News

Health Care Law’s Employer Mandate Delayed

In a major concession to business groups, the Obama administration Tuesday unexpectedly announced a one-year delay, until 2015, in a central requirement of the new health care law that medium and large companies provide coverage for their workers or face fines, the Tennessean reports. The employer requirements are among the most complex parts of the health care law, which is designed to expand coverage for uninsured Americans. Under the law, companies with 50 or more workers must provide affordable coverage to their full-time employees or risk a series of escalating tax penalties. “We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Treasury Assistant Secretary Mark Mazur said in a blog post. “We have listened to your feedback and we are taking action.”

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Attorneys Busy with Nuances of U.S. Health Care Reform

Attorneys are busy at work on some of the lesser-known aspects of the Affordable Care Act, the Memphis Daily News reports. Beginning in January, businesses that employ 50 or more full-time equivalent employees must provide health care plans that meet minimum essential benefits requirements. But the largest employers – those that have 200 or more employees – also must make sure employees are automatically enrolled in a plan by January, said Craig Cowart, a partner with Fisher & Philips. “I’m confident most insurance carriers are working with employers on that now,” he said. “Employees will be able to opt out, but it’s definitely something employers need to be made aware of.”

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Court Finds for Generic Drug Maker

The Supreme Court also ruled today that generic drug manufacturers cannot be sued in state court for a drug design defect if federal officials approved the brand-name version that the generic drug copied. The justices voted 5-4 to agree with generic manufacturer Mutual Pharmaceutical Co. Inc., which had asked that a $21 million judgment against it be dismissed. The Memphis Daily News has the story.

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Health Exchanges May Not Be Ready to Launch

A new Government Accountability Office report suggests that implementation of health care exchanges called for in the new heath care reform act may be rough going when enrollment in federally operated exchanges, including Tennessee's, begins on Oct. 1. The federal "data hub" designed to deliver real-time eligibility rulings has only undergone initial testing, of concern to the federal investigators who authored the report. The report also confirms what many policy experts have been warning about – namely, that the federal government wasn't prepared or expecting to operate 34 state exchanges, causing some deadlines to be missed or delayed. The Memphis Business Journal has the story.

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Tennessee AG Watching ACA Suit

Oklahoma's Attorney General is suing to get his state exempted from a portion of the Affordable Care Act, the Tennessee Watchdog reports, while Tennessee's AG is watching to see how that maneuver plays out, a spokeswoman tells the Watchdog. Oklahoma Attorney General Scott Pruitt argues that states not opting to create their own health exchanges -- including Tennessee, Oklahoma and 31 others -- don’t have to participate in the employer mandate, a tax on business owners.

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Group Petitions for TennCare Expansion

A coalition that includes the Tennessee Nurses Association, Tennessee League of Women Voters, Tennessee Health Care Campaign and the Tennessee Justice Center delivered to Gov. Bill Haslam an online petition with more 4,500 signatures urging the governor to offer TennCare services to everyone making 138 percent of the federal poverty level or less, the Tennessean reports. “I don’t care whether the governor calls it Haslamcare or tweaks some changes,” said Mary Headrick, the Tennessee physician who delivered the petition. “We really want these folks to be covered and our services to be preserved.”

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Meningitis Suits Against Tennessee Providers to Remain in State

In a major victory for a handful of the local victims of a nationwide meningitis outbreak, a federal judge has ruled that — at least for now — their cases will proceed before a circuit court judge in Nashville and could eventually be tried by a local jury. In a 33-page ruling issued late Friday, U.S. District Judge F. Dennis Saylor IV in Boston ruled that victims who have sued only local healthcare providers, and not the compounder who provided the drugs, may keep their cases in Tennessee. Meanwhile, the more-than-100 suits that include claims against the New England Compounding Center will be consolidated in Saylor’s court. The Tennessean has the story.

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Haslam on Medicaid Expansion: We’ll Know by Summer

Gov. Bill Haslam said he should know this summer whether the state can strike a deal with the federal government for an alternative plan for offering health coverage to more poor people, the Nashville City Paper reports. Encouraged by ongoing talks with the federal Department of Health and Human Services and the Center for Medicare and Medicaid Services,, Haslam said the key now is ensuring flexibility in the state’s program.

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Daily Show to Take on TennCare Lottery

The Daily Show will be doing a spoof segment on Tennessee’s dialing-for-healthcare program, TennCare Spend Down, the Tennessean political blog reports. Tennessee launched Spend Down in 2010 to help people with low incomes and high medical bills gain access to TennCare who would not normally qualify for the state’s Medicaid program. The state has never set up an effective way to process applications so two to three times a year it opens up a telephone line, the blog states. People end up doing competitive dialing to get an application. Critics compare it to a lottery. Tennessee Justice Center staff attorney Michele Johnson confirmed that the show filmed footage at the TJC last week as part of the story.

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New Meningitis Suit Filed in Nashville Court

An 86-year-old Nashville woman has become the fourth victim of the fungal meningitis outbreak to file suit against Saint Thomas Outpatient Neurosurgical Center, The Tennessean reports. In a complaint filed late last week, attorneys for Virginia Neely allege that she was sickened after getting two injections of a tainted spinal steroid. She is seeking $3 million in compensatory damages. Neely previously sued the New England Compounding Center, the company blamed for shipping the tainted medicine. That suit, however, has been put on hold because the company has filed for bankruptcy. Neely’s suit is expected to be sent to Judge Joe P. Binkley Jr., who already is handling the three previously filed cases.

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Legal Aid Partners with HIV Charity

Legal Aid of East Tennessee – through its Erlanger Health Law Partnership and Pro Bono Project – recently hosted a clinic at Chattanooga CARES. This first-of-its-kind clinic helped HIV-positive individuals take control of the legal aspects of their health by drafting powers of attorney and wills. Pro Bono Project Director Charlie McDaniel said the event was the first in a series of “Health Empowerment Clinics” that will take place in the city. For more information contact Legal Aid at (423) 756-4013.

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State Wins $40 Million for Charitable Donations

Tennessee will receive approximately $40 million to distribute to charitable purposes after reaching a settlement agreement with National Health Investors (NHI) and National Healthcare Corporation (NHC), the Nashville Business Journal reports. In 2007, the receiver for nonprofit organizations SeniorTrust and ElderTrust filed suit against NHI and NHC for selling financially troubled nursing homes to nonprofits at prices significantly above fair value. “We believe this settlement is in the best interest of the public and upholds the appropriate use of Tennessee charities,” said Attorney General Bob Cooper. “The Court will ultimately determine how these funds can be used for charitable purposes, and the Office of the Attorney General will seek and welcome public input in that process.”

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Haslam Still in Talks with Feds Over Medicaid Expansion

Gov. Bill Haslam continues to talk with President Barack Obama’s administration since his decision last month not to accept federal funding at this time for an expansion of the state’s Medicaid program. He was in Washington, D.C., last week to meet with federal health officials about a possible compromise, the Memphis Daily News reports. Haslam is not putting any kind of timeline on the talks saying, “I’m working hard to get it done as soon as we can. I honestly don’t know if that’s a month or a year. The new plan comes into play in January 2014. Whether we could have something by then, I honestly don’t know.”

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Medical-Legal Partnership Marks First Anniversary

A medical-legal partnership between Legal Aid of East Tennessee (LAET) and Erlanger Medical Center in Chattanooga recently marked its one-year anniversary. LAET reports that the program has served 100 low-income patients and provided $660,855 worth of legal services since its inception. Lawyers have helped clients with conservatorships, foreclosures, landlord/tenant issues and insurance benefits. Medical-legal partnerships focus on improving the health and wellbeing of vulnerable patients by addressing their unmet legal needs and removing legal barriers that impede health. For more information on the program, contact LAET’s Chattanooga office at (423) 756-4013.

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Health Department Analyzes Pharmacy Bill Loophole

A bill that would create a loophole so compounding companies from all states could bypass patient-specific prescription requirements during drug shortages is being neither endorsed nor opposed by the Tennessee Health Department, the Tennessean reports. The proposal, which passed the Senate last week, would allow health care providers to obtain compounded drugs without having to identify a patient in cases where a product “is not commercially available.” The state’s chief medical officer Dr. David Reagan said the agency recognizes the difficulty of balancing measures to prevent another fungal meningitis outbreak with efforts to ease drug shortages. “You’ve got competing priorities here,” Reagan said. “You have an unprecedented number of drug shortages in this country and in this state. It is really difficult to understand how pervasive this has become. It is a real need and a real issue that is occurring at the same time as this other real need and issue about the sterility and safety of these compounded products.” The House has yet to schedule a vote. 

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One Judge to Handle All Local Meningitis Suits

Davidson County Circuit Judge Joe P. Binkley Jr. has ordered that three pending and any similar future local cases involving the fungal meningitis outbreak to be assigned to him only. In a one-paragraph order, Binkly granted a request from lawyers for the Saint Thomas Outpatient Neurosurgical Center that all pending and future meningitis suits against their clients be assigned to a single judge. The Tennessean has the story.

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Clergy Parallel Bible Story to Support Medicaid Expansion

A left-leaning clergy group delivered baskets of loaves and paper fish to each Tennessee legislator on Monday in order to show support for expanding the state’s Medicaid program, NPR reports. Religious advocates gathered to deliver the baskets in an attempted biblical parallel to the miracle of feeding the 5,000. Gov. Bill Haslam has not yet said yes or no the expansion. “That’s a pretty clear command to have concern for the ‘least of these,’” Haslam said. “But we also have a responsibility to make sure that’s something that’s affordable for the state, not just now but 10 years from now.”

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Memphis Lawyer Accused in Alleged Insurance Scam

William L. Hendricks, a former partner in the Memphis law firm Evans-Petree PC has been arrested on charges of theft, conspiracy to commit theft and money laundering in connection with a bogus health-insurance operation in Springfield. According to the Tennessee Attorney General’s office, Hendricks, Springfield businessman Bart S. Posey Sr. and his former business partner, Richard “Rick” Bachman Jr. of Texas, are charged with the theft of $225,000 in insurance premiums that came from some of the victims of a nationwide health-insurance scam that netted more than $20 million from about 12,000 victims. The Tennessean has the story.

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Lawyers and Doctors Partner to Help Patients

Lawyers and doctors are finding some common ground in clinics and hospitals across the country, according to NPR. In an Ohio women’s clinic, doctors are studying how adding lawyers to the health care team can help improve patient care. Meredith Watts is an attorney for Community Legal Aid, a nonprofit that gives free legal help to low-income people, but works out of the clinic. Watt’s role on the team is to help solve issues outside a doctor’s control -- such as anxiety over an eviction -- that might affect a patient’s health. "It's exciting to be able to do what we think of as preventative law, rather than always being crisis intervention because you can help something not happen, before it becomes a crisis.” explained attorney Marie Curry who runs the medical-legal partnership.

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Appeals Court Decision May Slow Health Care Fraud Prosecution

A federal appeals court has thrown out nearly $94 million worth of Medicare and Medicaid fraud cases won by U.S. Attorney Jerry Martin’s office in Nashville, possibly restricting how federal prosecutors can pursue health-care fraud cases in the future, the Tennessean reports. The U.S. 6th Circuit Court of Appeals' decision on Monday reversed an $11.1 million judgment against a Georgia medical company with three local clinics accused by federal prosecutors of Medicare fraud. The reversal comes just months after an $82.6 million judgment against three other local companies was also dismissed.

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Haslam Says 'No' for Now to Medicaid Expansion

Expressing concern that the federal Medicaid expansion would prove too costly once subsidies run out and would hamper creative approaches to cost savings, Gov. Bill Haslam today said the state will not join the program for now. However, he left the door open for a reversal if federal officials address his concerns, The Tennessean reports. In a speech to state legislators, Haslam also said he wants to pursue a state plan for expanding health care coverage but has not received federal approval for that approach.

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Saint Thomas Blames FDA for Meningitis Outbreak

Lawyers for Saint Thomas Outpatient Neurosurgery Center are blaming officials with the U.S. Food and Drug Administration (FDA) and state officials for last year's fatal outbreak of fungal meningitis, The Tennessean reports. The center says the FDA failed to make findings available that showed the New England Compounding Center -- which supplied the tainted injections -- was out of compliance with regulations. It also argues that the Tennessee Health Department was responsible for any delays in notifying patients of the outbreak.

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Legal Aid Receives Medical-Legal Partnership Grant

The Legal Aid Society has received a $40,388 grant from Baptist Healing Trust to further the groups’ medical-legal partnership in Middle Tennessee. The funds will allow Legal Aid to provide free, direct legal service to low-income patients and their families receiving treatment at two Nashville clinics – the United Neighborhood Health Services Clinic and the Vanderbilt University’s student-run Shade Tree Clinic. It also will fund training and education to help health care workers identify patients’ need for legal assistance related to their illnesses. The agency announced the news today.

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Court Reinstates Damages in Assisted Living Death

The Tennessee Supreme Court reinstated a jury verdict against the management company of a Shelbyville assisted living center in the death of an 83-year-old resident. Records indicate the woman died from a ruptured colon after a nurse improperly administered an enema. The Supreme Court reinstated $300,000 in compensatory damages after finding that the center was understaffed and that the management company knew about it but did not fix it. A $5 million punitive damages award approved by the jury was sent back to the lower court for review.

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St. Thomas Clinic Wants Meningitis Lawsuits Consolidated

Attorneys for St. Thomas Outpatient Neurosurgical Center, where dozens of patients were injected with a meningitis-tainted steroid, filed a motion in Davidson County Circuit Court asking that the presiding judge assign the current and future lawsuits to a single circuit or chancery court judge, the Tennessean reports. The motion was filed on behalf of the Howell Allen Clinic, a codefendant in the two recent suits. The move for consolidation follows recent action merging cases in federal court stemming from the same fungal meningitis outbreak, which caused 14 deaths among Tennessee patients and sickened more than 700 people nationwide.

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