One-time Mass. health official heads Conn. agency

HARTFORD, Conn. (AP) — A California health care expert who played an early role in Massachusetts' revamped health care system has been appointed by Connecticut Gov. Dannel P. Malloy as chief executive of a new state health care agency.

The appointment of Kevin J. Counihan to lead the Connecticut Health Insurance Exchange was announced Thursday.

Health exchanges, which essentially are marketplaces where consumers can comparison shop for insurance plans, are intended to bring down prices and get more people insured.

Counihan said his priorities will be to get the exchange running in 2014 and have a user-friendly website ready by October 2013.

He was vice president of CIGNA and president of Choice Administrators Exchange Solutions, an Orange, Calif., private health insurance exchange that administers health care programs for employers.

From 2006 to 2011, Counihan was chief marketing officer for the Massachusetts Health Insurance Connector Authority, which administers that state's health insurance exchange.

The Connecticut health exchange was enacted by the legislature and signed into law by Malloy last year. Its job is to certify, recertify and decertify health benefit plans, provide enrollment periods, maintain a website offering standardized comparative information on health plans and screen applications to determine eligibility for Medicaid, the state Children's Health Insurance Program or other state public insurance programs and enroll eligible applicants.

State Healthcare Advocate Victoria Veltri says the health exchange is seeking nearly $109 million from Washington, D.C., to operate through 2014.

Also on Thursday, Rhode Island Gov. Lincoln Chafee appointed a former Massachusetts health official to lead Rhode Island's new health benefits exchange. He tapped Christine Ferguson, who was Rhode Island's human services director from 1995 to 2001 and Massachusetts' public health commissioner under former Gov. Mitt Romney.

Because Massachusetts was the first state to enact a public health insurance system, it was a marker for the federal Affordable Care Act signed into law by President Barack Obama in 2010, Counihan said.

"Clearly, it served as a blueprint for ACA," he said.

Counihan would not speculate about what might happen to state health exchanges if the U.S. Supreme Court strikes down portions of the federal law or all of it. The court is expected to act before the end of the month.

"It's just way, way early to see what happens until the justices issue their decision," he said.

Veltri said Counihan's priorities are to build relationships with consumers, the uninsured, doctors, hospitals, health care advocates and others.

"His highest priorities are to get up to speed so far on what's going on in Connecticut," she said.

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Vt. health official visits with NH doctors

LEBANON, N.H. (AP) — A leader of the effort to revamp Vermont's health care system said Monday the state will cope better than most if the U.S. Supreme Court guts President Barack Obama's health care law, but its reform efforts could be hurt by a loss of more than $200 million a year in federal subsidies.

Anya Rader Wallack, chair of the Green Mountain Care Board, made the comments during an appearance before about 40 physicians, administrators and staff at the Dartmouth-Hitchcock Medical Center. The "grand rounds" meetings are designed to keep health professionals up to date on trends in their field.

The effort by Gov. Peter Shumlin and the Legislature to push Vermont toward a publicly financed health system in which as many claims as possible are processed through a single payer could have a big impact at the Lebanon teaching hospital, which is just across the Connecticut River from Vermont and gets about 40 percent of its patients from that state.

And the federal law's fate likely will have a big impact on Vermont's envisioned Green Mountain Care plan.

The state passed a law last year designed to move Vermont toward — but not all the way to — a Canadian-style, single-payer health care system by 2017. Likely exceptions include federal employees living in the state and those working for "self-insured" employers

This year, lawmakers designed a health care "exchange," or marketplace, that will be the Web-based, one-stop shopping portal for consumers to compare plans and buy health insurance beginning in 2014.

But a linchpin of financial support both for the exchange and for the Green Mountain Care system planned for later are tax credits to be available under the federal law that have been counted on to help people buy health insurance in the exchange.

Wallack said one early estimate put the value of those tax credits at between $200 million to $300 million per year in Vermont. Other hoped-for federal funding for things like new computer systems to process patients' health records also could be in jeopardy, she said.

Much anticipation surrounded Monday's release of Supreme Court decisions because it was believed the federal health care law ruling might be among them. It wasn't, and the next time the court releases decisions is Thursday.

There's been speculation that the court could leave the multi-faceted law intact, strike down its most hotly debated provision — a mandate for individuals to buy health insurance — or overturn most or all of it.

Twenty-six states are asking the court to overturn the law, arguing that it's unconstitutional to require individuals to buy health insurance, and that the law curtails states' rights to design their own health care systems.

The impact of the court's decision on Vermont will depend on how broad it is, Wallack said. If it simply strikes the insurance mandate, she said, "I don't think the impact on Vermont is particularly significant."

Among the reasons: Vermont has a relatively small number of residents without health insurance; most employers offer insurance to their workers; and the state has expanded its Medicaid program to cover many of those who work but don't get insurance from their employer.

"I think there's a whole lot we can do to just maximize coverage through Medicaid," Wallack said, pointing to estimates that half of Vermont's uninsured population would be eligible for Medicaid, the publicly funded health insurance program for low-income residents, if they just enrolled.

The bigger fear, if larger parts of all of the health care are struck down, is the loss of the tax credits designed to help people buy insurance through the exchange, Wallack said. "We lose that money if the whole law goes down," she said.

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Jeffrey Thompson ‘unlikely’ to keep health-care contract, D.C. official says

Thompson might not be in the health-care business much longer. (C-SPAN) The health-care firm owned by Jeffrey E. Thompson, the D.C. businessman at the center of a federal campaign finance investigation, would be “unlikely” to win a new contract with the District unless the firm is quickly sold, a top city official said Thursday.

Wayne Turnage, director of the District’s Department of Health Care Finance, told a D.C. Council committee that as long as Chartered Health Plan remains in Thompson’s hands, it should not expect to continue managing the health care of low-income city residents after its current contract expires in May 2013.

“If a sale does not happen, it is unlikely we would allow Chartered to keep its current contract for a number of reasons,” Turnage said. He did not elaborate on the reasons, though the panel’s chairman, David A. Catania (I-At Large) referred to “a certain cloud ” being over the company.

Thompson’s home and offices were raided last month in connection with a federal probe of campaign finance in the city. He resigned last week from Chartered’s board of directors.

Turnage discussed a pending proposal from Chartered’s chief executive, Maynard G. McAlpin, to buy the company from Thompson. The firm confirmed McAlpin’s intentions to The Washington Post on Monday but offered no further details.

McAlpin, according to Turnage, expects to consummate a sale in 60 to 90 days — in time for it to respond to a solicitation for the new health-care contract, expected to be issued in the coming weeks. Turnage said McAlpin indicated he was pursuing a partnership with two investors, including “one of the largest [health-care] plans in country.”

Chartered handles the health care of more than 110,000 District residents; its D.C. government contract, which generated $355 million in revenue last year, is its sole source of business. In recent annual filings, both Chartered and the city’s other contractor, Unison Health Plan, reported significant operating losses. But Catania questioned whether those figures reflected actual financial hardship.

“There’s losses and then there’s losses,” he said. “It’s not real money, it’s not cash money they’re losing. ... You can manipulate the books any way they want.”

The discussion of Chartered came after Catania questioned the wisdom of continuing with the current managed-care contracting model, where for-profit companies like Chartered are engaged to handle provider networks and billings for the Medicaid and D.C. HealthCare Alliance programs.

Instead, Catania suggested returning to a “fee-for-service” model for those public health-care programs, where providers would be paid directly by the city — a sea change for a program responsible for a half-billion dollars worth of city spending every year.

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Lucknow official accused of health funds scam shoots himself

Sunil Verma, a bureaucrat among those accused of siphoning off crores from government funds meant to provide better health facilities for the poor, has shot himself in the head. He has died.

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