from Haslam’s press secretary, David Smith, on the healthcare exchange finding: “The governor weighed all of the information and made a business decision. He understood throughout the process that there were strong opinions on both sides of the issue but removed politics from his decision making.”

Note: Here’s the Vanderbilt news release on the poll:
NASHVILLE, Tenn. – A new poll from Vanderbilt University shows that Tennessee voters prefer that the state run the online health care exchange required by the federal Affordable Health Care Act, with Republicans more adamant about the issue than voters as a whole.
That sentiment reflected by the Vanderbilt Poll conflicts with the actions of Republican Gov. Bill Haslam. He informed the U.S. Department of Health and Human Services Dec. 10 that Tennessee is declining to create and run the exchange, an online marketplace where state residents can shop for health coverage. That means the federal government will step in and do it.
“If a health care exchange must be created, the voters of Tennessee place more trust in the state than the federal government to do it,” said John Geer, Gertrude Conaway Vanderbilt Professor of Political Science and co-director of the Center for the Study of Democratic Institutions at Vanderbilt. “And Republicans are even more trusting of the state to run the health care exchange than Democrats. That may be a surprise to some, but it makes sense since Republicans have long had more faith in state governments than Democrats.”

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