ACHP Media Monitoring Report: October 24, 2016

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Future of Medicaid relies on election
As stigma around Medicaid is fading, the outcome of the presidential election will shape its future. Under a Clinton presidency, the program would continue to expand. A Trump administration would reverse the increase in coverage. Ricardo Alonso-Zaldivar from the Associated Press shares Medicaid is no longer perceived as serving mainly those receiving welfare, but rather as providing coverage to a greater variety of people.

Colorado weighs single-payer system
Voters in Colorado are considering a ballot initiative to create a single-payer health care system in the state. If passed in November, the program would be funded by income taxes, and Coloradoans would not have deductibles or copays, writes Shelby Livingston of Modern Healthcare. Hospitals and clinics in the state are skeptical of the proposal and worry it could lower rates for Medicaid reimbursements, imperiling providers serving low-income residents.

Medicare fraud a top priority for federal authorities
Since 2010, the Medicare Fraud Strike Force has arrested more than 1,200 people who defrauded Medicare for billions of dollars. Fraud prevention is a top priority for the president, and prosecutors regularly seek jail time for offenses previously resulting in fines, reports Eric Pianin of The Fiscal Times.

Cigna changes opioid treatment policy
Cigna Corp. will no longer require prior authorization to cover medication treating opioid addiction. Concerned about barriers to treatment, New York State Attorney General Eric Schneiderman sought details on Cigna’s coverage policies and found patients sometimes had to wait several days for coverage approval of medication. In response to the query, the insurer is voluntarily ending the practice of prior authorization to increase access to treatment for opioid addiction. Jeanne Whalen and Anna Wilde Mathews at The Wall Street Journal have the story (subscriber’s content).

Nursing homes dispute residents’ right to sue
The nursing home industry is challenging rules that would give patients at federally funded facilities the right to settle conflicts in court. Local health care groups contend the Centers for Medicaid and Medicare Services overstepped boundaries with this policy. Lydia Wheeler from The Hill reports health care facilities are requesting the court temporarily block the rule while it is under review.

Blog Review

Our weekly Blog Review features insightful posts from around the web and keeps an eye on medical industry and health news via the Trend Watch. This week we review posts discussing the effects of narrow-network health plans. This week’s Trend Watch compiles posts about the effectiveness of the Affordable Care Act.

Narrow Networks

Policies Needed to Address the Rising Problem of Surprise Out-of-Network Doctor Bills
The Hill
Surprise out-of-network bills are becoming more common as narrow-network plans grow in popularity, according to New York University School of Medicine Assistant Professor Kelly A. Kyanko, M.D., MHS, and Yale School of Public Health Professor Susan H. Busch, PhD. The professors suggest insurers offer protections to patients who receive surprise bills and plans regularly update provider directories to safeguard consumers.

Savings? Yes. But Narrow Health Networks Also Show Troubling Signs
The Upshot
Health Economist Austin Frakt examines how narrow-network plans affect cost and access to primary care physicians. By reviewing several studies, Frakt concludes health plans with smaller networks can reduce expenses for consumers and providers but cautions primary care appointments may be harder to obtain.

Trend Watch

Affordable Care Act

Why 27 Million Are Still Uninsured Under Obamacare
Bloomberg
This interactive feature allows readers to explore why 27 million Americans remain uninsured six years after the passage of the Affordable Care Act. The piece visualizes data from a survey conducted by the Kaiser Family Foundation, and touches on affordability and consumer knowledge. Data Designer Jeremy Scott Diamond, Health Care Reporter Zachary Tracer and Visual Journalist Chloe Whiteaker created the feature.

So You Think Obamacare Is a Disaster? Here’s How California Is Proving You Wrong
LA Times
Reporter Noam Levey believes California’s health care marketplace is more stable than that of other states because officials embraced the Affordable Care Act (ACA) by expanding Medicaid and building a marketplace with strict guidelines for insurers. Levy contends the states facing crises now are the same ones that challenged the ACA rollout and refused to expand Medicaid.