State roundup: 10 ACA co-ops left after Ohio shutdown, Okla. abortion delicensing bill still alive

Here are some highlights of healthcare news from Ohio, Oklahoma, South Dakota, Alaska and Kentucky.

Ohio co-op shutting down over financial trouble

A judge has ordered Ohio health insurance co-op InHealth to be taken over and liquidated by the state, which will force its nearly 22,000 enrollees to find new coverage, reported Columbus Business First.

The complaint from the Ohio Department of Insurance said the insurer would end the year with negative $20 million in assets if it were to continue to operate, as claims outpaced premiums by $28 million in the first quarter.  

According to The Hill, the shutdown means only 10 of the original 23 co-ops set by the Affordable Care Act are still in business.

““It is unacceptable,” Rep. Pat Tiberi (R-Ohio), chairman of the health subcommittee of the House Ways and Means Committee, said in a statement. “My constituents deserve certainty, not plans that crumble and implode under their own weight.”

Okla. lawmakers will try to override veto on abortion bill

Legislation in Oklahoma which would delicense and jail physicians for performing abortions isn’t dead yet.

USA Today reported state lawmakers would try to override a veto from Republican Gov. Mary Fallin before the state legislative session ends. The sponsor, Republican State Sen. Nathan Dahm, said if the clock runs out, he’ll make some revisions and reintroduce the bill next year.

The proposal was opposed by Fallin on the grounds that it was “vague” and unlikely to withstand a court challenge. The state Senate’s only physician legislator, State Sen. Ervin Yen, MD, previously called the legislation “insane.”

S.D. hospital threatened with Medicare, Medicaid funds cutoff

CMS inspectors warned government-run Sioux San Hospital in Rapid City, S.D. that it may lose Medicare and Medicaid funding over safety violations in its emergency department.

The Associated Press reported the hospital, which is run by the Indian Health Service (HIS), failed to provide appropriate and timely screenings for 9 of 32 patients who came to the ED, putting the hospital in violation of Emergency Medical Treatment and Active Labor Act.

CMS gave the IHS until June 15 to correct the problems, or else it won’t be able to bill for services to Medicaid and Medicare patients.

This is the third such warning issued to a IHS-run hospital in South Dakota this year.

Alaska suspends Medicaid payments while state haggles over budget

Medicaid payments to providers in Alaska will be temporarily halted, according to the state’s health care services director, while the state is “challenged by a tight budget situation.”

In a letter obtained by Juneau Empire, director Margaret Brodie told providers “You have my assurance that the delay of payment will be brief, and that Alaska Medicaid will remain in full compliance with federal payment timeliness standards.”

Brodie later said in a separate statement to State of Reform that this “budget relief period” is common for many states at the end of the fiscal year, and denied it was linked to the state legislature not yet agreeing on a budget for the next fiscal year which begins July 1.  

“Alaska Medicaid is paying claims,” she said. “This week’s out-the-door payment is $24.6 million.  Any claims that are temporarily pended for this reason will process within federally required timeframes.”

Feds involved in Kentucky patient safety report case

The federal government has filed a brief in a case involving a Kentucky neurosurgeon who argues a report on complications which led to the death of one of his patients is privileged information, because it was filed to a Patient Safety Organization.

According to POLITICO, the government’s brief in the Supreme Court case argued not allowing a copy of information which had entered a PSO to be used in court would “undermine the Patient Safety Act’s purpose.”

Recent guidance released by HHS mirrors the government’s position in the case. The Kentucky Supreme Court had ruled against the neurosurgeon.