August 5-11, 2011
This report includes selected news items from the past week on issues of
concern to the bleeding disorders community.
It is designed to help keep NHF national and local leadership and staff
informed of the latest information from the news media. It will be distributed by email on Thursday
of each week, covering important news items from the previous seven days. Subjects covered will include hemophilia,
other bleeding disorders, thrombosis and thrombophilia, gene therapy,
hepatitis, HIV/AIDS, and others.
These news
articles are copyright-protected and are for your information only. Please do not forward, reprint, or otherwise
distribute. Questions or comments may be
sent to Nava Hopkins, Research and Medical Information Coordinator, at nhopkins@hemophilia.org
InsuranceNews.net
August 5, 2011
BioPlus
Now Part of the Blue Cross and Blue Shield of North Carolina Specialty Pharmacy Network
Altamonte Springs, FL
Blue Cross and Blue Shield of North Carolina has made BioPlus Specialty Pharmacy part of their
specialty pharmacy network. Specialty pharmacies provide access to high cost
medications needed for conditions such as arthritis, hepatitis C, cancer,
hemophilia, and other chronic diseases. Typically, access to these types of
medications is limited and not usually available at local drug stores.
“Our mission of measurably improving outcomes gives us a guideline to provide
cost effective management solutions for patients, payers, and physicians,”
states Dr. Stephen Vogt, president and CEO of BioPlus.
BioPlus not only provides access to these drugs, but also works on educating
the patients, which has led to improved drug adherence and a better quality of
life for patients. “Our partnership with the physician touches the life of a
patient in ways that mail-order simply cannot,” notes Dr. Vogt. The latest
compliance statistics, based on more than 19,700 BioPlus patients being treated
for hepatitis C, oncology, rheumatoid arthritis, psoriasis, Crohn’s disease,
and other conditions, show that BioPlus achieves a 91 percent compliance rate
at discharge. The compliance rate for retail and mail-order pharmacies is only
50 percent.
BioPlus provides comprehensive training by a registered pharmacist and provides
24/7 phone access to pharmacists including nights, weekends, and holidays. “As
families are faced with confusing choices of their benefits and increases in
their premiums and co-pays, it is a win for beneficiaries to get our value
added services,” states Dr. Vogt. “We don’t use phone-trees, we coordinate care
with the physician and insurance plan as we have for over 20 years.”
About BioPlus Specialty Pharmacy
BioPlus is a pharmacist-owned, VIPPS accredited, national specialty infusion
pharmacy providing high-touch services and specialty pharmaceuticals for
patients with chronic diseases such as arthritis, hepatitis C, cancer, and
other conditions. Licensed in all 50 states, BioPlus is one of the nation’s
largest independent specialty pharmacies. Accredited by the Community Health
Accreditation Program (CHAP), patients can contact the Pharmacy toll free at
1-888-292-0744.
For information: http://www.bioplusrx.com
or
Contact: info@bioplusrx.com
Phone: 1-800-566-6103
Read the full story at http://www.prweb.com/releases/2011/8/prweb8699377.htm
DesMoinesRegister
August 6, 2011
Six
reads for an Iowa
summer
Ruth Ada Clark, 86, resides in assisted living in Dubuque. Her husband died two years ago.
One day she opened a closet and out tumbled the great joy and sorrow of her
life, the kind that needed to be examined after being locked away for 20 years
in an attempt to lessen the pains of her son’s fatal automobile accident.
So with the precision of an English major, Clark
set about the task of writing a book about her son, his lifelong struggle with
hemophilia and triumph in overcoming its pains. “Beauty In Bent Grass”
(Vantage, $14.95) is further proof that in the barrage of self-published
memoir writing, both online and through small printers, there exists an
occasional small gem.
“I wanted to write this book, but you don’t really know your children —
until I opened that closet and read his journals. Otherwise, it would have been
a book about me taking care of him.”
Instead, it was a book of her son’s courage in facing daily, constant pain
from hemophilia, mixed with
accessible scientific writing about the medical condition in which the blood’s
ability to clot is severely reduced.
Even a slight accidental bump against a coffee table can be painful for
days. At an early age Christian’s joints became those of an 80-year-old because
of the disease.
Yet the lanky, 6-foot-5 young man graduated from college and became a
professional photographer.
“Christian’s life is a lesson in courage,” Clark
said. “He never let people know he was suffering. He faced life with
cheerfulness and sought out people who needed help.
“The tragedy was he fell in love with beautiful girls who needed help and couldn’t
love him because of his hemophilia. So he was a lonesome person.”
Clark wanted to leave the book to help her
other three adult children remember their brother. If he left them a lesson,
after dying in an automobile accident in 1987 at the age of 29, it was “to take
yourself outside yourself,” Clark said. “He
learned as a little child that to get outside of the pain you can’t focus on
yourself but focus on others.”
That focus was often via a camera, relaying the wonder in the decayed or
misshapen, in the fantastically flawed. Once, she asked him why he photographed
such strange things.
“Photography isn’t just lovely lawns and regal lilies. It’s rusty engines
and sagging doors. There’s beauty in bent grass, too, Mother.”
As summer wanes and beach
reading has grown tiresome, other memoirs by Iowans can tell you something of
the place you live.
Where else can you learn about growing up among the Amish and then read
about the raucous life of the lead singer of a world-famous rock band?
In “Growing Up Amish,”
(Tyndale, $14.99), Ira Wagner provides a portrait of a young Amish man
growing up near Bloomfield, Ia., living a lifestyle that is often puzzling to
outsiders.
One night, at age 17, he walked away from it all, yearning for the wider
world, not knowing that he was lost and headed for years of turmoil, not
knowing the scandal and shame it caused around Bloomfield, which was “losing so
many of its young sons to the ‘world.’ ” He would wrestle with the decision for
decades.
It took nine more years before Wagler left the Amish community for good, but
as he shows, he took much of their ways with him.
For a polar opposite experience, a trip with Des Moines’ famous Slipknot
front man Corey Taylor is like sitting with a dude at the bar before picking
“fights with douchebags openly brandishing guns,” as Taylor writes in “Seven Deadly Sins,” (Da Capo, $24).
Taylor tackles the self-absorption and self-indulgence of the rock scene,
the craziness of setting himself on fire at parties, watching his friends go to
jail, the abuse suffered as a teen, the excessive women and boozing that
followed his success, and finally deciding he didn’t need all that anymore.
He takes an f-bomb-loaded crack at philosophizing on sin and an often astute
look at modern society’s folly.
For a last stab at summer
fiction, try author Julie Kramer, who grew up along the Iowa-Minnesota border
before becoming a network TV producer in the Twin Cities. She weaves real life
into her fiction in “Killing Kate,”
(Atria, $23.99), which centers on Iowa’s
infamous Black Angel. The graveyard statue in Iowa City is considered haunted
because of its supposedly mysterious change in color from golden bronze to
eerie black and its strange posture, wings and head facing down. In her book, a
killer is drawing angel-shaped chalk outlines around victims’ bodies,
investigated, of course, by a TV reporter.
Another mystery set in Iowa
is “The Slave Tag” by Robert
Buckley (available as an e-book through Amazon or print version at
Lulu.com). The reader is onto the mystery from the beginning in this
page-turner, rooting for the young college students who stumble upon a
decades-old unreported murder and begin digging into it.
The novel begins in 1940 when three white teenagers kill a black man who
wandered into Dubuque when the Mississippi
River tow he worked on pulled in for repairs. One of the killers
is still alive 60 years later, and has an item that belonged to the victim — a
slave identification tag — that he yearns to return to the man’s family, if
anyone can find them.
To properly prepare for
college football season, an Iowan of the black-and-gold ilk now has an
encyclopedia of the glorious past of University
of Iowa football. “What It Means To Be a Hawkeye: Kirk Ferentz
and Iowa’s Greatest Players,” (Triumph, $26.95) by Lyle Hammes, Michael
Maxwell and Neal Rozendaal is packed with stories of more than 50 of the
greatest Hawkeyes, from George Frye to Chuck Long, from Larry Station to Bill
Ringer.
— Ellen
Modersohn contributed to this list.
PR Web
August 8, 2011
LA Kelley Communications, Inc. Announces the Winners
of the Second Annual Alex Lieber Memorial Scholarship Award
This scholarship was established
to provide financial assistance for people living with hemophilia or Von
Willebrand disease to support their higher education. Each student will receive
$500 to use for education-related expenses.
Georgetown,
MA
LA Kelley Communications, Inc. announces the winners of the second annual
Alex Lieber Memorial Scholarship Award.
This scholarship was established to provide financial assistance for people
living with hemophilia or Von Willebrand disease to support their higher
education. Each student will receive $500 to use for education-related
expenses.
In less than a month, the winners will be heading back to school. Rex Climer
III, from Tennessee, will be a sophomore at the University of Tennessee at
Martin studying engineering with a minor in agriculture; Ethan Jansen, from
Florida, will be a sophomore at the University of Central Florida and is
studying mechanical engineering; Christian Mund, from Massachusetts, will be a
freshman at Syracuse University and is studying film production and
cinematography at the College of Visual and Performing Arts, School of Art and
Design, art video program; and Nicholas Popp, from Illinois, will be a junior
studying biochemistry, and biology at the University of Chicago.
All four winners have demonstrated a strong commitment to volunteer work and
community service, and have been positive role models within the hemophilia
community.
The Alex Lieber Scholarship Award was established in memory of Alexander
Scott Lieber, of Florida,
who was born in 1986 with severe hemophilia A. Alex passed away on December 21,
2003, at age sixteen, after a brief bout with bacterial meningitis. He is
greatly missed, but through this scholarship, his inquisitive and caring spirit
lives on.
“We were honored to take part in the selection process of these wonderful
scholarships that have been awarded in Alex's memory. Best of luck to each and
every one of the applicants in this coming school year,” commented Tammy and
Jim Lieber, Alex’s parents.
To apply for the 2012 Alex Lieber Memorial Scholarship Award, please visit
the LA Kelley Communications website after January 1 for more details: http://www.kelleycom.com
About LA Kelley Communications, Inc.
Since 1990, LA Kelley Communications, Inc., has been a world leader of
groundbreaking educational materials and programs on hemophilia and related
bleeding disorders. With more than a dozen books, numerous publications, and
the oldest hemophilia newsletter in America, LA Kelley Communications
remains a trusted source of practical information about raising children with
bleeding disorders. For more information about LA Kelley Communications, please
visit http://www.kelleycom.com or call
978-352-7657
Reuters
August 9, 2011
Mother's blood test reveals baby's sex
By Frederik Joelving
NEW YORK (Reuters Health) - Blood drawn from expectant mothers could
offer parents an earlier sneak peek at their baby's sex than methods currently
used in the U.S.,
researchers said Tuesday.
The test may be particularly valuable for families that
harbor sex-linked genetic disorders like hemophilia, they add.
Because such disorders mostly strike boys, knowing that the
baby is a girl could spare the mother diagnostic procedures, such as
amniocentesis, that carry a small risk of miscarriage.
"It could reduce the number of invasive procedures that
are being performed for specific genetic conditions," said Dr. Diana
Bianchi of Tufts University School of Medicine, who worked on the new study.
But other researchers voiced concerns, saying it could be
misused to terminate a pregnancy if the baby isn't of the desired sex.
"What you have to consider is the ethics of this,"
said Dr. Mary Rosser, an obstetrician and gynecologist at the Montefiore Medical
Center in New York.
"If parents are using it to determine gender and then
terminate the pregnancy based on that, that could be a problem," she told
Reuters Health. "Remember, gender is not a disease."
The test looks for small pieces of the male sex chromosome
in the mother's blood, which would mean she is carrying a baby boy. Some
European hospitals already rely on the method, called cell-free fetal DNA,
although it's not available from doctors in the U.S.
"What they are finding in England is that many women are not
going on to have the invasive tests," Bianchi told Reuters Health.
In those procedures, doctors either extract a small amount
of the fluid that surrounds the fetus (amniocentesis) or they take a sample of
the placenta (chorionic villus sampling). Between one in 100 and one in 600
mothers miscarry as a result, according to Bianchi.
In a fresh look at the medical evidence for the blood test,
she and her colleagues analyzed 57 earlier studies that included more than
6,500 pregnancies.
They found parents could trust the test 98.8 percent of the
time when it said they'd have a boy, and 94.8 percent of the time when it
indicated a girl.
That leaves some room for error, which could be important if
parents are making medical decisions based on the results -- such as whether or
not to get an invasive procedure to look for genetic disorders.
However, the current non-invasive alternative -- an
ultrasound done at the end of the first trimester -- isn't always good at
spotting a baby's sex, Bianchi's team reported in the Journal of the American
Medical Association.
And the blood test is reliable as early as seven weeks into
the pregnancy, whereas ultrasound is not.
Bianchi said one study had estimated the blood test costs
about 255 pounds in the UK
(about $413), all included. While it's available over the Internet, she said
her team had only looked at hospital-based test performance.
"I don't know why it is not being incorporated in the US," she
said.
Rosser, however, chalked that up to the ethical issues it
raises.
"It is a great test that can be part of our
armamentarium of noninvasive testing that we use," she said. "But it
should only be used by families that are at risk for sex-linked diseases."
Bianchi said she owns stock in Verinata Health, a company
that is developing cell-free fetal DNA tests for Down syndrome, although that
company had no role in the new study.
The American
College of Medical
Genetics did not respond to requests for comment on the DNA tests.
SOURCE: Journal of
the American Medical Association, August 10, 2011.
By EVELYN LE
A lively, creative bunch of kids at a haemophilia camp proved that the
disease is no barrier to leading a full, healthy life.
THE children and teenagers at the camp looked and behaved like any other
boys. On the surface, no one would have been able to tell them apart from other
children and teenagers.
Yet, these ones have inherited a blood disorder called haemophilia; the
blood lacks a protein – Factor Eight (VIII) or Factor Nine (IX) – and therefore
cannot clot properly, leading to spontaneous or prolonged bleeding, especially
in the muscles, joints and internal organs. When this happens, ugly bruises
develop.
This condition, which is also marked by painful and inflamed joints, affects
primarily males while the carriers are females.
Co-hosted by the Taiwan Haemophilia Society and Bayer HealthCare, the 3rd
Asia Pacific Haemophilia Camp was held in Uni-Resort of Mawudu in Hsinchu
county, Taiwan,
recently. It brought together those affected by the condition, to learn and
share about haemophilia, and build friendships with fellow patients. The camp
also aimed to motivate, encourage and empower patients and their caregivers.
Over 100 participants from Malaysia,
Indonesia, Thailand, Taiwan
and China
attended the camp.
Facing the diagnosis
How can one tell if a bruise is just a normal bruise or whether it is due to
haemophilia?
“There are two ways to be diagnosed. If you are born into a family that
knows they have haemophilia, your parents are at least a bit prepared for it,”
says Brian “BJ” Ramsay, a haematology specialist nurse from New Zealand, in
an interview at the camp. “If a family has a history of haemophilia, the baby
is diagnosed at birth.
“In the first year of life, babies don’t do an awful lot: they lie still,
they’re picked up, fed and put down. So the actual bleeding risk is quite low,”
adds Ramsay.
Parents who know the diagnosis from the time of the baby’s birth have about
a year – before the baby starts crawling and walking – to get used to the
diagnosis.
“But for those who don’t get the diagnosis at birth, and haemophilia is new
to them, it is a lot more difficult. When it gets picked up as the baby starts
moving around and bruising, it is then that the problem begins,” says Ramsay.
“Treatment of small children can be difficult. You need specialist doctors
and nurses to get venous access. Babies’ veins are very small; sometimes it can
take two, three, even four attempts to get a needle in. Treatments can be as
traumatic as the bleeding.
“These parents hit the road running. There’s an awful lot to take on at
once,” he explains.
Without treatment, the disease can result in debilitating pain, damaged
joints, disability and even early death.
Wong Mun Kee knows all too well the grief and heartache of losing a child to
haemophilia. Her elder son was only five years old when he suffered a fall,
which led to bleeding and subsequently, death. If he had survived, he would be
21 years old today.
Wong has other children – two daughters and another son, Lam Weng Hong, 13.
Understandably, Wong is very protective of her son, a haemophilia patient. He
was diagnosed when he was a baby, after he developed unsightly bruises when
learning to crawl and using the bouncinet.
She does not allow him to be “too active” but, rather, encourages him to
pursue other interests, such as drawing and reading.
“He can draw very well. He draws buildings with intricate details,” she
proudly says at an interview during the camp. “I still keep the drawings which
he’s done since he was a little boy, when he drew a ‘map of the world’.”
“I want to be an architect when I grow up,” says Weng Hong, who has learnt
to live with his condition. He experiences discomfort, joint pain and swelling,
especially in the ankle. “I feel irritable when this happens,” he says.
However, he is not about to let life pass him by.
“My hobbies are playing games and the piano. My favourite game is ‘Angry
Birds’,” says the lanky boy. He is now at Grade Five for piano. At school, he
excels in his favourite subjects, Maths and Science.
Weng Hong – who had submitted a poem – and the other camp participants were
among the winners of the Live Your Best Life – Haemophilia Or Not!
contest launched on World Haemophilia Day, April 17, in the Asia Pacific
region. The children demonstrated creativity and originality in their entries,
which comprised comic strips, paintings, drawings, poems and music lyrics. The
entries also conveyed the hopeful message that one can lead full, healthy lives
despite having haemophilia.
“Even if they’re haemophilic, it doesn’t mean that they can’t be somebody.
Nor does it mean that they’re inferior to their friends. They just have to do
what they do best, for example, singing, swimming or drawing,” says Dr Novie
Amelia Chozie in a separate interview. She is a paediatrician with Cipto
Mangunkusumo Hospital in Indonesia.
“They are perfectly normal children. Only one gene isn’t
working properly,” says Ramsay.
Although there is no cure for haemophilia, patients can
learn to manage the disorder. Proper diagnosis and treatment are crucial so
that they can maintain a high quality of life. Haemophiliacs can enjoy most of
the activities that other people do.
For the Show And Tell segment on the first night of the
camp, some of the participants shone. For instance, Nabil Firdaus Mohd Nazri,
11, had brought his palm-sized skateboard, with which he performed some
“stunts”. This bright-eyed, active Malaysian boy loves skateboarding, he
shared, but since he cannot pursue the sport – which is deemed extra dangerous
for haemophiliacs due to its high risk of injury – Nabil has cleverly devised a
way of pursuing it, nevertheless.
The audience and the emcee, Andy Lee, were baffled. How does
one do skate-boarding on the little skateboard?
Nabil promptly showed the audience how. He “skateboarded” on
it with his fingers! He demonstrated such nimbleness with it, including
manoeuvres like flipping, tossing and catching the skateboard with his fingers,
which led to Lee dubbing the item a “fingerboard”.
Another patient, 10-year-old Nelson Jian, wowed the audience
with his rendition of Justin Bieber’s song, Never Say Never, and Jay
Chou’s Kua Shi Dai (The Era). The chubby, bespectacled lad from China
clearly had natural talent and was quietly confident as well.
While aggressive, body-contact sports such as football and
rugby should be avoided by haemophiliacs, other sports – like swimming and
cycling – are fine. During the camp, the boys had a lot of fun in the swimming
pool, doing hydrotherapy exercises under the watchful eye of fellow
haemophiliac Hsiao Wei-Chih, as well as Luo Min-Long and Tu Jhih-Wei.
Through a series of talks and practical workshops,
healthcare professionals equipped patients and caregivers with the necessary
skills and knowledge to manage haemophilia, while representatives from various
haemophilia societies shared about the progress they had made in raising
awareness and the standard of haemophilia care in Asia.
The camp also aimed at motivating participants to live life
to the fullest. Through the “Asia United Challenge” indoor group games, they
had the chance to meet and befriend many other people like themselves, all
living with the disorder and making the most of life despite the condition. The
campsite was transformed into a hive of activity as participants tackled
challenges at each of the six games stations: Lego-building, a musical
performance, piecing together a jigsaw puzzle, decorating a giant postcard,
designing an outfit and a trivia quiz plus landmark mix-and-match. The kids
learned to work as a team in order to complete the tasks.
There were more opportunities to kindle new friendships at
the campfire dinner on the second night of the camp.
The young patients had a hands-on experience making models
from recyclable materials during a model-building session organised by the
Taiwan Science Centre.
Meanwhile, parents and caregivers shared their views and
experiences in dialogue forums, thereby drawing strength from, and empowering,
one another. They also had sessions with specialist nurse Ramsay, and Dr Young
Ji-Hsiung, chief of the oncology-hematology division at Taiwan’s Lin-Shin
Hospital, on haemophilia care.
To deal with any emergencies that might arise, a First Aid
area was designated on the camp grounds. Patients could go there for health
checks or carry out self-infusion. A nurse was always on hand to assist
patients.
Ramsay took a workshop to demonstrate how patients can
administer injections to themselves. Practice kits were distributed to all the
patients, and Ramsay explained the usage of every item in it, then gave clear
step-by-step instructions on how to carry out self-infusion.
More insightful talks were given on the last day of the
camp. Dr Kang Jiunn-Horng from Taipei Medical University Hospital spoke on Joint
Effort: How To Care For Your Joints while Su Hsiu-Yueh, from the same
hospital, gave a talk on Eating Right.
At the end of the camp, patients and caregivers were
enlightened on how to manage haemophilia better while members of haemophilia
associations gleaned much from the experience of the Taiwan Haemophilia Society
in garnering government support for the haemophilia community.
Chicago
Tribune
August 11, 2011
Analysis:
Medicaid cuts may limit care for new 2014 enrollees
David Morgan
WASHINGTON (Reuters) - Three years
before Medicaid is due to cover millions of uninsured Americans, state funding
cuts may be undermining how much care the government-run health insurance
program for the poor will offer new enrollees.
Two dozen states across the country plan to slash at least $4.7 billion from
their Medicaid plans following four straight years of budget shortfalls,
according to data provided separately by the nonpartisan Center on Budget and
Policy Priorities and the consumer advocacy group Families USA.
The cuts would include reductions of up to 15 percent in reimbursement rates
for doctors, hospitals and other care providers, higher co-pays for
beneficiaries, including children, and the loss of optional benefits such as
preventive care and dental and vision services.
Several states hope to restrict eligibility under enhanced Medicaid plans that
offer services beyond the basic mandate.
Arizona is leading that charge. It suspended new enrollments for adults without
children as part of a $500 million savings package. The freeze bars access for
the next three years to an estimated 100,000 people.
As Congress seeks new ways to cut the U.S. deficit ahead of a November
deadline, further cuts to the $427 billion Medicaid program also are more
likely at the federal level.
Medicaid is funded jointly by federal and state governments but administered by
the states with federal oversight.
The growing pressures mean access to healthcare services under Medicaid may be
restricted, despite its role in expanding health coverage to 32 million more people
under President Barack Obama's healthcare restructuring law.
Medicaid and the Children's Health Insurance Program, which covers children who
do not qualify for Medicaid, are due to add 17 million currently uninsured
Americans beginning in 2014, when the law requires that most people have health
insurance.
The reimbursement cuts may prompt doctors, clinics and hospitals to restrict or
eliminate access for Medicaid beneficiaries.
"The provider rate cuts are going to mean that fewer providers will offer
Medicaid services by the time we get to 2014, and that's bad. It pulls in the
opposite direction of where healthcare reform's trying to go," said Mike
Leachman of the Center on Budget and Policy Priorities.
CONTROLLING COSTS
It is difficult to measure the effects cuts are having on the 60 million people
who already rely on Medicaid.
However, the volume of state cuts to Medicaid providers this year prompted the
Obama administration in May to publish new guidelines for safeguarding
federally mandated healthcare access levels while reducing costs.
"We do see a lot of rate cuts," said a senior administration official
who spoke on condition of anonymity. "Some of them are going to be more
temporary, some of them are going to be more permanent. Some of them are going
to hold and some of them may not hold based on access concerns."
"We ought to proceed in a thoughtful way, both we at the federal level and
states at the state level," the official said.
The Obama administration is working with more than a dozen states on plans to
control costs and eliminate inefficiencies, with a focus on the 28 percent of
Medicaid recipients whose chronic ailments generate a huge share of the costs.
Administration officials point out Medicaid's expansion will send a flood of
new federal money into state budgets. Washington will pay for more than 90
percent of Medicaid's expansion, with additional funding for primary care
physicians and public health centers.
But skeptics question whether those efforts can fully compensate for reductions
that could be felt years away.
A fight over California's plan to cut provider payment rates by up to 10
percent will be the subject of oral arguments before the U.S. Supreme Court in
the fall, in a case over whether Medicaid providers and beneficiaries can use
the courts to block state cuts. A ruling is expected early in 2012.
Expansion of Medicaid is also expected to provide a significant growth
opportunity for managed care companies.
Those companies include Medicaid specialists, such as Amerigroup and Centene,
as well as large insurers with Medicaid businesses, such as UnitedHealth Group
and WellPoint.
But state rate cuts could prompt the insurers to pull out of states if the
accounts become money-losers.
BUDGET CROSS-FIRE
Deep cuts have also been imposed in Texas, Florida, Massachusetts and Maryland,
and they can carry a double-whammy for Medicaid providers and beneficiaries
because federal disbursements are tied to state spending levels.
"You're getting close to the bone," said Dr. Gary Kalkut, chief
medical officer at Montefiore Medical Center in the Bronx, the New York City
borough that is home to one of the poorest congressional districts in the
United States.
"At some point, more cuts will impair the delivery of services," he
added. State advocates say governors and legislatures have little choice, given
that total state budget shortfalls since 2008 now top $500 billion.
Assistance from the Obama administration's federal stimulus package has nearly
dried up after having covered up to one-third of state shortfalls. Medicaid is
a prime target for cuts, as it represents 22 percent of state budgets on
average, according to Moody's Investors Service.
There are signs that next year will bring new funding gaps, driven by low
revenues, rising healthcare costs, growing numbers of Medicaid-eligible
residents, balanced-budget requirements and a political aversion to raising
taxes.
Matt Salo, executive director at the National Association of Medicaid
Directors, warns that healthcare reform could mean hidden costs as well as
benefits for states.
He says government efforts to encourage participation in the Medicaid expansion
could also bring in an estimated 13 million people who currently qualify for
the program but are not enrolled due to challenges, including homelessness.
If they joined Medicaid, Salo says, they would not be covered by federal
funding for new enrollees under the health law. Instead, the cost would be
covered by federal and state funds under the conventional Medicaid formula.
(Reporting by David Morgan; Editing by Michele Gershberg and Paul Simao)