Health Exchange Financial Sustainability Reports to Monsanto, Fraud and Our Upcoming Technology Series

In this issue:  Wsahington and Colorado Health Exchanges File Sustainability Reports, Protections Against GMO Lawsuits, Fraud of the Week, Good News(?) of the Week and Our Upcoming Technology Series

Washington State Health Benefit Exchange files Sustainability Report with the State

The ACA law requires the Exchanges to submit a sustainability report that outlines how they are going to operate financially after federal funding for the exchanges comes to an end in 2014.  Here is the Washington Report now under review in the State Legislature.   Know as ESHB 1947, the bill passed the House by 60-29 and is now in the Senate and was just referred to the Ways and Means Committee.

Here’s how Colorado proposes to finance their Exchange.

Also in Washington is SRC 8401 to create an ACA implementation legislative over sight committee. It passed the Senate with no opposition and is now waiting action from the House.

Patenting Life Forms, Monsanto and the Courts

The bill that kept the government funded which passed this week also included a provision that protects Monsanto and other companies that have GMO products, such as corn and soybeans, included a provision that protects these companies from any, and apparently all, court actions.

In another patent suit, the  Supreme Court  will weigh in on whether human genes can be patented.

For a good book on this subject read The Immortal Life of Henrietta Lacks.

It turns out there has already been one case that boils down to—you don’t own your body parts.

Fraud of the Week

ALEXANDRIA, VA (March 22, 2013) – The owners of a Woodbridge-based home health care business were sentenced today to 121 months in prison each, followed by three years of supervised release, for submitting more than $2.1 million in false claims to Virginia Medicaid and Anthem Blue Cross and Blue Shield (BCBS) for reimbursement of in-home personal care and nursing services they did not provide.

Good News of the Week??

And both revolve around how we pay for health care.  This will be interesting to watch, because it will also put more pressure on value and quality vs. fee for service.

This is an interesting experiment in how care is organized and delivered, especially for complex patients, but so far these experiments have not found their way out west.

The project received a CMS grant in June. TransforMED estimates that it can achieve total savings of $49.5 million.

Coming Up:  Health Care Technology—Priorities, Evaluations, Perverse Payment Incentives, Venture Capital and more.

After finding the article last week on the $152 million new cancer treatment that was developed y a Venture Capital Firm, I started getting curious about who makes the decisions about the types of technologies we are developing and how they are evaluated.  This facility, the 11th of its kind in the U.S., is a scientific marvel. Instead of using standard radiation beams to zap tumors, the $152 million facility covers two-thirds of a football field…

This came to my attention because I was introduced to a new company that developed a device that can measure blood flow and be better predictor of heart attacks and strokes.  It promises to reduce cardiac hospitalizations by as much as 50%.  The company notes that hospitals are not interested in their products.  Which is no surprise because cardiac and orthopedic care are the major and most profitable lines of business.

With technology changing so quickly, with all different apps, perhaps it is time we re-thought what a health care system should do and then find ways to organize it.

Kathleen O’Connor (c) 3-29-13




About Kathleen

Kathleen O’Connor: 30+ year health care consumer advocate, non-profit executive and author. For more information about Kathleen, please see "About" on the main content bar above.
This entry was posted in business, consumer protection, Economy, Health Care Reform, health insurance, health promotioin, policy and politics, technology and tagged , , , , , , , , , , , , . Bookmark the permalink.

2 Responses to Health Exchange Financial Sustainability Reports to Monsanto, Fraud and Our Upcoming Technology Series

  1. Gerald W. Roller, MD says:

    I am greatful for your “returning” of somewhat recent note! Your news and comments are always interesting. i was in a lecture this am about care of the
    pregnate patient…what could and should not be used in infection, thrombosis,
    urinary tract problems etc. Many new drugs, new tests, and much new inform-
    ation is present and ongoing. It is certainly difficult to know “it all” and how to
    keep even partially up with the ebb is a definite challenge.
    Best wishes…..keep on keeping on! Gerald

Leave a Reply

Your email address will not be published. Required fields are marked *