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First Edition: October 27, 2010

July 15, 2019

It's Not Over: Consumer Groups Still Worried About Insurance Rules Just last week, the National Association of Insurance Commissioners voted on tough new rules for insurers that will govern how much they have to pay out in medical care versus overhead and profits. It was a big win for Democrats and consumer groups, who had worried that last-minute pressure from insurers could weaken this aspect of the health law (The Wall Street Journal's Health Blog). Little-Known AMA Group Has Big Influence On Medicare Payments The Center for Public Integrity reports: "Early this month, a group of 29 doctors gathered in a modern conference room at the Hyatt Regency Chicago, a few blocks from Lake Shore Drive. Over the course of four days, the little-known group of mostly specialists made a series of decisions crucial to the massive government entitlement program known as Medicare ?? issuing recommendations for precisely how Medicare should value more than 200 different medical procedures" (Center for Public Integrity/Kaiser Health News). Physician Panel Prescribes The Fees Paid By Medicare Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars (The Wall Street Journal). Dividing The Medicare Pie Pits Doctor Against Doctor One of the biggest disputes in the Relative Value Scale Update Committee came in 2005, when members clashed over primary-care groups' push for increases in the payments for doctor office visits, which are among the most commonly-billed Medicare services (The Wall Street Journal).

Mentally Troubled Youths Turned Away Children who are hallucinating, feeling suicidal, or suffering other acute mental health problems are increasingly being turned away from some Massachusetts hospitals' psychiatric wards, a problem the hospital industry acknowledges and blames on insufficient insurance payments to cover treatment of such sick children (The Boston Globe).

Glaxo To Pay $750 Million For Sale Of Bad Products GlaxoSmithKline, the British drug giant, has agreed to pay $750 million to settle criminal and civil complaints that the company for years knowingly sold contaminated baby ointment and an ineffective antidepressant ?? the latest in a growing number of whistle-blower lawsuits that drug makers have settled with multimillion-dollar fines (The New York Times). Sign up to receive this list of First Edition headlines via e-mail. Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.

This article was reprinted from kaiserhealthnews with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.