Monthly Archives: October 2013

Bridgeport parents ask state to investigate district’s handling of special education

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A group of Bridgeport parents has filed a complaint with the state about the district’s “systemic failure” in educating students with disabilities.“In sum, [Bridgeport] failed to meet their obligation,” reads the 11-page complaint filed late last week with the State Department of Education.The complaint highlights the stories of six students and their parents, who have either struggled to get their children evaluated for special education services, or whose children have faced delays in receiving those services.While the attorneys representing the students say things changed once they got involved after waiting for years for services, they worry about all the other Bridgeport students who can’t afford an attorney.“We are concerned about those not represented by counsel. This is a chronic and pervasive problem,” said Edwin Colon, an attorney with the Center for Children’s Advocacy, which represents children from low-income families throughout the state. “It wasn’t until we became involved as attorneys that we saw some action.”Lisa, whose name was changed for privacy, is one of these students.Even though Lisa had been hospitalized multiple times for hurting herself and constantly missing school after being bullied at Harding High School, the complaint says the district routinely denied requests that she be evaluated for special accommodation.“For a period of over two years [Bridgeport] failed to accept and process a referral from the student’s guardian to determine the student’s eligibility for special education,” the complaint reads.Although Rob Arnold, executive director for specialized instruction in Bridgeport, said he wouldn’t want to dismiss the complaints as inaccurate, he did say that the district is heavily focused on special education and is improving.“Everybody is working really hard,” he said during an interview. “We have to agree to disagree at some points. There are always going to be complaints.”Roughly 3,100 students in Bridgeport — about 1 in 10 — have special education plans, a rate that is about the same as the statewide average, according to the most recent data from the State Department of Education.Since Paul Vallas took over as superintendent nearly two years ago, several changes have been made in how special education is provided.In addition to sending fewer students to specialized schools outside the district, Arnold said the school system has opened programs to accommodate students with autism, and it has also opened almost 20 classrooms that accommodate special education students in small settings. Continue Reading →

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Congress considers permanent solution to Medicare doctor pay

doctor image by Phalinn Ooi

Washington – A nightmare Connecticut doctors fear this time of year may soon be banished by Congress.It has nothing to do with Halloween, and everything to do with the “sustainable growth rate,” a formula approved by Congress in 1997 that was designed to curtail Medicare spending by cutting physician payments if the program’s costs exceeded a set amount.The problem is that galloping health costs would have drastically reduced doctors’ Medicare reimbursement under the formula. So pressured by the nation’s doctors, Congress has delayed the cuts every year since 2002, usually at the last minute before they would take effect at the end of December.If members of Congress fail to agree to another “doc fix” this year, payments to the nation’s physicians would be cut by nearly 25 percent.But Thursday, top-ranking members of the House Ways and Means Committee and the Senate Finance Committee came up with a bipartisan agreement to put an end to the yearly fight over the sustainable growth rate.”For years, Medicare payments to doctors have been at risk of getting slashed, limiting seniors’ access to high quality care,” said Senate Finance Committee Chairman Max Baucus, D-Mont. “Enough with the quick fixes.” The proposal would freeze payments to doctors at their current levels until 2023 while alternative payment models are tested.Beginning in 2017, the current system of paying doctors a fee for every Medicare patient they treat would be shifted toward a  “value-based performance” program that would tie payments to the quality of treatment a patient receives. Bonuses would go to physicians who made more same-day appointments for patients with urgent needs, made better use of medical records or proved in other ways they practice good medicine.The agreement still has to be drafted into bill form, approved by the Ways and Means and Finance committees and considered on the floors of the House and Senate before the end of the year to avoid the pending deep cut to physician fees.Rep. John Larson, D-1st District, a member of the Ways and Means Committee, said he is open to the proposal.“It is imperative that we move forward on a permanent solution to replace the flawed SGR [sustainable growth rate] formula,” Larson said. “I look forward to hearing from the medical community in Connecticut on this discussion draft and to working with members of the Ways and Means Committee in the coming weeks on this proposal.”Rep. Joe Courtney, D-2nd District, who has worked for years for a permanent solution to the problem, said he is pleased.“Over the last several years, I have advocated for a bipartisan and long-term fix to the SGR formula that ends the year-to-year uncertainty that doctors and patients have experienced for far too long.” Courtney said. Continue Reading →

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Connecticut’s cash flow is better after $900 million loan

The state no longer needs the emergency credit line set up last winter to ensure it can pay its bills on time.But whether that means Connecticut’s finances are any better off was a matter of debate Thursday at the Capitol.One of the main reasons the state’s coffers are flush with cash is because it borrowed nearly $900 million this week to postpone two controversial debts until after the next gubernatorial election.“A long-term structural problem with the state’s general fund has finally been addressed head on,” State Treasurer Denise Nappier wrote in a statement Thursday. “And we are on a disciplined path to resolve the GAAP deficit once and for all.”The treasurer, a Hartford Democrat, was referring to $560 million in state bonds sold this week to investors to assist the state’s conversion to Generally Accepted Accounting Principles.Unlike the modified cash basis system the state had long used, under GAAP, expenses and revenues must be promptly assigned to the year in which they were incurred or received. In the context of the state budget, the practice ends an array of accounting gimmicks that have pushed current expenses into future years. If GAAP standards are used, state finances are about $1.2 billion in the red.Gov. Dannel P. Malloy and his fellow Democrats in the legislature’s majority originally planned to close that margin by setting aside $80 million annually for 15 years starting this July.But Malloy, who has struggled to erase the huge budget deficit he inherited when he took office in January 2011, didn’t meet that goal. And last June he and the legislature ultimately decided that the state would borrow — and therefore pay interest — to reduce a debt it effectively owes itself.Because of the GAAP differential, as well as a sluggish recovery from the last recession, the state’s cash flow has been poor in recent years, forcing Nappier frequently to dip into capital programs, temporarily transferring funds to pay operating expenses. Continue Reading →

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Medicare Part B premiums remaining level for 2014

Monthly premiums for Medicare Part B will remain stable in 2014 at $104.90 for most beneficiaries, the federal Centers for Medicare and Medicaid Services announced this week. The premiums paid Medicare recipients with higher incomes — less than 5 percent of the beneficiaries — will also remain level in 2014. Continue Reading →

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CT GOP, Democrats joust over Malloy’s fundraising

The Connecticut Republican Party filed a complaint Wednesday accusing Gov. Dannel P. Malloy of illegally soliciting a state contractor for a campaign contribution to the state Democratic Party while on a fundraising trip to California a week ago. But the GOP offered no evidence that the contractor made a contribution, much less that Malloy violated campaign finance laws, which allow the solicitation of state contractors under certain circumstances. “This is a baseless complaint and an empty stunt for a press release,” said James Hallinan, a spokesman for the Connecticut Democrats. “What they allege happened, didn’t happen.”

Zak Sanders, a spokesman for the Republicans, acknowledged the basis for the complaint was thin: He relied on press reports about a tweet from a congressional candidate, David Peterson, who thanked Lenny Mendonca for hosting an “event” attended by Malloy in California. Mendonca is a director of McKinsey & Company, a state contractor. Continue Reading →

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Federal hub crashes again, pulling down Access Health CT

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Washington – For the second time since Sunday morning, the federal system that verifies identities and other personal information about Americans shopping for insurance on exchanges created by the Affordable Care Act has crashed.In a statement, Access Health CT, said it was informed by the Centers for Medicare & Medicaid Services that the federal data services hub, which confirms applicant information for all health care exchanges, is experiencing an outage. The statement did not say when CMS expected the data hub to be functional again although Verizon, which operates the data hub, said it hoped to fix it overnight.When the hub went down Sunday, it took about 24 hours to fix.The Access Health CT release said that during the outage, “customers will not be able to access Remote Identity Proofing, Social Security Administration or Advanced Premium Tax Credits also referred to as subsidies. As a result, consumers will not be able to complete the sign up process for Medicaid or Advanced Premium Tax Credit determinations.”While consumers can’t complete applications — or determine whether they qualify for federal subsidies to buy insurance — they “can continue to create accounts as well as shop anonymously for pricing comparisons,“ the Connecticut exchange’s statement said.Access Health CT had planned to have a backup system in place so visitors to the site could continue to apply for insurance coverage if the data hub faltered, but its “plan B,” has technical problems, too.CMS directed a request for more information to Verizon, which did not respond.Instead, Verizon released a statement that said it was “undertaking infrastructure maintenance, which should be completed overnight.”“Since HHS asked us to provide additional compute and storage capacity, our engineers have worked 24/7 to trouble-shoot issues with the site,” the statement said.The interruption in service comes as the Connecticut health exchange planned to issue an update of its operations on Wednesday.It also comes on the eve of Health and Human Services Secretary Kathleen Sebelius’ testimony before the Republican-controlled House Energy and Commerce Committee Wednesday.Besides having to answer questions about the severe technical problems plaguing, Sebelius is likely to also have to explain the repeated problems with the data hub, which HHS insisted was glitch-free before Sunday’s shutdown.She is also likely to be grilled about a NBC report that determined many Americans are losing their health insurance coverage as the Affordable Care Act requires insurers to stop selling plans that fail to offer, at a minimum, a certain amount of coverage and benefits, including maternity and mental health care.  Continue Reading →

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Health care redesign plan focuses on primary care, doctor payments and reducing waste

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A team of state officials and health care industry representatives are trying to redesign the way health care is paid for and delivered to the vast majority of Connecticut residents.According to a draft of their plan, their vision includes bolstering primary care practices to take on a larger role in patient care and offer treatment during expanded hours. It calls for better linking of medical practices with social services and other supports that could help people in high-risk communities. And it includes changing the way health care providers are paid by giving them an incentive to rein in what their patients’ care costs — a model that’s been embraced by Medicare and insurance companies but has drawn fire from patient advocates.The idea is to cut into the $29 billion spent on health care in Connecticut each year while improving the health of state residents. David Nuzum, a consultant for the firm McKinsey who is working on the project, said the plan assumes that over five years, it will eliminate 10 percent of the waste in the system, with some of the money funneled back to health care providers as part of bonus or shared-savings programs.The draft plan says it aims to save more than $1 billion over 10 years by reducing the growth of per-capita health care spending by 1 to 2 percentage points, reducing avoidable complications, preventable hospitalizations, unnecessary emergency room use and duplicative testing.The effort is still in an early stage. Officials are working on an application for $45 million in federal funds, part of a grant included in the federal health reform law. Continue Reading →

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Connecticut health exchange ‘backup plan’ no help during national outage


Washington – A backup plan Connecticut’s health exchange developed to help insulate it from Washington’s problems in the rollout of Obamacare was no help at all Sunday, when the federal system that checks information from applicants went down, stalling most enrollments.“There are some things that still have to be worked through, some technical problems,” said Jason Madrak, chief marketing officer for Access Health CT, Connecticut’s health care exchange.He was referring to what he called “Plan B,” created by the Connecticut exchange to continue to process applications if there are troubles with a federal data hub that verifies identities, income, citizenship and other personal information of applicants. The hub verifies this information both for states that use the federal exchange website and states like Connecticut, which have developed their own portal. It also determines an applicant’s eligibility for subsidies to help pay for insurance or for Medicaid, which has been expanded in Connecticut through the ACA.While much attention has been paid to the massive problems plaguing the federal website many states use to enroll the uninsured under the Affordable Care Act, less notice has been made of the hub’s operations, which seemed fairly glitch-free before Sunday morning’s failure that knocked all state exchanges out of business. Connecticut’s site was the first to report the outage.According to Access Health CT officials, the hub was back up about 24 hours later. But Department of Health and Human Services officials said they are still testing “one piece of the system impacted by the outage.”If the federal hub crashed, a “backup plan” was supposed to be ready to take its place, Kevin Counihan, CEO of Access Health CT, said last month.In an email sent to The Connecticut Mirror before the Oct. Continue Reading →

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Journalist Brill: Health care prices are too high


North Haven — Journalist Steven Brill spent months researching the nation’s health care system for his widely read Time magazine article, “Bitter pill: Why medical bills are killing us.”His primary diagnosis: “All the prices are too high.”“And everybody — with the exception of doctors and nurses — hospital administrators, CT scan equipment salesmen, hospital CFOs, drug company executives, everybody except for the people actually providing the care is just making way too much money, and that’s why we’re paying too much,” Brill said Monday.He spoke at Quinnipiac University’s North Haven campus as part of a panel on health care costs presented by the Universal Health Care Foundation of Connecticut. The group, which pushed for years for a public insurance option in the state, has turned its focus to addressing the high cost of health care.The speakers agreed that costs are too high, if not on who’s responsible or the ways to combat the problems.Griffin Health Services Corp. President and CEO Patrick Charmel took issue with how hospitals were portrayed in Brill’s article, but said the piece raised “a number of important issues.” The article scrutinized hospitals’ profit margins and executive compensation, as well as those of the pharmaceutical and medical device industries.“Clearly the cost of health care has become unaffordable, and for the nation, it’s unsustainable,” said Charmel, whose organization includes Griffin Hospital in Derby.Charmel pointed to what he called “the perverse incentives that plague the system,” which generally pays health care providers for doing more.There are multiple efforts under way to change that, many centered on trying to pay health care providers to coordinate patient care or tying patient outcomes or the cost of care into provider pay.But there are other changes afoot in the industry, including the consolidation of health care providers as hospitals align to form larger systems and physicians join hospital networks or larger physician groups. Brill has pointed out that those changes raise the providers’ clout in negotiating prices with insurance companies, potentially raising prices.State Comptroller Kevin Lembo, whose office oversees the health plan that covers about 200,000 state employees and retirees and their families, said changes happening in the care delivery system make him uneasy.“I feel in some ways like we are once again behind this major shift in the marketplace, trying to figure out how to get out,” he said.Show us the pricesA frequently discussed solution was transparency, making consumers more aware of the cost of health care.“Let’s face it, all of us are insulated from the cost of care, and we’re not making true value decisions,” Charmel said. He noted that people with insurance typically have little incentive to find the lowest-cost care because they usually pay a fixed amount — a $500 copay for a hospital stay, for example — regardless of whether they choose a high- or low-cost hospital. Continue Reading →

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Jepsen launches complaint form for patients charged facility fees

Attorney General George Jepsen is seeking information from patients who were charged “facility fees” by health care providers. Patients who were charged facility fees without receiving notice or weren’t told what the fees would cost can submit complaints using a form available through the attorney general’s office. The form is available by clicking here. Continue Reading →

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