The state wants retail workers to help consumers enroll in healthcare expansion. Critics say Wal-Mart does not provide adequate health coverage and shouldn’t be advising consumers on the matter….California officials face mounting criticism from union leaders over plans to let retail giant Wal-Mart Stores Inc. enroll shoppers in President Obama’s healthcare expansion. The state wants employees at Wal-Mart and other retailers to help consumers learn about their options and assist them in buying federally subsidized private insurance. These plans are part of state efforts to implement the federal healthcare law and reach out to 5 million Californians eligible for new coverage starting in January….
The problem is not too much government, but too passive a government….Passive intervention—serving public goals by making them lucrative private profit centers—not only increases costs; it increases complexity, which in turn invites inflation, confusion, and corruption. Though private abuse is responsible, government as sponsor gets the political blame….
Source: Melanie Evans, Modern Healthcare, Vol. 43 no. 7, February 16, 2013
Despite disparity in margins, rich and poor hospitals offer similar levels of subsidized care… Both [ Memorial Medical Center, TX and St. John’s Medical Center, OK] are among the roughly 60% of private U.S. hospitals that receive local, state and federal tax breaks in exchange for operations that benefit the community….
…Modern Healthcare found no correlation between margins and spending on free care in an analysis of roughly 2,500 tax records for organizations that operate tax-exempt hospitals. The results suggest that profits do not determine what hospitals spend on free and discounted care and other subsidized services to benefit the community, experts said. … Capital plans that prompt hospitals to seek to build reserves to invest may also influence what hospitals spend on community benefits, he said. …
…The same held true in an analysis of spending on a broader group of hospital activities the Internal Revenue Service counts as “community benefits,” such as community health services, donations, medical education and research. Data analyzed by Modern Healthcare, provided by the not-for-profit charity watchdog GuideStar, includes 2009 and 2010 figures reported under new disclosure rules intended to yield a clearer accounting of the public benefits that tax-exempt hospitals provide. …
…Hospitals are not held to any federal threshold for spending on community benefits or charity care, and until recently, were not required to report such data. Tax-exempt hospitals have operated for decades with only loose standards and limited or voluntary public accounting for how they earn those tax breaks. …
From the summary:
…This research examines the potential long term savings that could be realized through greater regional consolidation of select local government services, specifically emergency call handling and dispatch, public health, and high-level government administrative services. It focuses especially on the expected long term savings in the New England states, with specific estimates for Massachusetts and Connecticut.
The report finds that regional service-sharing can be an effective means to achieve savings, particularly for services that rely on high levels of technology, capital, or specialized expertise. The author recommends that the state consider playing a stronger role in encouraging local regionalization through measures such as instituting quality standards and using funding to promote and facilitate consolidation….
Source: Mary Ellen Klas, Miami Herald, February 9, 2013
Florida’s two-decades-long push to shift state services to contract vendors has meant big business for a burgeoning industry of lobbyists….But equally important, and less celebrated, is Ballard’s talent for helping his clients land lucrative state contracts: $938 million this year alone, according to a Herald/Times analysis of contracts in the $70 billion state budget…. No one is keeping track of the total, but Chief Financial Officer Jeff Atwater last year estimated the total contract expenditure for Florida’s 2011-12 budget cycle at $50.4 billon — 72 percent of the budget. The bulk of it, nearly $42 billion, was for healthcare contracts and service sector grants that often are never competitively bid….
…With the state using more and more outside vendors, transforming the state government as a broker of contracts, less attention is being given to managing those contracts. As a result, say critics, all too often contractors and their lobbyists outwit and outman the state at the negotiating table….
But writing contracts to benefit vendors is the job of the legions of lobbyists. Using last-minute amendments to the budget, lobbyists write narrowly crafted budget language into the “special categories” section in the back of the annual appropriations bill or tweak language in other bills.
Here are some recent examples:
• Former Senate President Mike Haridopolos used his influence to get lawmakers to insert millions into the budget at the final stage of the budget process to pay for a state law enforcement radio system the agencies didn’t ask for, a juvenile justice contract that agency didn’t seek and the extension of a contract to expand broadband service in rural areas.
• A lobbyist close to former House Speaker Dean Cannon persuaded lawmakers to insert language allowing billboards on state lands, using language disguised as “public information systems,” into a must-pass bill to fund water management districts.
• The former Senate chief of staff, Steve MacNamara, signed a no-bid $5.5 million contract with a company to develop and lease a budget transparency website for lawmakers that was paid for but never used….
The Northeast State Hospital began a $3.7-million contract on Tuesday with a Connecticut company that will provide housekeeping services. … The facility is operated by the Florida Department of Children and Families and signed the contract with Owens, Renz and Lee, Co. Inc., which will expire in January 2017. DCF also entered into a much larger $42-million contract last year with Aramark to provide housekeeping services at the Florida State Hospital in Chattahoochee. Data provided by DCF show that privatization effort affected 191 employees….
Retail giant Walmart will open a small store on the campus of Georgia Institute of Technology in Atlanta, Ga. later this year. Georgia Tech will be the second college to host a miniature Walmart, joining the University of Arkansas in Fayetteville store which opened in January. The Walmarts on campus will have pharmacy services, basic groceries, general merchandise, check cashing and bill paying services. The UA location replaces a university-run pharmacy, Advertising Age reports. …
Nearly 1,000 New York government entities will receive a check for overcharges as part of a $2.4 million settlement with one of the nation’s largest medical waste disposal companies. Under the agreement, Stericycle, Inc., will fully reimburse New York police and fire departments, schools, hospitals, prisons and other entities for a scheme to charge automated price increases without notice and in violation of contract terms. … Government entities affected by the overcharges are located throughout New York. Some entities receiving the largest compensation include the WF Bruen Rescue Squad, Rensselaer, $26, 671.16; Albany Sheriff’s Correctional, $22,160.28; Broome Community College, Binghamton, $13,966.86; Clinton Correctional Facility, Dannemora, $21,094.35; and Cornell University College of Veterinary Medicine, Ithaca, $9,409.46. …
Lawsuit: Stericycle systematically overcharged governmental agencies
Source: Jeremy Carroll, Waste & Recycling News, January 8, 2013
Stericycle Inc. systematically overcharged governmental agencies throughout the country, including the federal government, a whistleblower lawsuit alleges. The suit, first filed in 2008 in Illinois, was unsealed Jan. 8. Former employee Jennifer Perez is named as a plaintiff, along with 14 states, the federal government and the District of Columbia. New York Attorney General Eric Schneiderman alluded to the lawsuit after he announced a $2.4 million settlement against the Lake Forest, Ill.-based medical waste giant Jan. 8. …
From the lawsuit:
Stericycle is a company that collects and disposes of medical waste throughout the United States. Stericycle has defrauded federal, state and local governments by knowingly or recklessly overcharging its governmental customers and by withholding accurate pricing data from its customers when it agrees to pick up medical waste. Stericycle tails to inform its customers that despite the contract price it has agreed to, Stericycle intends to and adds unallowable surcharges to each bill, in addition to an undisclosed 18% across the board increase every 9 months. Stericycle conceals its intent to add these increases to each bill because it knows governmental customers would never agree to them if disclosed in advance.
Source: Matthew Dolan, Wall Street Journal, January 13, 2013
Hoping to bridge the gap between low-income residents and health-care services, a $100 million fund will be unveiled this week to build community centers near affordable housing as demand for primary-care services is expected to rise. Supporters say it is a new kind of public-private partnership boosted by the philanthropic sector that was inspired by the 2010 Affordable Care Act, which could expand Medicaid coverage by up to 16 million additional people. The act includes about $10 billion for the creation of new, federally qualified health centers. ….. The new fund, called Healthy Futures, is backed by Morgan Stanley, The Kresge Foundation and Local Initiatives Support Corporation, a nonprofit that controls tax credits for services to the poor.
Thirty years ago, Bonnie Svarstad and Chester Bond of the School of Pharmacy at the University of Wisconsin-Madison discovered an interesting pattern in the use of sedatives at nursing homes in the south of the state. Patients entering church-affiliated nonprofit homes were prescribed drugs roughly as often as those entering profit-making “proprietary” institutions. But patients in proprietary homes received, on average, more than four times the dose of patients at nonprofits. …..” Sedatives are cheap, Mr. Weisbrod noted. “Less expensive than, say, giving special attention to more active patients who need to be kept busy.” …. These profit-maximizing tactics point to a troubling conflict of interest that goes beyond the private delivery of health care. They raise a broader, more important question: How much should we rely on the private sector to satisfy broad social needs?…
…This behavior was hardly surprising. Hospitals run for profit are also less likely than nonprofit and government-run institutions to offer services like home health care and psychiatric emergency care, which are not as profitable as open-heart surgery….
Does Nonprofit Ownership Matter?
Source: Jill R. Horwitz, Yale Journal on Regulation, Vol. 24, Winter 2007