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Medicaid gap2In case you missed it yesterday, the Wall Street Journal featured a powerful article on the terrible toll that is resulting from the failure of 25 states (including North Carolina) to expand Medicaid under the Affordable Care Act. The article – “Millions trapped in health-law coverage gap” tells the story of low-income workers like Ernest Maiden of Birmingham, Alabama who make too much to qualify for their own state’s Scrooge-like Medicaid programs, but not enough to qualify for federal subsidies under the ACA. (There are as many as 500,000 Ernest Maiden’s in North Carolina):

“Ernest Maiden was dumbfounded to learn that he falls through the cracks of the health-care law because in a typical week he earns about $200 from the Happiness and Hair Beauty and Barber Salon.

Like millions of other Americans caught in a mismatch of state and federal rules, the 57-year-old hair stylist doesn’t make enough money to qualify for federal subsidies to buy health insurance. If he earned another $1,300 a year, the government would pay the full cost. Instead, coverage would cost about what he earns.

‘It’s a Catch-22,’ said Mr. Maiden, an uninsured diabetic. Read More

Puppy millsFew developments are surprising these days in the through-the-looking glass world of the North Carolina General Assembly, but the recent developments surrounding “puppy mills” legislation takes a very large cake.

As was reported last week in multiple places, one of the North Carolina Senate’s most powerful members, Senate Rules Committee Chairman Tom Apodaca, issued a statement in which he said that the Senate would not move legislation on this subject in 2014 because of its objection to the “tactics” of bill supporters — specifically the fact that a supporter meeting with Senator Bill Rabon openly recorded the Senator’s inflammatory comments on the subject and then made them public.

This was apparently not an idle threat by Apodaca. Yesterday, N.C. Policy Watch obtained an email sent by another lawmaker (Senator Bill Cook of Beaufort County) to a concerned constituent in which he recited Apodaca’s threat verbatim (see the bottom of this post for the full text). Read More

Medicaid expansionThe drumbeat calling on state leaders to reverse course and accept federal Medicaid dollars in order to provide health insurance to hundreds of thousands of poor North Carolinians continues to grow louder and louder.

As this morning’s Greensboro News & Record editorial argues (after citing a new report by the accounting firm Jackson-Hewitt that the failure to expand will lead to tens of millions of dollars in tax penalties for North Carolina businesses):

“A society and an economy are stronger when people are healthier. Expanding Medicaid coverage could help North Carolina achieve that goal. If that could spare employers tens of millions of dollars in tax penalties at the same time, our pro-business governor should explore that opportunity.”

Meanwhile, be sure to check out this essay by Duke writer and doctor Laura Musselwhite in  Raleigh’s News & Observer in which she points out: Read More

Aldona Wos

NCHHS Sec. Aldona Wos

Can’t keep up or remember all the headline-grabbing goofs over the last year at the N.C. Department of Health and Human Services?

WRAL reporter Mark Binker compiled a chronological list here.

The N.C. Department of Health and Human Services under Secretary Aldona Wos has rarely gone a few weeks this year without contending with some major crisis or controversy.

Here’s a snippet of some of the problems, though it’s worth clicking on the WRAL link to refresh your memory of just what’s gone sour at the state agency over the last year.

From WRAL:

Sept. 2013: Chief of staff paid $37,000 “severance”

The Department of Health and Human Services paid Thomas L. Adams $37,227.25 as “severance” after he served just one month as chief of staff at the department. Adams’ severance payment stood out because he occupied an exempt position, meaning he could be hired and fired at will with little notice and no need for the state to give cause and no appeal rights. The settlement was in addition to $14,000 in salary he earned over a short tenure.

And

Oct. 2013: State closes off WIC benefits for women and children as questions rise about whether the move was necessary Questions remain on WIC closure

Dysfunction in Washington came to North Carolina as the partial federal government shutdown stemmed the flow of tax dollars to North Carolina. The Women, Infants and Children, or WIC, nutrition program was one of the hardest hit by the shutdown. North Carolina announced it would stop processing applications due to the shutdown. But the federal government raised questions about that response, saying that the state should have had a reserve to allow them to carry on work through the shutdown period. Question intensified because WIC programs in other states continued operating.

And, most recently:

Jan. 2014: Doctors sue over Medicaid billing problems

North Carolina’s Medicaid billing system has been so dysfunctional that it costs doctors time, money and patients, according to a class-action lawsuit filed by a group of medical providers in early January 2014. The suit alleges the state Department of Health and Human Services and some of its computer services providers were negligent in developing and implementing a new Medicaid claims billing system, known as NCTracks. Doctors from Cumberland, Nash, New Hanover, Robeson and Wake counties are part of the suit and claim “NCTracks has been a disaster, inflicting millions of dollars in damages upon North Carolina’s Medicaid providers.”

nctracksSeven doctors’ offices filed a class-action lawsuit against the state’s health agency today, seeking relief for the bungled N.C. Tracks Medicaid billing system that has delayed payments to doctor’s offices and hospitals around the state.

The 48-page lawsuit (click here or scroll down to read) filed this morning in Wake County Superior Court is looking for damages from Computer Sciences Corporation (CSC), the company contracted to build the billing system;  the N.C. Department of Health and Human Services and two companies hired to test the system before its launch.

“The Defendants’ wrongful conduct caused massive delays in payment of reimbursements that were due and owing but simple were not paid due to errors in NCTracks,” the lawsuit states. “By one estimate, the State failed to pay nearly $700 million in the first 90 days of NC Tracks’ operation alone.”

In some instances, patients cancelled payments and doctors’ practices went months without payments, leaving medical practitioners in financial straits, the suit alleges.

Read More