IdeaFestival: How to contain the next lethal pandemic Wednesday, Sep 28 2016 

Where the next pandemic is likely to emerge.

Zika in the Americas. Cholera in Haiti. West Nile in half of the United States. Bird flu. Swine flu. Ebola. Antibiotic-resistant bacteria. More urbanization, global transportation, humans encroaching on animal habitats and rising inequality that keeps billions from access to clean water and sanitation are increasing the risk that a deadly microbe will sweep across the […]

With Switch From Kynect to HealthCare.gov Imminent, Questions Remain Wednesday, Sep 28 2016 

Gov. Matt Bevin’s administration says HealthCare.gov will be up and running in Kentucky in time for Kynect customers to reapply for their health insurance later this year.

But roughly one month from the beginning of open enrollment on Nov. 1, some of those who work on the ground to help Kentuckians sign up for coverage are concerned about whether exchange customers will know when, where and how to re-enroll. That’s in part because education and outreach efforts have thus far been minimal.

Kentucky is moving from its state-based marketplace to the federal HealthCare.gov this year, after Bevin decided to dismantle Kynect and roll back Medicaid expansion in the state. Consumers must reapply this year for 2017 coverage even if they were auto-enrolled last year because eligibility information from Kynect won’t be transferred to the federal system.

The window for open enrollment is Nov. 1 until Dec. 15. Amanda Stamper, press secretary for Bevin administration, said they’ve hit milestones to make the switch in time.

“We’ve also been working with [the Centers for Medicare and Medicaid Services] and stakeholders to develop a comprehensive outreach plan to ensure people have the information they need well before open enrollment to know when and how to enroll,” Stamper said.

She did not say when that effort would begin.

But health care navigators, the organizations that help people sign up, have not pushed public awareness campaigns ahead of the change.

Cara Stewart, a health law fellow at the Kentucky Equal Justice Center, is also Kynector who helps people enroll. She said her group has held off from doing outreach because of uncertainty around the change. Kentucky still has to meet certain federal requirements to stop using Kynect for enrollment and join the national system.

“This time last year we were doing multiple events a week. You ramp up your outreach with back-to-school — in August — and here we are at the end of September, and we can’t really do anything,” Stewart said. “Even if you keep benefits in place, if you move the door and don’t tell people where the door is, it doesn’t mean much.”

Costs, Benefits to Federal System

Tonia Wooton, who works with Community Action of Southern Kentucky to help enroll consumers, said the process for signing people up would be a little different this year.

Instead of filling out an application for an enrollee, she’ll only be able to help them pick a plan, she said, HealthCare.gov rules require the applicant to complete enrollment. She also won’t be able to access enrollees’ eligibility processing once it’s submitted to HealthCare.gov.

“If someone calls me and asks ‘What’s going on with my case?,’ I can’t pull that information up anymore,” Wooton said.

Most questions were around whether and what level of payment assistance they’d receive, she said.

Josh Archambault, a senior fellow at the think tank Foundation for Government Accountability, said one of the reasons to dismantle the enrollment part of Kynect was money.

“Gov. Beshear increased a fee on all insured lives to help fund the state-based exchange,” Archambault said. “So whether or not they were using it, they were paying for it. So if you transition away from that, there will be a small decrease in premiums.”

Former Gov. Steve Beshear implemented a fee on all insurance plans in the state to help pay for Kynect’s operations. The cost of running Kynect was $28 million a year, according to the Kentucky Cabinet for Health and Family Services.

Insurers operating in Kentucky would have to pay 1.5 percent of the premiums they charge to use the federal system. There’s been conflicting information about how much Kentucky would pay in one-time costs do dismantle Kynect. Beshear put it at $23 million, while Bevin’s administration says $11 million.

Advocates are also concerned about using HealthCare.gov to determine whether a person is eligible for the marketplace or would qualify for Medicaid. At present, Kynect makes that determination. But such eligibility information will now be held by HealthCare.gov, and they’ll send Kentucky officials information on those who qualify for Medicaid.

“Every time you have a handoff there’s the potential for people to fall through the cracks,” said Joel Ario, a health care consultant at Manatt Health Solutions and former insurance commissioner of the Pennsylvania Department of Insurance.

But, he said, there are also benefits: HealthCare.gov is rolling out a mobile app and has a provider directory to help people choose a plan.

Kentucky will also keep some of its responsibility with marketplace exchanges by continuing to negotiate exchange plan benefits and costs. This means there will be more of a chance that insurers keep offering benefits, according to Ario.

“If you look at states where they’ve had problems with only one insurer, they’re almost all federal marketplace states where the state hasn’t been involved with working with insurers,” Ario said.

The Bevin administration declined to make state officials available to discuss the changes in further detail.

Attorney General Andy Beshear Joins Multistate Suit Against Maker Of Suboxone Friday, Sep 23 2016 

Kentucky Attorney General Andy Beshear has joined a multistate antitrust lawsuit against the makers of Suboxone, a prescription drug used to treat heroin and other opioid addiction by blocking cravings for the substances.

The suit alleges that Reckitt Benckiser Pharmaceuticals — now Indivior — switched Suboxone from a tablet to a mouth-dissolving film so that the Food and Drug Administration would grant the drug maker more years of exclusivity before generic alternatives could hit the market.

“Substance abuse is the single greatest threat to our Commonwealth,” Beshear said in a news release. “For these companies to allegedly try and monopolize the market on a treatment drug is beyond belief and borderlines on inhuman.”

Beshear said in order to win the battle over heroin in addiction in Kentucky, the state needs “every resource available and affordable.”

“In Kentucky, drugs are killing our children, destroying our families and scarring our neighborhoods,” he said. “It is also the single greatest threat to job growth.”

The Louisville area has a seen spike in heroin overdose deaths recently, and last year, Jefferson County led the state with nearly 270 fatal drug overdoses.

The companies are accused of violating state and federal antitrust competition laws in the handling of Suboxone. Reckitt originally had patent exclusivity until 2009. During that time, they developed a dissolving film form of the drug — similar to a breath freshening strip.

The FDA grants new exclusivity when the delivery mechanism is changed. The suit says Reckitt expressed “unfounded safety concerns about the tablet version and intentionally delayed FDA approval of generic versions of Suboxone.”

The suit also claims the company hiked prices for the dissolving film – annual sales of Suboxone have been more than $1 billion a year since the drug was converted from pill to dissolving film.

Suboxone is a mixture of naloxone — the opioid-reversal medication — and a less potent opioid called buprenorphine. It was developed in 2002 to stop drug users from taking buprenorphine to get high.

Kentucky joins 35 states in filing the suit, including Tennessee, Michigan, Virginia and Pennsylvania.

Months After Rollout, Some Problems Persist With Benefind Monday, Sep 19 2016 

Earlier this year, first grader Cora Maddox stopped receiving Medicaid benefits that helped pay for treatment of her apraxia, a brain disorder that affects her speech and motor skills.

Cora’s mother, Angie Maddox, a web designer from Boone County, had to supplement what the family’s private insurance wouldn’t cover for her child’s tube feedings and therapy sessions — a total of $1,500 a month that had previously been paid for by Medicaid.

Cora was one of thousands of Kentuckians who lost services while the state transitioned to a new one-stop portal for welfare benefits called Benefind, which was designed by previous Gov. Steve Beshear’s administration and rolled out in the first months of Gov. Matt Bevin’s.

“All of Cora’s information from the old system never got transferred to the new system,” Maddox said during a legislative hearing on Monday. “Everything was gone.”

Cora’s benefits have been restored since June, but Maddox says she still gets confusing letters from the state saying Cora’s benefits are being reviewed or have been denied. She said she even got a letter from the state incorrectly saying that Cora had died and that the state would be starting an investigation.

“I wasn’t even sure how to proceed with this one, so I just set it aside and did nothing,” Maddox said.

The next day, Maddox received a letter saying that the investigation was complete and that Cora would once again receive benefits.

“These glitches are a big deal,” Maddox said. “This is happening to families across the state. Many families are not fortunate enough to have the time to commit to getting it fixed because of other responsibilities.”

Benefind launched in late February and erroneously sent out about 25,000 notices to people saying that their benefits had been canceled. The state also had to work through a backlog of about 50,000 cases created from conflicting information from newly merged systems. The administration says it cleared the backlog in mid-May.

The $100 million program was the product of an initiative by the Beshear administration to combine the application and management of several welfare programs under one roof.

Bevin administration officials say they didn’t know about Benefind’s problems before the launch. Delaying the new system would have cost about $3.5 million in personnel and maintenance costs for each month they delayed, officials say.

Deck Decker, technology director at the state health cabinet, says that Benefind’s glitches “should have been looked at before it went live.”

“Unfortunately it wasn’t this administration that processed it,” Decker said. “We walked in on this issue.”

Decker said that the system is still having trouble processing applications for long-term care — like nursing homes — and home-based Medicaid waivers. Cora receives the home-based waiver, which gives benefits to people with disabilities so they can remain in their homes.

Rep. Addia Wuchner, a Republican from Florence, said the state should apologize to Kentuckians who have lost benefits through the Benefind transition.

“Sometimes just to hear from government that we are so sorry, we made a mistake, explaining what happened sometimes clears up the angst that people have,” Wuchner said.

Later during the committee hearing, Medicaid Commissioner Steve Miller apologized to Maddox.

Deck Decker encouraged anyone encountering glitches in the Benefind system to email him at Deck.Decker@ky.gov.

BayMark faces resistance over plans to open downtown methadone clinic Wednesday, Aug 17 2016 

BayMark is proposing a methadone clinic in downtown office space at 708 Magazine St., where Seven Counties Services currently houses an addiction treatment program | Photo via Google Maps

A proposed downtown methadone clinic continues to face heavy opposition, with most of the criticism coming from employees of regional behavioral health care provider Seven Counties Services, which already houses an opioid addiction treatment program in the same building. But despite concerns about the appropriateness of the clinic’s location and model of treatment, the Texas-based company behind the proposal intends […]

Jewish Hospital explains guiding principles, recent feats and new initiatives Wednesday, Aug 17 2016 

jewish-hospital

Jewish Hospital was founded in Louisville in 1903 under the guiding principle of tikkun olam, an ancient Hebrew phrase that means “healing of the world.” “According to the Bible, it refers to Jews as being charged to partner with God in mending this world that is not yet whole,” says Rabbi Dr. Nadia Siritsky, vice […]

Norton awards $1.5 million health services grant to Bellarmine University Monday, Aug 15 2016 

Bellarmine University

Norton Healthcare has awarded a $1.5 million grant to Bellarmine University to support existing and expanding health programs on campus. The five-year grant — distributed in five $300,000 increments — will help fund the Lansing School of Nursing and Health Sciences, as well as expansion of the school’s sports medicine program. As the university’s athletics program continues to grow, some of the […]

Norton to remove ‘Kosair’ name from children’s hospital within six months Thursday, Aug 11 2016 

Norton Healthcare owns Kosair Children’s Hospital, which is supported in part by Kosair Charities.

Kosair Charities and Norton Healthcare said they will remove the “Kosair” name from the children’s hospital within six months but are declining to release details about the settlement agreement that has ended their contentious legal battle. Kosair Children’s Hospital was created in 1981 when Kosair Crippled Children’s Hospital and Norton Children’s Hospital joined forces. In 2006, […]

Justice Department vs. Aetna-Humana trial set for Dec. 5 Wednesday, Aug 10 2016 

Humana horizontal

Humana and Aetna are scheduled to defend their merger in court beginning on Dec. 5, according to a report by Bloomberg. That puts the companies on a tight deadline to complete their deal. The companies plan to close the transaction before the end of the year. Health insurer Aetna, based in Hartford, Conn., wants to […]

Seven Counties plans to sell downtown HQ, relocate to East End Monday, Aug 8 2016 

Seven Counties

Citing a downtown real estate market boom and space limitations of their current office, Seven Counties Services CEO Tony Zipple told staff in an email last week that they are putting their headquarters up for sale and are close to signing a lease for new space east of St. Matthews. Zipple told staff of the […]

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