With Georgia case pending, Centene probed in California

By Samantha Young, Kaiser Health News Prescription drug costs for California’s massive Medicaid program were draining the state budget, so in 2019 Gov. Gavin Newsom asked the private sector for help. The new Medicaid drug program debuted this January, with a private company in charge. But it was woefully unprepared, and thousands of low-income Californians were left…

State hits Anthem with whopping fine for insurance violations

By Rebecca Grapevine and Andy Miller The state insurance department has levied a $5 million fine against health insurer Anthem Blue Cross Blue Shield, the largest such penalty in the agency’s history, for violations of state law involving medical providers and consumers. Insurance Commissioner John King, at a Tuesday news conference at the State Capitol,…

With one week to go, Senate makes key changes to mental health parity bill

A Senate committee Monday unanimously approved a rewrite of key provisions in the House’s mental health bill championed by powerful Georgia House Speaker David Ralston. The revised version of the legislation, passed by the Senate Health and Human Services Committee, backs off the House’s stronger language on determining “medical necessity’’ of treatment, and on involuntary…

Commentary: U.S. medical costs are shockingly high

The U.S. health care system has many great features. One thing that isn’t great is the cost of care. In a new GHN Commentary, retired health care executive Jack Bernard points out that compared with other developed countries, the United States is spending much more money on health care, yet in some cases is actually…

‘Game-changer’ bill on mental health clears House, heads for Senate

The Georgia House on Tuesday overwhelmingly passed a wide-ranging mental health bill that includes stricter financial requirements on the state’s Medicaid managed care companies. House Bill 1013 now heads to the state Senate, where its path is less certain. House Speaker David Ralston made a rare appearance at the podium to address his chamber before…

After Ralston makes rare pitch, House panel OKs mental health bill

“I think it’s the most important [topic] we will take up this year.” With that remark, Georgia House Speaker David Ralston, in a rare appearance at a legislative committee hearing, set out the stakes Wednesday for passage of the mental health parity bill that he has sponsored. “The No. 1 state for business in this…

The Piedmont powerhouse: Health system’s expansion reaches Augusta

Piedmont Healthcare has added Augusta to its expanding hospital footprint. The Atlanta-based nonprofit system now contains 19 hospitals, with the announcement Tuesday that it has taken over University Health Care System, which includes University Hospital in Augusta. Other hospitals in the agreement are smaller facilities: University Hospital Summerville and University Hospital McDuffie. The two systems…

Prescription drugs: Another potential legislative change that Medicaid insurers face

One House bill would make Georgia’s Medicaid managed care insurers face stricter requirements on how they spend their government dollars. There’s a second bill that has also captured their attention – an attempt to wrest control of patients’ prescription drugs from those health plans. House Bill 1351 would remove the function of the three managed…

House panel endorses more transparency in health plans’ data

By Andy Miller and Rebecca Grapevine  A House committee Tuesday approved a bill that would require more public disclosure about Georgia health plans serving Medicaid patients and state employees and teachers. House Bill 1276, if it becomes law, would require the main state health agency to post reports showing how many primary care providers these…

Battle between Biden and GOP-led states over Medicaid leaves enrollees in the balance

By Phil Galewitz and Andy Miller  When Republican-led states balked at expanding Medicaid under the Affordable Care Act, President Barack Obama’s administration tossed them a carrot — allowing several to charge monthly premiums to newly eligible enrollees. Republicans pushed for the fees to give Medicaid recipients “skin in the game” — the idea they would…