State news: Meningitis outbreak in L.A., Ill. blocks risk-adjustment payment from co-op

State news: Meningitis outbreak in L.A., Ill. blocks risk-adjustment payment from co-op

Here’s a roundup from healthcare news from California, Illinois, Ohio and Massachusetts.

Gay, bisexual men in L.A. urged to get meningitis vaccine after outbreak

Since May, seven cases of invasive meningococcal disease have been confirmed among gay and bisexual men in Los Angeles County, leading its public health department to publicly urge others to get vaccinated to halt the spread of the infection.

“In L.A. County there are an estimated 300,000 self-identified gay or bisexual men, in a population of more than 10 million," said Jeffrey Gunzenhauser, MD, interim director for the L.A. County Department of Public Health, according to Southern California Public Radio. "Seven cases occurring among this group, during a two-month period, is much higher than expected."

Gunzenhauser said research is being conducted Centers for Disease Control and Prevention to figure out why the gay and bisexual community have been disproportionately affected. There have been a total of 17 confirmed meningitis cases throughout the county this year. Five cases have been reported in neighboring Orange County, with one person dying from the infection.

In response, the L.A. LGBT Center is offering free vaccinations, but the center’s medical director, Robert Bolan, MD, told the Los Angeles Daily News that only 30 people have taken advantage of the service so far.

“I want us to be busy,” Bolan said. “I want the doors to be bursting at the seams. I want people to come and be vaccinated now.”

A similar outbreak in L.A. County in 2014 resulted in the deaths of three gay men.

Ill. co-op blocked from making risk-adjustment payment to CMS by state

The Illinois Department of Insurance has ordered insurance co-op Land of Lincoln Health not to pay the $31.8 million CMS says it owes under the Affordable Care Act’s risk-adjustment program.

The department’s acting commissioner, Melissa Dowling, argued in a letter to Healthcare.gov CEO Kevin Counihan that making the payment would cause the co-op to shut down, leaving 49,000 policyholders looking for new coverage in the middle of the year.

“A mid-year liquidation would require a special enrollment, the consequence of which would force LLH policyholders to ‘restart’ their calendar year deductibles and out-of-pocket maximums and, as we have observed in other states, cause the elimination of in-network provider participation and/or discounts,” Dowling wrote.

Risk adjustment payments for 2017 would hit co-ops hard, with Connecticut putting its co-op under supervision after CMS said it owed $13.4 million. Smaller insurers have complained the program’s risk score calculation unfairly benefits older, larger rivals.

Dowling’s order said Land of Lincoln Health shouldn’t make the payment until CMS pays $73 million the insurer requested under the separate risk-corridor program.

Drug price cap referendum doesn’t make Ohio ballot

A proposal to cap what Ohio health programs pay for prescription drugs at the amount paid by the U.S. Department of Veterans Affairs won’t be included on the November ballot.

As the Cleveland Plain Dealer explains, Ohio allows proposed laws initiated by petition drives to be put directly to voters if the legislature doesn’t act on them within four months, provided supporters collect more signatures.

The leaders of the petition drive, Ohioans for Fair Drug Pricing, now say they won’t have enough time to gather the additional signatures needed to make it on this year’s ballot, but will instead aim at putting the proposal to voters in 2017.

The Pharmaceutical Research and Manufacturers of America (PhRMA) had tried to block the proposal by challenging the petition signatures. A similar proposal in California will be on that state’s ballot this year.

Study: Mass. opioid prescriptions falling much faster than other states

A new study from athenahealth suggests Massachusetts law limiting first-time opioid prescription to seven days may be behind a drop in the number of opioid prescriptions in the state.

After the law was signed earlier this year, there was a 14 percent drop in the number of patients prescribed opioids between the first and second quarters of 2016, compared to 8 percent nationwide.

The decrease was slightly larger among patients visiting primary care physicians (15 percent) than specialists (11 percent).