Health Net Federal Services, Penn State and Red Cross Promote Behavioral Health Symposium for Physicians and ...

Wed, Jul 11, 2012, 2:37 AM EDT - U.S. Markets open in 6 hrs 53 mins

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State of Illinois Selects Coventry Health Care for Open Access Plan and HMO Health Benefit Plans

CHAMPAIGN, Ill.--(BUSINESS WIRE)--

Coventry Health Care of Illinois, Inc. (“Coventry Health Care”), formerly PersonalCare Insurance of Illinois, Inc., is pleased to announce that Coventry Health Care will continue to participate in the state of Illinois’ Open Access Plan (“OAP”) and HMO benefit plans.

On May 1, the state of Illinois and Coventry Health Care signed a long-term contract for the OAP that will allow Coventry Health Care to administer the health benefits plan through 2016.

The state also recently announced its decision to offer Coventry Health Care’s HMO plan to its employees for a 90-day period, effective July 1 to September 28. HMO members looking for a long-term solution are encouraged to consider the OAP, which offers many of the same benefits as the HMO with an expanded provider network and an option to renew through 2016.

The OAP administered by Coventry Health Care offers nationwide provider access, low-cost dependent coverage, online wellness resources and a proven track record of excellent service. Based in Champaign, Coventry Health Care’s services are delivered locally and supported by national parent company Coventry Health Care, Inc.

"We’re grateful for another opportunity to assist state employees and their families with high quality, affordable health care,” said Mike Wolff, Coventry Health Care executive director in Illinois. “The state and their employees can rest assured our local health plan staff is prepared to provide the same excellent service and benefits they have enjoyed for the past 28 years."

State employees can enroll in the plan of their choice throughout the benefit choice period, which began on May 1. The duration of the open enrollment period is being determined by the state. Employees are encouraged to stay up to date by visiting www.benefitschoice.il.gov.

About Coventry Health Care

Serving the community since 1984, Coventry Health Care, formerly PersonalCare Insurance of Illinois, Inc., is a local health plan supported by resources of its parent company, Coventry Health Care, Inc. Recognized by Consumer Reports and the National Committee for Quality Assurance (NCQA) as one of the top-ranked commercial health plans in Illinois for the sixth consecutive year in November 2011, Coventry Health Care’s employees serve customers from offices in Champaign, Downers Grove, Peoria and Rockford. Visit www.chcillinois.com to learn more.

About Coventry Health Care, Inc.

Coventry Health Care, Inc. (“Coventry”) is a national managed health care company operating health plans, insurance companies, network rental companies and workers’ compensation services companies. Coventry provides a full range of risk and fee-based managed care products and services to a broad cross section of individuals, employer and government-funded groups, government agencies, and other insurance carriers and plan administrators. The company is based in Bethesda, Md.

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State Announces Intent to Award Four Medi-Cal Contracts to Health Net of California Subsidiary

Mon, Jun 4, 2012, 9:36 AM EDT - U.S. Markets close in 6 hrs 24 mins

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Washington state health officials appeal contraception ruling

SEATTLE (Reuters) - Washington state health officials asked an appeals court on Wednesday to reinstate a rule requiring that pharmacists dispense emergency contraceptives even when doing so violates their religious beliefs.

District Judge Ronald Leighton blocked the regulation last month, finding it trampled on the pharmacists' right to "conscientious objection" in violation of the Constitution.

Leighton's ruling in a case brought by a drugstore owner and two of his pharmacists in the state capital, Olympia, comes amid a national political debate over a federal policy mandating free coverage for women's contraceptives through employer-sponsored health plans.

Several universities with religious affiliations have sued to block that regulation, using arguments similar to those that prevailed in the pharmacy case -- namely that the government has no right to compel individuals to violate sincerely held religious beliefs.

But the state's Department of Health and Board of Pharmacy asked the Ninth Circuit Court of Appeals to overturn the trial court's determination that the requirement targets religious opposition to certain medications.

"This isn't about religious objections," health department spokesman Tim Church said. "This rule is meant to ensure that people have access to time-sensitive medications."

The morning-after pill, available under the brands Plan B One-Step, ella and Next Choice, can be taken up to 5 days after unprotected sex, but is most effective when taken within the first 72 hours.

State officials said that particularly in rural areas of eastern Washington, where pharmacies may be more than 20 miles apart, a patient denied service by one pharmacist would not be able to go elsewhere for the medication in time.

GOVERNOR WEIGHS IN

The case stems from a rule adopted by the Washington State Pharmacy Board in 2007 requiring pharmacies to stock and dispense legal medications for which there is a demonstrated community need.

The drugstore owner and two pharmacists who brought the lawsuit said they believed that emergency contraceptives were tantamount to abortion because they could theoretically stop an already-fertilized egg from implanting in the uterus.

As conservative Christians, they refused to dispense the medication, then sued to block the regulation.

After a 12-day trial, the court found overwhelming evidence that the regulations allow pharmacies to refer patients elsewhere for all sorts of business, economic, and convenience reasons, but not for reasons of conscience.

"The Constitution does not allow the state to single out religious conduct for unfavorable treatment," said Luke Goodrich, an attorney with the Becket Fund for Religious Liberty, which served as co-counsel for the pharmacists.

Washington Governor Chris Gregoire, a Democrat in her last year of office, issued a statement supporting the appeal.

"Any decision that puts patients at risk by delaying or denying them lawful and lawfully prescribed medications should be carefully reviewed by a higher court," she said.

Planned Parenthood of the Great Northwest also plans to join in the state's appeal of Leighton's verdict.

"We really feel that this could set a dangerous precedent and allow other health care providers to refuse to dispense emergency contraception or any other drug they personally disagree with," said Kristen Glundberg-Prossor, spokeswoman for Planned Parenthood of the Great Northwest.

Last spring, a state judge in Illinois struck down a similar law requiring pharmacies to dispense emergency contraception.

A handful of other states, including California, New Jersey and Wisconsin, have laws requiring pharmacies to fill all valid prescriptions, but loopholes allow pharmacists with moral objections to refer the patient to another drugstore.

Six states explicitly allow pharmacists to refuse to dispense contraceptives, and several more have broad right-to-conscience laws that provide some protection to pharmacists as well as to other health care professionals.

(Editing by Dan Whitcomb and Cynthia Johnston)

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Health Net of Arizona Named #1 HMO in the State Eight Consecutive Years

Tue, Feb 28, 2012, 2:58 PM EST - U.S. Markets close in 1 hr 2 mins

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The National Alliance of State Health Cooperatives Applauds Initial Round of Health CO-OP Funding

HELENA, Mont., Feb. 21, 2012 /PRNewswire/ -- The National Alliance of State Health Cooperatives (NASHCO) applauded today's U.S. Department of Health and Human Services (HHS) announcement that $638,677,300 is being invested by the agency in seven health cooperatives serving eight different states.  This is the initial round of federal loans to support these innovative cooperatives, which were established in Section 1322 of the Affordable Care Act.  Several more funding announcements from HHS are anticipated throughout the year as more state-based cooperatives submit applications.

"Today's announcement marks an important step toward providing access to high quality, affordable health care and wellness benefits to ALL Americans," said John Morrison, President of NASHCO and former Montana Insurance Commissioner.  "Tens of millions of Americans remain uninsured and businesses are buckling under the crushing cost of health insurance.  CO-Ops represent an innovative, free enterprise solution to the health coverage crisis.  Health care CO-OPs, combined with the state-based health care exchanges that will launch in the 2013-2014 timeframe, hold great promise for all Americans." 

Functioning similarly to existing co-ops for electricity, agriculture, and credit unions, health care CO-OPs will provide health insurance to individuals and small businesses which currently have a difficult time obtaining or affording quality health care and wellness benefits. A health care CO-OP will be governed and run by its members, who will form a majority of the board of directors. Unlike traditional insurance, however, any profits earned will be used to either lower premiums or to improve benefits.

The formation of health care CO-OPs will help drive cost savings, enhance competition in the newly-created state-based exchanges, and provide choice in markets traditionally dominated by one or few insurance companies.

"Today's loan announcement provides an opportunity for CO-OPs across the United States to create a new form of health insurance that is more accessible, accountable, and consumer-governed," said Dr. Tom Roberts, Chairman of the Montana Health Cooperative in Helena, Montana.  "We are very excited about the prospects of providing more choice in the Montana health insurance market by creating an innovative system based on a proven idea.  I am confident the CO-OPs receiving funding today will provide a viable and affordable alternative to existing health care plans."

"It is time to place consumers back in the center of the health insurance system. We hope to restore real competition that is truly responsive to consumer and small-business needs for affordability and improved health," said Dave Lyons, Cliff Gold and Steve Ringlee, the founders of Midwest Members Health serving Iowa and Nebraska.

"Physicians are excited about the opportunity to work with CO-OP health plans because they are committed to involving consumers in using the health care system more effectively to improve their health," said Dr. David Carlyle, a family physician from Ames, Iowa who served on the HHS Advisory Committee on CO-OPs.

$3.4 billion has been appropriated for Start-up and Solvency loans for qualifying CO-OPs.  Start-Up loans must be repaid within 5 years, while Solvency loans must be repaid within 15.  In the initial round of applications, preference was given to applicants that demonstrate plans to operate in states with no other qualified applicants; use an integrated care model; use innovative reimbursement models; are able to accept enrollment applications by October 2013; have private support; and operate statewide over time.

"We are excited to support the health insurance CO-OPs," said Marilyn Tavenner, Acting Administrator of the Center for Medicare and Medicaid Services (CMS).  "CO-OPs will promote competition in the insurance market and respond well to the health care needs of Americans."

Organizations receiving funding in the initial round of loan disbursements are:

Freelancers CO-OP of Oregon
New Mexico Health Connections
Montana Health Cooperative
Midwest Members Health (Iowa and Nebraska)
Common Ground Healthcare Cooperative (Wisconsin)
Freelancers CO-OP of New Jersey
Freelancers Health Service Corporation (New York)

In addition, NASHCO will hold its second annual conference in Washington, D.C. on March 9th.  The conference will bring together representatives from state-based CO-OPs, health care experts, and public health officials.  For more information about the conference, please visit www.nashco.coop.

Following the passage of the Affordable Care Act in 2010, The National Alliance of State Health Cooperatives (NASHCO) was organized as a nonprofit corporation to promote the development and success of the health co-op movement.  NASHCO is the only association of state-based health cooperatives.  It is composed of dedicated teams of volunteers throughout the nation seeking to establish a new way of accessing care using the cooperative governance model.

CONTACT: John Morrison, NASHCO: 406-442-3261, jmmmontana@msn.com
Lewis Lowe, Strategies 360: 706-302-8404, lewisl@strategies360.com 

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Health Net Enrolls One Millionth Member in Its Combined California State Health Programs

Fri, Feb 17, 2012, 8:16 AM EST - U.S. Markets open in 1 hr 14 mins

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UCSF's Director of Glide Health Services Receives State Recognition

UCSF's Patricia Dennehy, director of the nurse-managed Glide Health Services center, is among five Californians to receive the 2012 James Irvine Foundation Leadership Awards for applying proven, innovative approaches to some of the state's most difficult problems. Dennehy, a clinical professor in the UCSF School of Nursing, is being recognized for her extraordinary work developing Glide Health Services into a model nurse-managed health center that delivers high-quality, cost effective primary care to a low-income population.

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State Sued Over Mental Health Services

A lawsuit has been filed against the state by people with severe mental illness who said New Hampshire is falling short in providing services and assistance.

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The state of Massachusetts health reform, in 3 charts

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(Health Affairs) Health Affairs is out this afternoon with a four-year look back at Massachusetts health reform. It has some good news (coverage has gone up!) and not-so-good news (health care isn’t getting any cheaper). With the Massachusetts reforms serving as the model for the federal law, it’s worth taking a look at what has and hasn’t worked in the Bay State reforms.

The clearest effect is an increase in health insurance coverage, going from 86.6 percent of adults with health insurance in 2006 to 94.2 percent in 2010. As the above chart shows, most of the coverage gains came in the first two years of the health reform efforts, and have remained relatively stable ever since.

An increase in coverage has correlated with another encouraging trend: a decrease in more costly forms of health coverage, such as emergency room visits. That turns out to be a more recent development, with rates of emergency room visits dropping 3.5 percent between 2009 and 2010.

(Health Affairs) “This pattern, combined with increases in the use of specialists and preventive care over time, may imply a shift in use toward other providers for some needs,” study authors Sharon Long, Karen Stockley and Heather Dahlen write.

What Massachusetts health reform has not done, however, is bring down the cost of health care. The percent of adults who have delayed care because of cost in the past year has steadily crept upwards, while those who have had trouble paying medical bills increased for a few years, before dropping off in 2009:
(Health Affairs) Part of this trend is likely tied up in the recession, which has made paying medical bills tougher for Americans across the country. So even as the amount of expensive, emergency room care goes down, health care remains costly. And that underscores the big health reform challenge that Massachusetts now faces: making universal coverage affordable. “Nearly one in four of these adults reported unmet need for care, often because of health care costs,” the study authors write. “Consistent with that finding, Massachusetts continues to struggle with escalating health care costs, reflecting the decision to defer addressing costs in the 2006 legislation so as not to hold up the expansion in coverage.”

In the coming year, you can expect more action on this front. Lead by Gov. Deval Patrick (D), there’s increasing attention paid toward global payments that compensate doctors for each patient they cover or condition they treat, rather than a traditional fee for every service they provide. That next round of reform will be a crucial test for Massachusetts’ efforts to move past its coverage solution, and onto its cost challenge.

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State of the ... Health Care Reform

President Obama’s largest legislative accomplishment to date was the passage of the health care reform law, which has been going into effect in stages, with regulations currently being written for the most substantial changes due to take effect in 2014. So it is odd the President mentioned health care only briefly, and in passing, in his State of the Union address last night.

Perhaps this has something to do with the fact that the law remains deeply unpopular with a skeptical public, or the fact that despite some provisions “to increase coverage” have already gone into effect, the percentage of American adults without health coverage has increased to an all-time high of over 17%.

Still, it’s worth looking at the two sentences of the speech that dealt with health care. First, President Obama said, “I will not go back to the days when health insurance companies had unchecked power to cancel your policy, deny you coverage, or charge women differently from men.”

For his first example, he would have to go back very far indeed – for decades, it has been illegal for health insurance companies to cancel polices, except for fraud or misrepresentation by patients. The relevant section of Obama’s health reform law merely restates, at a federal level, what was already the law in all 50 states. Even prior to the passage of those state laws, traditional contract law – which predated the invention of health insurance by several centuries – prevented insurance companies from having “unchecked power to cancel” contracts they had entered into.

As far as health insurance companies denying coverage, this is a particularly odd claim to make. The primary federally-run health program is Medicare, which denies a higher percentage of claims than six of the largest seven health insurance companies. And unlike with private health insurance companies, when Medicare denies coverage, the patient can’t sue claiming that coverage is required under the insurance contract – because there is no contract. Unlike the case with insurance companies, Medicare’s claim denials are effectively final.

And while in theory some states allow for rating differences based on the difference in health care costs between men and women, this affects only those with individual, non-family, non-employer-based coverage – that is, substantially less than 5% of the insured population, and only in some states. Men and women covered through their employers pay the same rates, as do those with family coverage.

Obama second statement about health care – from a much later point in the speech, is even more at odds with reality: “I believe what Republican Abraham Lincoln believed: That Government should do for people only what they cannot do better by themselves, and no more. … That’s why our health care law relies on a reformed private market, not a Government program.”

Health insurance was invented by private companies in the mid-nineteenth century – far closer to Abraham Lincoln’s time than the present, and almost a century before Medicare and Medicaid. And apparently the insurance companies did such a good job of developing their product that it’s now considered a travesty that anyone goes without it.

Yet despite President Obama’s description of the new health care law as a “reformed private market, not a Government program,” the government will determine the benefits – which will be essentially the same for all health plans – while regulating every aspect of the financial arrangements – the premiums, deductible, copayments, and loss ratios – and require every virtually every American to enroll. This arrangement is not a “market” at all, and is “private” in name only. Whether it can “do better” than what they people have done for themselves for over a century remains to be seen.

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State health exchange hits snag

The GOP-run state House of Representatives is holding up legislation pushed by Gov. Rick Snyder to create a Michigan health insurance exchange, which threatens to leave the state with a federal marketplace where consumers shop for health coverage.

Many House Republicans are rejecting the wishes of their fellow GOP governor, arguing that they don't want to prematurely install federal health requirements they consider faulty and unconstitutional.

State House Speaker Jase Bolger, R-Marshall, said Friday that the House wants to wait until after a U.S. Supreme Court ruling on President Barack Obama's federal health reforms to decide its next steps on the exchange.

"The governor and I are not in agreement on this issue," he said. "The rights of our citizens to control their own health care is more important than an IT (information technology) deadline."

Michigan Attorney General Bill Schuette is supporting the legal effort to get the federal reforms declared unconstitutional.

State Rep. Chuck Moss, R-Birmingham, who chairs the House Appropriations Committee, also said the GOP caucus doesn't want to act unless it has to.

"We don't like Obamacare; we don't like national health care. We don't think it's good for the country; we don't think it's good for Michigan," Moss said. "We don't want to be early adopters and go down that road if we don't have to."

But if a Supreme Court decision isn't made until late June — normal for high-profile cases — some proponents of a Michigan exchange fear the state won't meet a Jan. 1, 2013, deadline to create its own exchange — essentially a website such as Orbitz.com or Travelocity.com for consumers and small businesses to compare and enroll in health insurance.

A federally created exchange could limit consumer choice, with possibly only major national carriers on the exchange, said Rick Murdock, executive director of the Michigan Association of Health Plans, which represents 17 health plans covering more than 2.1 million Michigan residents.

"We may be left with a system that doesn't work best for Michigan," Murdock said.

Snyder wanted legislation for a state exchange by Thanksgiving. In November, the state Senate approved legislation to create the MiHealth Marketplace — a clearinghouse of insurance information that would be run by a nonprofit and paid for by user fees from insurance companies. But the House didn't act.

Snyder last week in his State of the State address called on the Legislature to approve an exchange, cautioning that not acting will result in a program designed by the federal government instead of Michiganians.

The state estimates about a half-million people would use a Michigan exchange to buy coverage, many of whom will be eligible for federal subsidies to help buy health insurance.

An estimated 400,000 to 600,000 additional state residents will be eligible for Medicaid under health care reform changes coming in 2014 and could use the exchange to enroll in the health program for low-income residents, Murdock said.

The subsidies will be available for individuals and families who meet income requirements, including up to $89,400 for a family of four, who aren't eligible for employer coverage or coverage through a government program.

The Urban Institute, a nonpartisan research group in Washington, D.C., estimates that $1.3 billion in subsidies will flow through Michigan's exchange in 2014, according to the state.

This past week, the state House Health Policy Committee heard testimony from the public on creating an exchange, one of about 10 weeks of testimony so far on the issue, said Rep. Gail Haines, R-Waterford Township, the committee chairwoman.

Haines said the committee is taking a deliberative approach, but if the Supreme Court finds health reform constitutional, the House will be ready to act.

"Rest assured, we are not going to have this run by the federal government," she said.

But in December, the House did not include appropriation for about $9.8 million in federal government funding the state was granted in November to further efforts to create an exchange. The state has 12 months to spend the money, said Steven Hilfinger, director of the Michigan Department of Licensing and Regulatory Affairs.

While almost $10 million hangs in the balance, the state faces a June 29 deadline to apply for a second federal grant to pay for creating the exchange. That application requires the state to have passed legislation for a health exchange.

"This is a very complex IT project," Hilfinger said. "It includes a lot of interfaces with the business community, with health care insurers, with health care providers, the federal government."

Some Republicans fear the delay could be costly. State Sen. Jim Marleau, R-Lake Orion, who introduced the Senate health exchange bill, said a state exchange will allow for competition and help keep health insurance rate increases smaller.

"We're losing one by one the days that we control our destiny," Marleau said.

Michigan Consumers for Healthcare, an organization including groups such as the Detroit Wayne County Health Authority and AARP of Michigan, also wants immediate action on legislation and approval of an appropriation for the grant money.

Delays on a health information exchange for the uninsured could lead to confusion among consumers, Murdock said.

"That confusion can lead toward disappointment, anger even," Murdock said. "We're going to take the heat for it, even though it's largely due to actions that are beyond our ability to control."

mburden@detnews.com

(313) 222-2319

Q. What is a health exchange?
A. It is a government-required place where consumers without health coverage can find information about health insurance plans in their state.
Q. When will the health exchange start?
A. In 2014.
Q. Why must the Legislature make a decision on creating an exchange?
A. Federal health care reforms require it. States can set up their own by a Jan. 1, 2013, deadline or let the federal government set up one for them.
Q. How might a state exchange work?
A. The Michigan Senate’s proposed exchange would operate similar to a website such as Orbitz.com or Travelocity.com for health insurance. Consumers and small businesses could learn if they qualify for federal subsidies to help with premiums, compare coverages and enroll in health plans.
Q. Who would run and monitor the proposed state exchange?
A. It would be run by a by a nonprofit and overseen by an independent board of seven members — five appointed by the governor, one by the Senate majority leader and one by the House speaker.
Q. How much would it cost for the state to create the exchange?
A. The state doesn’t have an estimate on the cost.

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Health care changes: Will state lead or follow?

The 2012 Legislature convenes Tuesday facing a contentious battle over consumer health initiatives that could thrust Minnesota into the national spotlight and determine whether the state is a leader or a follower in the national wave of health care innovation.

One key debate will determine whether Republican opposition to federal "Obamacare" is so intense that the GOP-led Legislature will block a Republican-authored bill to create a statewide health insurance exchange, a one-stop marketplace where more than 1 million Minnesotans could be shopping for coverage in two years.

That's what happened in the Legislature last year, leaving Minnesota in gridlock while many other states began implementing various provisions of the 2010 Affordable Care Act, President Obama's signature health care proposal.

A dozen states have already approved laws to shape their own health insurance exchanges, which are required under federal law for all states by January 2014.

"Uncharacteristically, Minnesota seems to be slipping behind in an area -- health care -- where it traditionally is a national leader," University of Minnesota political scientist Larry Jacobs observed recently at a U forum.

Under the 2010 federal law, which remains hotly debated, the federal government will put its own exchange in place in 2014 if Minnesota doesn't act.

That is likely to occur in Florida, Louisiana, South Dakota and perhaps a dozen other states, including Wisconsin, where Gov. Scott Walker announced last week that he will return $38 million in federal planning money and quit work on an exchange.

Twenty-eight states have filed suit to stop elements of the federal law, an issue now before the U.S. Supreme Court.

At the same time, however, three of them have also begun to set up insurance exchanges. A White House report last week said 28 states, including Minnesota, are "on their way toward establishing" exchanges.

In Minnesota's legislative session last year, a bill to create an exchange drew only anti-Obama speeches from Republicans when it was proposed by their own colleague, Rep. Steve Gottwalt, R-St. Cloud, chairman of the House Health and Human Services Reform Committee.

"Governor Dayton is already moving ahead, without consulting us, on the kind of exchange he wants to see," Gottwalt said last week. "We shouldn't settle for that, or for a federal one-size-fits-all model. I don't like the Obamacare law, but I do think we can do something here that benefits Minnesota, so let's do it."

A task force appointed by Dayton will soon recommend details of how an insurance exchange should be organized and governed -- areas in which the federal law offers states wide latitude.

A clue that the Legislature might approve an exchange came recently from Sen. David Hann, R-Eden Prairie, who heads the Senate Health and Human Services Committee and has been one of the most vocal legislative opponents of the federal law.

Last year, he and other Republican legislators threatened to sue to stop Dayton from establishing an insurance exchange. But 10 days ago, Hann said he won't sue but likely will draft legislation to set limits on an exchange.

Not just politics

Republicans don't necessarily oppose the idea of an insurance exchange -- first proposed a decade ago by conservative-leaning think tanks in Washington, along with the notion of requiring universal health insurance coverage.

What they oppose is Obama, and election-year politicking has Republicans speaking against any administration initiative.

But they also have fiscal and philosophical concerns about the exchanges becoming too restrictive, too bureaucratic, too expensive or a potential doorway to a government entitlement plan like Medicare for the aged and disabled or a single-payer national health plan like those in many other developed countries.

"Nobody was really in the mood to talk about the real issues last year," said Rep. Jim Abeler, R-Anoka, who heads the House Health and Human Services Finance Committee. "I hope we can have a good discussion this year, a good debate, but I honestly don't know what the will of the [Republican] members is right now."

The federal law requires that, in two years, nearly all Americans have health insurance through employers, government programs or by buying it directly. Health plans will be required to accept all applicants, and millions of people who can't afford it will get tax credits to help pay premiums. Those who don't buy insurance will face penalties.

To make it work, the state must figure out a way to regulate the insurance risk, so that one insurer doesn't get saddled with most of the sickest and most expensive patients.

"That means we need to change some laws," said Rep. Tom Huntley, DFL-Duluth. "We can't wait. We've got a lot to do that should have gotten done last year," he said.

Fraud, care and newborns

Although a dominant topic, the insurance exchange will be just one health and human service issue legislators take on.

Legislators, advocates and the Dayton administration are considering a raft of programs, but await a February budget forecast to tell them if the state's modest projected surplus will grow or shrink.

Among the issues:

• Emergency Medical Assistance: Abeler will offer legislation to convert the stripped-down program to a managed-care plan, perhaps with lump-sum payments for each patient in the program who is cared for by community clinics. The program last year provided emergency and other expensive care to 3,647 people at a cost of $45 million, half paid by the state. After a $14 million cut in state funding, 262 people were kicked off earlier this month and have until February to appeal.

• Unwanted babies: After the bodies of two babies were found in the Mississippi River in southeastern Minnesota, Human Services Commissioner Lucinda Jesson proposed to expand the state's Safe Haven Law, allowing mothers to give up unwanted infants with no questions asked. Mothers could drop off babies up to 7 days old instead of 3 days, and at police or fire stations as well as hospitals.

• Fighting fraud: Jesson will seek broader authority for her department's new inspector general to go after fraud, waste and abuse in health and human service programs.

• Personal care attendants: Jesson and some Republican legislators are looking for ways to restore some or all of the 20-percent cut in pay to about 7,000 family members who act as care attendants. A Ramsey County District judge granted a temporary restraining order after some care providers challenged the law as unfair and unconstitutional, and a final decision is expected soon.

Warren Wolfe • 612-673-7253

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Former Penn State coach Joe Paterno's health status serious

(Reuters) - The health of former Penn State football coach Joe Paterno, who was fired last November in the wake of a child sex abuse scandal involving an assistant coach, has deteriorated and his status is serious, a family spokesman said on Saturday.

"Over the last few days Joe Paterno has experienced further health complications. His doctors have now characterized his status as serious," a statement said.

The Paterno family said it would have no further comment on the situation and asked that their privacy be respected "during this difficult time."

Paterno, 85, disclosed on November 18 that he had treatable lung cancer. He has been in and out of the hospital since then for treatment with radiation and chemotherapy, and after he fell at home in December and broke his pelvis.

The winningest coach in major college football history, Paterno was head coach at Penn State for 46 years. University trustees ousted him for failing to tell police what had been passed on to him about the alleged sex abuse.

Longtime Paterno assistant Jerry Sandusky faces 52 counts of sexual abuse of boys over a period of 15 years, including some incidents at the football complex on campus. Disclosure of the charges against Sandusky shocked the university and led to one of the biggest scandals in college sports history.

A Penn State graduate assistant testified to a grand jury that he told Paterno in 2002 that he witnessed Sandusky assaulting a boy in the showers at the football building. Paterno said he passed the information on to his boss, then Athletic Director Tim Curley. But no one told police, and the abuse continued for years, according to prosecutors.

Trustees of the university fired Paterno on November 9 with four games remaining in the football season. His ouster sparked demonstrations by students who felt he was treated unfairly, and anger among some alumni. The two top officers of the university trustees stepped down this week.

University President Graham Spanier was fired along with Paterno, and Curley and a former finance official in the athletic department face charges of lying to a grand jury about the alleged abuse.

Sandusky is under house arrest awaiting trial on the abuse charges. He has pleaded not guilty.

(Reporting and Writing by Greg McCune; Editing by Cynthia Johnston)

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