Posts Tagged ‘Nevada State Medical Association’

Medical Association Applauds Sandoval Medicaid Decision

By Sean Whaley | 11:11 am December 13th, 2012

CARSON CITYNevada State Medical Association President Florence Jameson said today that Gov. Brian Sandoval made a “politically courageous and correct” policy decision to expand the Nevada Medicaid program.

The decision will ensure that there will not be a new class of uninsured Nevadans when the federal health coverage changes are implemented in January 2014, said Jameson, a physician.

This decision assures coverage for low income uninsured Nevadans who would not be eligible for the new health insurance products provided through the Silver State Health Insurance Exchange. While controversial, the principal achievement of the Patient Protection and Affordable Care Act (PPACA) is the development of a complex scheme for providing health care coverage for most Americans, the announcement said.

The association recommended in September that Sandoval opt for the expansion, but Nevada physicians remain concerned that it does not improve the current Medicaid program, which is significantly underfunded, Jameson said.

The association “urges Governor Sandoval and the state Legislature to address the access to care needs of the patients who are, and will continue to be, covered by the current Medicaid program,” she said.

This medical care access issue is one reason the Nevada Policy Research Institute, a libertarian think tank, has criticized the decision.

NPRI Deputy Policy Director Geoffrey Lawrence said that because the Medicaid program systematically under-reimburses health-care providers, many are not taking new patients. This means current Medicaid enrollees – by definition the most vulnerable populations – will now be competing with healthy adults for fewer and fewer doctors. Sandoval’s decision will exacerbate the doctor shortages already faced by the children and the disabled who use Medicaid, he said.

“All this said, one must applaud the governor’s decision to finally institute consumer co-pays and thus introduce some real-world price sensitivity into the calculations of Medicaid consumers,” Lawrence said. “The primary reason for the health-care system’s high costs is the government-induced breakdown of the price system.”

Imposing co-pays is a proven way of encouraging individuals to seek only the care they really need, helping to control cost growth, he said.

Another concern cited by NPRI with the expansion is the increasing cost of the Medicaid program to taxpayers.

State Medicaid spending is already growing at an unsustainable pace and will soon displace K-12 education as the state’s largest budget item, Lawrence said. While Congress has pledged that federal taxpayers will cover a majority of costs for the newly eligible population through 2020, that will likely shift more to state taxpayers in later years, he said.

State Medical Association Supports Expansion Of Medicaid Eligibility Under Affordable Care Act

By Sean Whaley | 1:35 pm September 13th, 2012

CARSON CITY – The Nevada State Medical Association has announced it supports expanding Nevada’s Medicaid caseload as permitted under the federal Patient Protection and Affordable Care Act (PPACA).

The association’s board of directors met on Sept. 8 and adopted the policy statement, which was based on the information currently available about the expansion of the Medicaid program.

Photo by Debora Cartagena/CDC.

“We believe that this is necessary to assure that there is not a new class of uninsured Nevadans created by a gap in the PPACA coverage plan,” said the statement by the association, released Wednesday.

“Nevada physicians are concerned that this does not improve the current Medicaid program, which is significantly underfunded,” the statement said. “Current payment levels have made it increasingly difficult for physicians and hospitals to maintain their availability for Medicaid patients. This has become particularly true for children with disabling conditions or chronic illnesses and for women facing high-risk births.”

As a result, the association said it is urging Gov. Brian Sandoval and the Legislature to “address the access to care needs of the patients who are, and will continue to be, covered by the current Medicaid program.”

The Nevada State Medical Association is Nevada’s oldest and largest physician advocacy organization.

The authorized Medicaid expansion is still under review by the Sandoval Administration. If recommended by Sandoval and approved by the Legislature in 2013, it would take effect on Jan. 1, 2014 for Nevadans up to 138 percent of the federal poverty level. The potential caseload expected under such an expansion is still being analyzed.

Federal funding would pay for 100 percent of any Medicaid expansion for the first three calendar years beginning in 2014, with the state required to pick up a percentage of the cost beginning in 2017. The first year state cost is 5 percent, in 2018 the state cost is 6 percent, in 2019 the state cost is 7 percent, and in 2020, the state cost is 10 percent.

The expansion in Nevada would mostly cover childless adults who are not covered by the state program now.

Nevada is already moving forward with its Silver State Health Insurance Exchange, which will offer eligible residents the opportunity to purchase health insurance beginning on Oct. 1, 2013.

Meanwhile, data from the U.S. Census Bureau shows that Nevada’s uninsured population continues to increase. While the rate nationally declined by 0.5 percent to 16 percent between 2008-09 and 2010-11, Nevada’s rate increased 2.7 percent in that same time period, to 22 percent.

Nevada Groups React To U.S. Supreme Court Decision On Health Care Law

By Sean Whaley | 1:52 pm June 28th, 2012

CARSON CITY – Nevada groups and organizations weighed in on the controversial U.S. Supreme Court ruling on the health care law today, with comments across the spectrum.

The Nevada Policy Research Institute, a libertarian think tank, called it a, “practical and significant blow to individual liberty.”

Photo by Franz Jantzen courtesy of the U.S. Supreme Court.

“Our nation’s founders intended the constitution to greatly restrict the power of the federal government, but unfortunately, this ruling further expands federal authority,” said Joseph Becker, chief legal officer and director of NPRI’s Center for Justice and Constitutional Litigation. “Not even King George believed he had the authority to compel colonists to buy the tea tossed overboard in Boston Harbor, yet we now have an expansion of federal authority which, through the force of taxation, mandates as a practical matter that citizens must buy private-sector goods.”

Geoffrey Lawrence, deputy policy director at NPRI, said: “Just because the Supreme Court has ruled that the Affordable Care Act is constitutional doesn’t change the damage this flawed policy will do to individuals in America’s health care system.

“The primary shortcoming of the health care industry is that government policies have induced too much cost-shifting and neutered the effectiveness of the price system,” he said. “The ACA just doubles down on this shortcoming by increasing the degree of cost-shifting to ludicrous proportions. Small businesses will pay more, families and individuals will pay more, and states could pay more.”

Nevada State Medical Association (NSMA) President Florence N. Jameson, M.D., a Las Vegas obstetrician-gynecologist and founder of Volunteers in Medicine of Southern Nevada, said in part: “Unfortunately, major health care problems are not resolved by this law. The Congress and the president must continue to work to find an acceptable way to sustain Medicare for seniors and persons with disabilities and the Medicaid program for indigent and chronically ill children and seniors.

“Governor Brian Sandoval and the Nevada Legislature will have to determine the impact on Nevada Medicaid of the Supreme Court’s decision, but it doesn’t make the funding of the Medicaid program easier,” she said. “It means that they must address again the often unfair way that health insurance coverage fails patients when they have the greatest need for medical care.”

Randi Thompson, Nevada state director for the National Federation of Independent Business, which was the named plaintiff in today’s landmark decision, said: “The Supreme Court may have ruled that the act may be constitutional, but it’s not good policy.

“I agree with the dissenting statement that the Affordable Care Act exceeds federal power in mandating the purchase of health insurance,” she said. “The court confirmed the mandate is a tax on every American. Add the mandate tax to a host of other new taxes in the new heath care law and you have the most costly bill every thrust on the American taxpayer.”

Michael Ginsburg, Southern Nevada director of the Progressive Leadership Alliance of Nevada, said: “This law expands coverage to more than 30 million people and eliminates the worst insurance company abuses such as premium price-gouging, discrimination and denial of care for the sick in order to increase corporate profits. This decision makes clear that implementation of the law must move forward at the state and federal level without further delays from partisan political interference – including governors and elected officials.”

Scotty Watts, president of the Nevada Alliance for Retired Americans, said: “Today is an historic day for Americans of all ages, an affirmation of a law that helps children, workers, and retirees obtain affordable health care. Americans can now live more secure, knowing that their health and well-being are no longer tied to the whims and greed of the big insurance companies.”

“Today is a tremendous victory for Nevada  seniors, their children, and their grandchildren,” he said. “But we cannot rest on our laurels.  In the 2012 elections we cannot let politicians roll back the progress we have made.”

Nevada was one of 26 states that challenged the constitutionality of the law that resulted in today’s ruling. Nevada was represented by Las Vegas attorney Mark Hutchison, who worked on the case for free after Nevada Attorney General Catherine Cortez Masto declined to challenge the law at former Gov. Jim Gibbons’ request.

Nevada State Democratic Party Chairwoman Roberta Lange said the decision, “offers relief to Nevadans with preexisting conditions, young people who can stay on their parents’ healthcare plans until they are 26 and seniors who rely on lower prescription drug costs.

“However, despite the Supreme Court settling this issue, Mitt Romney is still promising to fight old political battles of the past that would roll back protections from some of the worst abuses by the private insurance industry,” she said. “It’s time to move forward, end the partisan games and get back to work creating good paying middle-class jobs that stay here in Nevada.”

Romney, the presumptive GOP presidential nominee, said today: “What the court did not do on its last day in session, I will do on my first day if elected president of the United States. And that is I will act to repeal Obamacare.

“Let’s make clear that we understand what the Court did and did not do,” he said. “What the court did today was say that Obamacare does not violate the Constitution. What they did not do was say that Obamacare is good law or that it’s good policy.”

President Obama said in remarks at the White House: “The highest court in the land has now spoken. We will continue to implement this law. And we’ll work together to improve on it where we can.  But what we won’t do – what the country can’t afford to do – is refight the political battles of two years ago, or go back to the way things were.

“With today’s announcement, it’s time for us to move forward – to implement and, where necessary, improve on this law,” he said. “And now is the time to keep our focus on the most urgent challenge of our time: putting people back to work, paying down our debt, and building an economy where people can have confidence that if they work hard, they can get ahead.”


Nevada State Medical Association To Seek Health Insurance Transparency

By Sean Whaley | 3:29 pm December 7th, 2010

CARSON CITY – The Nevada State Medical Association believes consumers should have access to clear and understandable information about the cost and coverage provided under health care insurance policies before they sign on the dotted line.

Executive Director Larry Matheis  said the association will pursue legislation next year to require companies offering health insurance policies to post such information on the Nevada state website to provide transparency for such critical health care decisions.

“It is essential that people have an understanding of what they’re getting with this package called health insurance,” he said.

There are many anecdotal examples of people purchasing health insurance policies only to find out that illnesses such as cancer were excluded, Matheis said.

“So all of those kinds of issues are what we want to see a much more open demonstration of the information that people need,” he said. “They (insurance companies) can make decisions about what they will and won’t cover, but it has to be then very clearly explained to people at the front end, not the back end. You don’t want to be shocked after you’ve had care to find out that the insurer has decided, not that you didn’t need it, but that they’re not going to pay for it.”

Making health insurance decisions more transparent by providing the information up front to consumers is even more important as the federal health care law begins to take effect, Matheis said.

Transparency efforts are moving forward in Nevada in the areas of reporting key hospital and physician data, he said. But the same cannot be said for the health insurance policies offered by the insurance industry.

“How does the health insurance industry deal with things like coverage,” Matheis said. “What does coverage mean? When do they exclude something. When do they exclude somebody. How much of the premium dollar goes for health care. How much goes for other things. Just a range of issues.

“People don’t need to have the unpleasant surprise when they or their family are going through serious illness and medical care decision making,” he said. “That is not the time to find out what your insurer does and doesn’t cover.”

The association plans to work with lawmakers to require such information to be posted by the state on its official website. Matheis says he hopes to win the support of the state Insurance Commissioner and Gov.-elect Brian Sandoval in the effort, which has no significant fiscal issues associated with it.

State Sen. Sheila Leslie, D-Reno, said she has not talked with Matheis about his proposal but that it is an idea she would support. Standardizing such information would be of great benefit to consumers, she said.

“Of course we should be educating ourselves but reading an insurance policy is like trying to find a needle in a haystack,” Leslie said. “You can never find the answer to the question you have without a lot of work.”

Assemblyman David Bobzien, D-Reno, proposed a similar measure in the 2009 session that would have required health insurance policies to identify certain medical conditions not covered by the policy. It also would have required posting on the state website. Assembly Bill 438 did not make it out of the Assembly Commerce and Labor Committee, however.

Las Vegas attorney Jim Wadhams, a lobbyist who represents Anthem Blue Cross and Blue Shield in the Nevada Legislature, said the industry would not likely have any issue with the idea of providing helpful health insurance information to consumers on the state’s official website.

But he did suggest that if the Legislature wants to move ahead with such an idea, it should include all health insurance providers, including those operated by private companies for their employees and those operated by such organizations as the Culinary Union.

“I don’t think the industry would have a particular problem with it,” he said. “But if we are going to have transparency let’s have it for all.”

Individuals seeking health insurance can already do some comparison shopping on the internet through a couple of different brokerages, and, Wadhams said.

“So the concept is not particularly radical,” he said.

 Matheis said the association agrees that all plans should be included. But he said the special need is going to be for those buying individual or small group plans, particularly if the health insurance exchanges are to function under the new Patient Protection and Affordable Care Act.

Matheis said that while some opposition could emerge to the idea from the health insurance industry, it will be hard to oppose the idea of providing more information and information people need when they make their critical health care choices.

The idea is not to create new regulation or mandates, but to provide more sunshine on the issue of health care insurance coverage, he said.

“More front end information makes for fewer unpleasant surprises at the back end,” Matheis said. “If we do it right, that is what transparency brings to the health care system.”

Audio clips:

Larry Matheis of the Nevada Medical Association says people need to know what their health insurance plan covers before they need care:

120310Matheis1 :17 does not cover.”

Matheis says health insurance industry needs to make insurance information more transparent:

120310Matheis3 :13 that people need.”

Matheis says the public needs the information before purchasing health insurance:

120310Matheis4 :19 pay for it.”

Matheis says more information at the front end will eliminate unpleasant surprises at the back end:

120310Matheis5 :14 health care system.”

State Sen. Sheila Leslie says transparency in health insurance plans would be helpful to consumers:

120710Leslie1 :24 should participate in.”

Leslie says any way to help consumers understand policy coverages is important:

120710Leslie2 :15 is very important.”