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State panel meets over ailing rural hospitals

Struggling to stay afloat financially, a northwest Georgia rural hospital has opted to file for bankruptcy protection from its creditors.

Officials at Hutcheson Medical Center in Fort Oglethorpe said Wednesday evening that the filing would allow it to continue operations, restructure debt, and help protect it from a Chattanooga system’s effort to foreclose on the hospital’s property.

Erlanger Health System has tried to recoup about $20 million it loaned Hutcheson as part of a management agreement.

Hutcheson Medical Center

Hutcheson Medical Center

The bankruptcy action came just hours before Gov. Nathan Deal’s Rural Hospital Stabilization Committee met in Lavonia on Thursday at Ty Cobb Regional Medical Center — another rural hospital experiencing severe financial challenges.

The panel heard speakers outline the depth of the state’s rural health care crisis.

Four rural hospitals have closed in Georgia over the past two years. Jimmy Lewis of HomeTown Health, an organization of rural hospitals, told the committee that 15 more facilities are “financially fragile.” Six of those, he said, “could go tomorrow due to low cash.”

“We’re approaching Third World care in the state of Georgia,’’ Lewis said.

More than 40 Georgia counties lack obstetrical providers, and just 75 of 180 hospitals in the state have labor and delivery units, Pat Cota of the Georgia OB/GYN Society told panel members. full story

Latest ACA court case reverberates in Georgia

The U.S. Supreme Court’s decision Friday to take up a case challenging the subsidies in the Affordable Care Act’s exchanges could wind up having a huge impact in Georgia.

The federal subsidies help millions of Americans afford health insurance offered in the exchanges, which were created as part of the health reform law.

The U.S. Supreme Court made Medicaid expansion optional for states..

According to the plaintiffs, those subsidies are improperly being given in the more than 30 states, including Georgia, that have decided not to run their own insurance exchanges. The federal government runs the exchanges in those states.

If the Supreme Court strikes down subsidies in federally run exchanges, it almost certainly would cause those marketplaces to collapse unless the states step in to run them.

In Georgia, however, that is not legally possible. This year, the Georgia General Assembly passed legislation that bars the state from running an ACA exchange. That prohibition was among other anti-Obamacare provisions that were signed into law. full story

Suit claims WellCare improperly pocketed funds

Six former WellCare officials are suing the Tampa-based company over health care fraud allegations related to its services in Georgia and other states.

The six claim that WellCare improperly kept money that should have been paid to hospitals or been repaid to Medicare or state Medicaid programs in Florida, Georgia, Illinois, New York, Ohio, Kentucky and Missouri.

logo_corporateThe plaintiffs say they each were fired Dec. 3, 2012, after resisting pressure from top officials to deny payment for medically necessary hospital stays.

The False Claims lawsuit, filed in the U.S. District Court in Tampa in May 2013, had been sealed while the U.S. Attorney’s Office decided whether to intervene in the case, Health News Florida reported this week. The case was unsealed last week after federal prosecutors decided not to step in.

WellCare serves more than 590,000 Georgians in the state’s Medicaid and PeachCare programs.

The company operates one of three care management organizations in Georgia that oversee the care of  a total of more than 1 million members in the two government insurance programs. These organizations operate like HMOs for patients in the programs.

full story

A campaign debate on Obamacare

Arguments for and against the Affordable Care Act dominated the debate last Sunday between candidates for Georgia’ insurance commissioner post.

Incumbent Ralph Hudgens, a Republican, faced off against Democrat Liz Johnson and Ted Metz, a Libertarian, in the Atlanta Press Club debate.

Here’s the video of it:

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Navigators aided consumers in need, report shows

Consumers in Georgia and three other states who were helped by navigators for the 2014 insurance exchanges tended to be people of color who were not financially secure, a recently released report says.

Navigators, who are specially trained in the provisions of the Affordable Care Act, provide face-to-face, in-person help for consumers seeking information about health insurance policies in the state exchanges, also called marketplaces.

The report by the University of Georgia also said many consumers helped by Seedco navigators in the four states had limited knowledge about health insurance concepts.

Sidney Wood meets with navigator Amanda Ptashkin in March.

A consumer meets with Atlanta-based Seedco navigator Amanda Ptashkin in March.

Seedco, a nonprofit group, was the lead organization in Georgia supplying navigators during the last Open Enrollment period for the ACA insurance exchanges. It also provided these counselors in Tennessee, New York and Maryland, and will do so again in the new enrollment period, which starts next month.

A UGA unit was the second Georgia navigator grantee group last year, but it is barred from participating this time by a newly passed state law. Top Georgia officials have been strongly critical of the ACA and have worked to limit official state involvement in its programs.

The UGA report found that among consumers in the four states helped by Seedco navigators, almost two-thirds (64.5%) were people of color. African-Americans were especially prevalent among these Georgia consumers. About 10 percent of consumers preferred to speak a language other than English. full story

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