Healthcare News

  • Planned Parenthood blasts Virginia’s new abortion regulations

    Planned Parenthood Federation of America is denouncing new restrictions on abortion providers that Virginia Gov. Bob McDonnell signed Thursday.

    “Make no mistake,” Planned Parenthood President Cecile Richards said in a statement, “Governor McDonnell’s excessive regulations are based on his political agenda, not on medical necessity. This is an attempt to shut down all abortion providers in the state in a backdoor attempt to ban abortion.”

    Virginia’s conservative legislature passed legislation last winter that requires abortion clinics to be regulated like ambulatory surgery centers instead of doctor’s offices. The legislation requires temporary “emergency” regulations to be in place by year’s end before final regulations are approved.

    Planned Parenthood says the regulations are too onerous and would force most abortion providers to shut their doors, causing women to lose access to breast and cervical cancer screening, STD prevention and treatments and birth control services that are often offered at the clinics.

    “These regulations are a product of an amendment that passed both the House and Senate with bipartisan support,” McDonnell’s office said in a statement. “The governor believes these common-sense regulations will help ensure that this procedure takes place in facilities that are modern, safe and well-regulated, in order to help ensure the safety and well-being of all patients.”


  • Delaware approves Blue Cross Blue Shield plan’s affiliation with Highmark

    Delaware Insurance Commissioner Karen Weldin Stewart announced Friday that she has approved the affiliation of Blue Cross Blue Shield of Delaware with Highmark of Pennsylvania.

    The agreement came with 49 conditions, including requiring BCBSD to remain a separate, Delaware-based nonprofit health service corporation. The affiliation will allow BCBSD to “share in the financial strength and administrative functions of the much larger Highmark,” according to Stewart’s office.

    “With these protections, I find that the affiliation should go forward and I hereby approved the application early this morning,” Stewart said in a statement. “I am confident that this affiliation will prove to be in the best interests of Blue Cross Blue Shield of Delaware and its subscribers.”

  • Senators call for joint government task force on adverse drug reactions

    Sens. Michael Bennet (D-Colo.) and Olympia Snowe (R-Maine) requested Thursday that the Health and Human Services Department convene a joint task force with other agencies to help identify patients at risk for adverse drug reactions.

    The request was sparked by a study in the New England Journal of Medicine that found that two-thirds of hospitalizations related to drug reactions stem from four common drug medications: warfarin, insulin, oral anti-platelet agents and oral hypoglycemic agents. The task force would be charged with proposing ways to reduce unnecessary hospitalizations, such as easier-to-understand patient medication guides, care transition that helps patients understand and take their medications, coordination of electronic health records and e-prescribing.

    It seems clear that action to better educate providers and patients about these common medications and the potential for inappropriate utilization could significantly reduce the number of hospitalizations, the senators wrote in a letter to HHS Secretary Kathleen Sebelius. While you are already undertaking efforts to reduce costs in the health care system, we believe that, in light of this compelling data, the Department can do more to coordinate and ensure the adverse events of these everyday drugs prescribed to our Medicare beneficiaries become the exception, rather than the norm.

  • Government report faults Justice Department for failing Americans with disabilities

    The Department of Justice is failing Americans with disabilities by not holding educational testing companies accountable for meeting their needs, according to a new report from the Government Accountability Office.

    The report found that only 2 percent of disabled people taking postsecondary exams received special accommodations in the most recent testing year. Thats a far smaller rate than the 12 percent of Americans who have disabilities.

    GAO also found that the DOJ is not properly enforcing provisions of the Americans with Disabilities Act that require testing companies to provide accommodations to make tests accessible for people with disabilities. The law also requires that test-takers achievement on the tests reflect their aptitudes rather than their disabilities, by giving people with dyslexia more time to answer for example.

  • Federal judge blocks California’s Medicaid cuts

    California can’t slash its Medicaid payments to hospitals despite getting the go-ahead from the Obama administration, a federal judge ruled Wednesday.

    Los Angeles-based Judge Christina Snyder granted an order stopping cuts of more than 20 percent for skilled nursing services provided by hospitals, Bloomberg reported.

    “The state’s fiscal crisis does not outweigh the serious irreparable injury the plaintiffs would suffer absent the issuance of an injunction,” Snyder wrote.

    California said it will appeal the decision.

    The ruling comes after the Obama administration approved California’s request for massive cuts earlier this year. The cuts would help Gov. Jerry Brown shore up the state’s dismal finances but could jeopardize President Obama’s healthcare reform law, which expands Medicaid to 15 million low-income Americans.


  • CAQH CORE Operating Rules Adopted By HHS For Patient Eligibility And Health Claim Status Transactions

    Rules to Ensure Electronic Data Transactions are More Predictable and Consistent

    WASHINGTON, DC – December 21, 2011 – CAQH® announced that the Department of Health and Human Services (HHS) adopted the use of many of the CAQH Committee on Operating Rules for Information Exchange® (CORE®) operating rules regarding eligibility for a health plan and healthcare claim status transactions.  All HIPAA covered entities will be required to comply with these operating rules, which will make electronic healthcare transactions more predictable and consistent, by January 1, 2013 as part of the Patient Protection and Affordable Care Act (ACA).

    “We are pleased that HHS has recognized the valuable role of operating rules in achieving administrative simplification,” said Robin Thomashauer, Executive Director of CAQH.  “With the adoption of the CAQH CORE Phase I and Phase II operating rules related to eligibility and claim status transactions, the industry is taking an important step forward as we move to the next level of electronic solutions.”

    CAQH CORE is a national industry multi-stakeholder initiative that is working to streamline electronic healthcare administrative data exchange and improve health plan-provider interoperability.  CAQH CORE rules build on existing standards, such as those in the Health Insurance Portability and Accountability Act rules, to make electronic data transactions more predictable and consistent, regardless of the technology.

    “The CORE participants are committed to leveraging their experience to assist in the successful implementation of the final operating rules, so health plans, providers, hospitals, vendors and other organizations can exchange more efficient and predictable patient-eligibility and claims-verification information,” said Thomashauer.

    To date, nearly 60 leading national healthcare organizations are voluntarily certified as exchanging electronic administrative data in accordance with CORE Phase I and/or Phase II rules.

    CAQH CORE is applying and hopes to continue to serve in the role as author of ACA mandated operating rules given its commitment to improving the efficiency of healthcare transactions.

    About CORE

    CAQH Committee on Operating Rules for Information Exchange (CORE) is a multi-stakeholder industry collaboration developing operating rules that streamline administrative transactions. Over the past six years, CORE participation has grown to more than 130 organizations that represent approximately 75 percent of the commercially insured lives plus Medicare and Medicaid beneficiaries. CORE has a proven track record of operating rules adoption through voluntary certification and stakeholder return on investment.  CAQH CORE was recommended by the National Committee on Vital and Health Statistics (NCVHS), a federal advisory committee to the HHS Secretary (NCVHS), to draft the EFT/ERA operating rules mandated by the ACA, and has testified to NCVHS on other ACA mandates for operating rules.  To learn more about CAQH CORE, visit

    About CAQH

    CAQH serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers. CAQH solutions help promote quality interactions between plans, providers and other stakeholders; reduce costs and frustrations associated with healthcare administration; facilitate administrative healthcare information exchange; and encourage administrative and clinical data integration. Visit for more information.

    Related posts:

    1. NCPDP and CAQH CORE Partner on Harmonizing Operating Rules and Standards Across Healthcare
    2. CAQH Receives WEDI Leadership in Technology Award
    3. CAQH CORE Launches Transition Committee to Recommend Plan for Multi-Stakeholder Governance

  • British doctors decry healthcare rationing

    Four out of five British doctors say patient care suffered in 2011 as a result of cuts to Great Britain’s government-run healthcare system, according to a new poll from the left-leaning Guardian newspaper.

    Conservative groups in the United States quickly disseminated the findings to bolster their arguments against European-style socialized medicine — and, by extension, President Obama’s healthcare reform law.

    The polled doctors cited “hospital bed closures, pressure to give patients cheaper, slower-acting drugs, cuts to occupational health support, and reductions in community health services as examples of recent cost-cutting measures,” according to The Guardian. The cuts to healthcare funding are part of conservative Prime Minister David Cameron’s efforts to reel in the nation’s deficit.

    Great Britain has the most socialized medical system in Europe, with doctors working directly for the National Health Service. Obama’s healthcare law, by contrast, creates new requirements for health insurance plans while expanding Medicaid and giving citizens subsidies to buy private coverage.


  • FDA releases draft guidance on medical device applications

    The Food and Drug Administration unveiled draft guidance Wednesday on how it reviews applications for low-risk medical devices.

    The FDA has been working with industry and patient advocacy groups to overhaul its so-called 510(k) program, which medical device makers complain has grown too complicated and uncertain. The draft guidance is not final and is not currently in effect, but gives stakeholders a chance to comment before the agency begins to develop its final guidance.

    Comments are due by April 26, 2012.


  • Obama administration awards $300 million for children’s healthcare

    The Obama administration on Wednesday awarded 23 states $296 million in bonus payments for exceeding enrollment targets in the Children’s Health Insurance Program.

    The awards come as a new report from the Department of Health and Human Services shows that 1.2 million children have gained coverage since the CHIP program was reauthorized in 2009.

    “More children now have the advantages health coverage provides,” HHS Secretary Kathleen Sebelius said in a statement. “And parents now have the security of knowing their children can get the health care they need without worrying that an illness could leave them with a lifetime of medical bills.”

    The 23 states are Alabama, Alaska, Colorado, Connecticut, Georgia, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, Virginia, Washington and Wisconsin.


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