Citizens' Council on Health Care
CCHC HEALTH eNews
Monday, August 27, 2001


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* CCHC PROVIDES NEW MEDICAL PRIVACY FORMS FOR THE PUBLIC

* EXPANDING MEDICAID TO THE MIDDLE CLASS DISEASE BY DISEASE

* DROPPING GOVERNMENT PROGRAMS IS GOOD FOR POCKETBOOK

* JUDGE: CHILDREN OF ILLEGAL IMMIGRANTS ELIGIBLE FOR MEDICAID

* ILLEGAL IMMIGRANTS BANNED FROM RECEIVING NON-EMERGENCY CARE

* CHARITY CARE TAKES A DIVE

* JUDGE: HEARINGS TO RULE ON RELIGIOUS CONVICTIONS OF
IMMUNIZATION RESISTING PARENTS ARE ILLEGAL

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CCHC PROVIDES NEW MEDICAL PRIVACY FORMS FOR THE PUBLIC

Citizens' Council on Health Care (CCHC) has created and made
available online three privacy declaration forms for public use at: http://www.cchconline.org/fortherecord.php3.

CCHC's FOR THE RECORD Medical Privacy Project 2001 gives
online access to three 2-page medical privacy declaration forms
one for each of three recent federal rules and laws dealing with
access to the medical, psychological, behavioral, financial and
personal information of patients: the federal medical privacy rule,
NAIC recommendations for compliance with the Gramm-Leach-Bliley Act,
and OASIS, the national home health data collection system.

"These forms are meant to directly engage patients, doctors, and
institutions in a conversation about medical privacy and patient
consent," says Twila Brase, RN, President of CCHC.

Importantly, the federal medical privacy rule specifically says that
doctors, hospitals and health plans do not have to comply with patient
requests for confidentiality. However, except for one required
disclosure to the federal government and the federal OASIS home health
care questionnaire, they can choose to honor the wishes of patients.

"We have created a central place where people can obtain as many
medical privacy forms as they need from the convenience of their
homes," says Brase. "We also hope the declarations will give health
care professionals and institutions the support they need to rebuff
any and all efforts to access patient data without patient consent."


Source: "FOR THE RECORD: CCHC's New Online Medical Privacy Forms
Helping patients protect their medical, financial, and personal
information" CCHC Press Release, August 22, 2001.


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EXPANDING MEDICAID TO THE MIDDLE CLASS DISEASE BY DISEASE

Extending Medicaid benefits to uninsured women diagnosed with
breast or cervical cancer has been extended to nine more states
today, for a total of 19 states.

Tommy G. Thompson, Secretary of the U.S. Department of Health
Insurance approved the applications of Alabama, Georgia, Iowa,
Mississippi, Missouri, North Dakota, South Carolina, Virginia,
and Washington to the benefit extensions allowed by the federal
Breast and Cervical Cancer Prevention and Treatment Act of 2000.
The act allows states to expand Medicaid coverage to these women
who otherwise would not have health coverage.

Women screened through the National Breast and Cervical Cancer
Early Detection Program run by the Centers for Disease Control and
Prevention (CDC) and found to need treatment for breast or cervical
cancer can receive full Medicaid coverage. States that choose to
extend Medicaid benefits to women under this new option will receive
federal taxpayer dollars for up to 85 percent of the costs of
treatment.

To qualify for Medicaid coverage under the program, women must be
under age 65, not eligible for Medicaid and without creditable health
care coverage. Details about this Medicaid option are available at
http://www.hcfa.gov/medicaid/bccpt. Information about the CDC
screening program is at http://www.cdc.gov/cancer/nbccedp/index.htm.

Source: "HHS APPROVES NINE STATE PLANS TO EXTEND MEDICAID COVERAGE
TO WOMEN WITH BREAST, CERVICAL CANCER" HHS Press Release, August 27,
2001.

-Citizens' Council on Health Care
-August 27, 2001

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DROPPING GOVERNMENT PROGRAMS IS GOOD FOR POCKETBOOK

CareFirst BlueCross BlueShield, Maryland's largest insurer,
on Aug. 15 announced that its second quarter profits "jumped" 31.9%
over the same period last year, an increase the company attributed
largely to its exit from the Medicare+Choice and Medicaid managed
care business, the Baltimore Sun reports.

CareFirst reported operating profit of $22.2 million in the second
quarter, up from $16.8 million during the same period last year.
The insurer's Medicare and Medicaid managed care business accounted
for $3.8 million in losses during the second quarter last year.
Second quarter revenue was $1.48 billion this year, a 10.2% increase
from the same period last year.

The Sun reports that membership, at about 2.9 million members,
remained stable, with the loss of Medicare and Medicaid beneficiaries
offset by a 4.4% increase in commercial enrollment. CareFirst
Executive Vice President and CFO G. Mark Chaney said the company was
"generally pleased" with its second quarter performance, but he added
that the insurer is "concerned" with its 1.66% operating margin as
"recent hospital rate increases and other trends" accelerate medical
cost inflation (Salganik, Baltimore Sun, 8/16).

Source: Taken Directly from "Maryland's CareFirst Reports Q2
Profits Up 31.9% After Dropping Medicare, Medicaid Managed Care
Beneficiaries" KAISER DAILY HEALTH POLICY REPORT,
Thursday, August 16, 2001
http://www.kaisernetwork.org/daily_reports/rep_hpolicy.cfm


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ONLY CHILDREN OF ILLEGAL IMMIGRANTS ELIGIBLE FOR MEDICAID

LEWIS v. THOMPSON, No 00-6104 (2d Cir. July 27, 2001)
The Welfare Reform Act, which prohibited female illegal aliens from
receiving Medicaid-sponsored prenatal care, is constitutional with
respect to alien mothers but their citizen children are entitled to
automatic eligibility for Medicaid benefits for a year after birth.
To read the full text of this opinion, go to:
http://laws.lp.findlaw.com/2nd/006104v2.html

Source: Taken directly from HEALTH LAW PULSE, http://www.findlaw.com
August 14, 2001: Issue # 17


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ILLEGAL IMMIGRANTS BANNED FROM RECEIVING NON-EMERGENCY CARE

Officials for the Texas hospital districts of Harris and
Montgomery counties are "questioning" a state legal opinion
effectively banning hospitals from providing non-emergency medical
care to undocumented immigrants, the Houston Chronicle reports
(Rice, Houston Chronicle, 8/23).

In July, Texas Attorney General John Cornyn said the 1996 Personal
Responsibility and Work Opportunity Reconciliation Act (national
welfare reform) prohibits public hospitals from providing health
services -- except emergency room care, immunizations, treatment
of communicable diseases and care for child abuse -- to undocumented
immigrants. Although Cornyn said that states may bypass the federal
law with legislation, he said that "no such law exists" in Texas.

After Cornyn issued the opinion, Harris County Attorney General
Charles Rosenthal launched a criminal investigation (Kaiser Daily
Health Policy Report, 7/31). While saying that Rosenthal's
investigation will not result in any charges, Harris County hospitals
officials also said Cornyn's opinion is "flawed and ignores" the
opinions of previous attorneys general. The hospital officials are
in talks with the county attorney, who is drafting an opinion that
refutes the state's (Houston Chronicle, 8/23).

In Montgomery County, hospital officials have drafted a letter to be
sent to Cornyn that requests that he "clarify and reconsider his
opinion." Because of the "doubt" surrounding his opinion, the hospital
officials say the district is "caught" trying to both meet federal
requirements to service the "neediest" patients while continuing to
obey Texas law. While Harris County is mounting a legal challenge to
Cornyn's opinion, Montgomery County official have "no plans" to follow
suit (Brewer, Houston Chronicle, 8/23).

Source: Taken directly from "Two Texas Counties Question AG's
Legal Opinion On Non-Emergency Care for Undocumented Immigrants",
KAISER DAILY HEALTH POLICY REPORT
Friday, August 24, 2001


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CHARITY CARE TAKES A DIVE

The percentage of physicians offering charity care dropped
from 76% to 72% between 1997 and 1999, despite an overall increase in
the number of physicians during the same period, according to a study
by the Center for Studying Health System Change. For the report,
"Physicians Pulling Back from Charity Care," researchers polled more
than 12,000 physicians and determined that although the number of
physicians increased from 347,000 in 1997 to 363,000 in 1999, the
number of physicians offering charity care remained constant at
approximately 260,000. Figures compiled during another HSC study
show that the number of uninsured persons "did not change
significantly" over the same period, and that the uninsured typically
made half as many trips to the doctor per year as people with health
coverage. According to the HSC, the figures "rais[e] concerns" that
access to charity care, "a key component of the nation's safety net"
for the poor and uninsured, could decline. The study offered several
reasons for the declining number of physicians offering charity care,
including physicians' decreased rate of owning their own practices,
"significant financial pressure" resulting from lower payment rates
and increased "administrative burdens" that leave less time to devote
to charity care. According to Marie Reed, HSC analyst and the
study's lead author, the increase in the number of physicians likely
offset the lower percentage of physicians providing charity care,
meaning "the impact on medically indigent patients, including the
uninsured, was probably negligible." However, recent estimates
indicate that the physician supply is growing at 1% per year, down
from 3% per year in the last decade -- "raising the question of
whether there will be enough new physicians to offset declines in
physicians providing charity care" in the near future. Paul
Ginsburg, president of HSC, said, "If insurance costs continue to
rise rapidly and the number of physicians providing charity care
declines, access to care for the poor and uninsured will be in
jeopardy" (Center for Studying Health System Change release, 8/23).

Source: Taken directly from "Lower Percentage of Physicians
Offering Charity Care, Study Finds," KAISER DAILY HEALTH
POLICY REPORT, Friday, August 24, 2001


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JUDGE: HEARINGS TO RULE ON RELIGIOUS CONVICTIONS OF
IMMUNIZATION RESISTING PARENTS ARE ILLEGAL

On August 8, in Casper Wyoming, a federal judge approved an
agreement barring the Wyoming Department of Health from holding
hearing to determine the sincerity of religious convictions of
parents who object to immunizing their children.

After Wyoming officials made Hepatitus B vaccinations mandatory for
entry into the public school system, parents refused. The Department
wanted to hold administrative hearing to determine whether parents
who refused on religious grounds were sincere in their convictions.
The parents held that such hearings violated their constitutional
rights.

With assistance by the Rutherford Institute, the parents took the
Department to court. The Wyoming Supreme court ruled in favor of
the parents calling the hearings illegal.

According to the Associated Press, "The state Health Department had
made the vaccinations mandatory, contending it had a duty to protect
children from disease and that too many non-immunized children would
endanger other children.

Source: "Judge Backs Parents on Immunizations," Associated Press, http://dailynews.yahoo.com/h/ap/20010821/us/religion_immunizations_1.html
Tuesday August 21 8:52 PM ET

-Citizens' Council on Health Care
-August 27, 2001



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