News in brief - Oct. 15, 2007

House panel adopts parity bill

The House Ways and Means Committee passed mental health parity legislation on Sept. 26. The Paul Wellstone Mental Health and Addiction Equity Act would require health plans that offer mental health benefits to restrict them no further than physical and surgical benefits. The measure is a stronger version of a bill adopted unanimously by the Senate on Sept. 18 in that it mandates a wider scope of coverage and out-of-network coverage in certain situations.

The measure was approved by the House Education and Labor Committee in July.

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Edwards offers medical liability reform plan

Democratic presidential candidate John Edwards, a former trial lawyer and former U.S. senator from North Carolina, said he would take action as president to reduce frivolous medical liability cases. But he stopped short of endorsing comprehensive liability reform as a way to control health care costs. His proposal includes a certificate-of-merit requirement, in which at least two experts attest to the validity of a claim before it is filed. At least 20 states have adopted similar laws, according to American Medical Association research.

Under Edwards' plan, if a lawyer fails to obtain the certificate, the attorney, not the patient, would have to bear the legal costs of the case. Finally, if a lawyer violates the law three times, he or she would be barred from filing future medical liability cases. Edwards presented his proposal at a Sept. 24 health care forum sponsored by the consumer group Families USA, the Kaiser Family Foundation and the Federation of American Hospitals.

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Ohio physicians propose insurance mandate

An Ohio State Medical Assn. panel last month unveiled its principles to reform the state's health system. The Physicians Task Force on Access and Quality, which has been meeting since January, recommended adoption of an individual insurance mandate, better wellness incentives, preventive care, improved quality and transparency, and a self-sustaining system.

The task force decided early in its work that the plan should attempt to cover the state's 1.3 million uninsured, said Neal Nesbitt, MD, a general surgeon and the task force's chair. The group would like to see the existing employer-based system transformed into more of a consumer-based model, but that doesn't mean the new system would start from the ground up, he said.

"We're not going to bulldoze the house of medicine. What we're going to do is to try to remodel the house we have," Dr. Nesbitt said. The principles suggest a tax on "lifestyle choices that are detrimental to good health" as one funding mechanism.

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Colo. commission unveils fifth health care reform plan

The Colorado Blue Ribbon Commission on Health Care Reform added a fifth, Massachusetts-like plan to the pool of proposals to reform the state's health care system and cover many of the state's 792,000 uninsured.

The plan -- developed by the commission -- would require all Coloradans to have health insurance or pay an income tax assessment. It also would create an insurance pool with sliding-scale subsidies. Like three of the other four plans, which were submitted by advocates and other stakeholders, the commission's proposal would expand public health programs and try to create more affordable coverage. The remaining plan is for a single-payer system.

The commission is due to issue its recommendations to the General Assembly by Jan. 31, 2008. The five plans are detailed on the commission's Web site (www.colorado.gov/208commission).

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OIG survey finds Medicare hotline problems

Customer satisfaction with the telephone hotline that Medicare uses to answer questions has declined in the past several years, according to the Dept. of Health and Human Services' Office of Inspector General.

OIG conducted a survey of more than 200 people who called 800-MEDICARE in January. Only 71% of those who completed the calls reported that they were satisfied with the service they received, compared with 84% who reported satisfaction in a similar survey in 2004. Roughly one in five callers in 2007 said they hung up before receiving answers to their questions because the hold times were too long.

OIG said the Centers for Medicare & Medicaid Services should consider spending more money to improve automated answering technology or hire additional customer service representatives. The office also noted that CMS had been using two private contractors to administer the hotline when the survey was conducted but is now using only one of them.

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