A Missouri consumers group has sued the Department of Health and Human Services over its alleged failure to disclose health insurance rates filed with the state. The lawsuit, filed Tuesday in federal court in St. Louis by the Consumers Council of Missouri, comes just six weeks before the enrollment period for coverage under the Affordable Care Act begins on Nov. 15. An HHS regulation requires the Centers for Medicare & Medicaid Services, an arm of HHS, to set up a procedure to enable the public to comment on proposed health insurance rates. The lawsuit, however, alleges that HHS ignored a request for the rates sent by the council as well as dozens of other state consumer organizations and eight consumer representatives of the National Association of Insurance Commissioners. Missouri is one of the few states whose insurance departments have no authority to review health insurance rates for the individual market. Some states require health plans to justify rate increases; others require rate filings but may or may not exercise their authority to push rates down. In Kansas, rate filings are required but the state so far has not been willing to identify the insurers for 2015 or their rates. KCUR filed a request for the information in June but was told by the insurance department that a request had been made that they be kept confidential. The Affordable Care Act, also known as Obamacare, authorizes HHS to review proposed rate increases of 10 percent or more if HHS decides that a state does not have an effective rate review process.…...

Kansas was one of just three states that saw their rates of people without health insurance go up since last year, according to a new survey. And, if the poll results are accurate, Kansas was the one whose rates went up the most. The data, collected as part of the Gallup-Healthways Well-Being Index, show that the uninsured population in Kansas rose from 12.5 percent in 2013 to 17.6 percent by midyear 2014 — a whopping increase of 5.1 percentage points. Even Kansas Insurance Commissioner Sandy Praeger confesses she’s surprised, although she says there may be several possible explanations for the data. One, she says, is that the state’s own estimate of a 12 percent uninsured rate was off the mark because, before Obamacare kicked in, uninsured people inaccurately reported being insured. “We’ve had a woodwork effect in Kansas of more people, even under our stingy Medicaid rules, applying for Medicaid under the old rules who didn’t apply before, just because there’s greater discussion around insurance now,” she says. “So it may be that people are more aware of what it means to have insurance and are less likely to self-report that they have insurance when they are in fact uninsured. And it may be the way the pollsters asked them the question that made them more likely, I don’t know.” Like Praeger, Cindy Samuelson, a vice president of the Kansas Hospital Association, says she’s baffled by the sharp rise in uninsured Kansans – although she says Kansas’ failure to expand Medicaid – called KanCare in Kansas – was certainly a…...

Just days after Prime Healthcare Services agreed to buy two Kansas City-area hospitals, laid-off employees of two other area hospitals owned by Prime sued the company, claiming they were not provided with promised severance benefits. The suit seeks class-action status on behalf of other terminated employees. It says 49 workers were let go immediately after Prime bought Providence Medical Center in Kansas City, Kan., and Saint John Hospital in Leavenworth, Kan., from the Sisters of Charity of Leavenworth Health System in April 2013. The complaint, filed by Patricia Geiger and Michelle Hunget, doesn’t name the hospitals at which they worked. But their LinkedIn profiles identify Geiger as a former director of cardiovascular and intensive care at Providence Medical Center and Hunget as the one-time director of Providence’s Family Care Center. Prime did not immediately respond to a request for comment on the lawsuit. According to the suit, the Sisters of Charity laid off “roughly 24 employees” before the purchase was completed and paid them severance. After the closing date, however, another 49 employees were terminated but not awarded severance pay. The suit says Prime delayed announcing the layoffs to avoid their financial impact on the deal. In addition to the Prime subsidiaries that operate the hospitals, the suit names the Sisters of Charity as a defendant. A spokeswoman for Sisters of Charity could not be reached for comment Wednesday. Kathleen Conwell, a spokeswoman for Providence and Saint John hospitals, said in an email that Providence had gained 92 employees since Prime bought it and Saint John had lost four. “I…...

Truman Medical Center Hospital Hill is among 175 hospitals nationwide most likely to be penalized with the loss of Medicare payments because of high rates of infection and other complications. In April, the Centers for Medicare & Medicaid Services calculated preliminary “hospital-acquired condition” scores from 1 to 10, with one being best and 10 being worst. Truman was the only hospital in the Kansas City area that received a preliminary score of more than 9. Experts say hospitals with preliminary scores of nine or higher are the ones most likely to get hit with the penalty, according to Kaiser Health News. Hospitals with scores above seven risk losing 1 percent of each Medicare payment from Oct. 1 through Sept. 30, 2015. Medicare has identified about a quarter of the nation’s hospitals – 761 altogether – as falling into that category. Besides TMC Hospital Hill, six other area hospitals – out of nearly two dozen - received preliminary scores of more than seven. (See chart) Mark Steele, the chief medical officer of Truman, acknowledges that during the period covered by the preliminary scores, Truman "had an undesirable rate of urinary tract infections and blood stream infections." "Though it should be noted," he wrote in an email to KCUR, "that blood…...

Considering a major joint replacement? If you check into the University of Kansas Hospital, you might be charged more than $115,000. But if you go to Olathe Medical Center just 22 miles down the road, you’re apt to be billed just over $50,000. Coping with renal failure? At Truman Medical Center, the bill is likely to add up to more than $14,000. But at Research Medical Center, a mere six miles distant, it’s more likely to come to $48,000. Those are some of the striking – even random - disparities reflected in figures released this week by the Centers for Medicare & Medicaid Services (CMS). The data trove includes hospital charges in 2012 for the 100 most common inpatient procedures. Different figures The figures – the amounts hospitals bill for items and services - don’t reflect actual reimbursements, which are significantly lower since Medicare and commercial insurers negotiate prices down. Hospital executives, in fact, insist that the charges – which come from a master list know as a “chargemaster” - are irrelevant for that reason. For example, the average Medicare payment to KU Hospital for joint replacement – the most common Medicare procedure - was $28,866, a far cry from its average charge. (Including payments from other sources, KU’s total reimbursement came to $29,771.) By contrast, Olathe Medical Center received $16,434 from Medicare for joint replacement (and $17,428 in all). There are many reasons a hospital’s bills might exceed those of another. KU Hospital, for example, is a teaching hospital and incurs additional costs for those responsibilities. It’s also a…...

By Dan Margolies - KCUR An executive with TMC Lakewood has been chosen to succeed John W. Bluford III as president and CEO of Truman Medical Centers. Charles W. "Charlie" Shields, currently the chief operating officer of TMC Lakewood, part of the TMC Health System,  will replace Bluford, who is retiring in July. Shields, a former Missouri state representative and senator, served as president pro tem of the Missouri Senate in 2009. Before joining the TMC system, he was with Heartland Health in St. Joseph. Truman Medical Centers announced in February that Bluford would retire after 15 years leading Truman. Bluford turns 65 Thursday. The announcement of Shields' appointment was made by Peggy Dunn, chairman of TMC's board. In a statement, Dunn said that Shields was "an outstanding leader at Lakewood, and we are excited to have him take on this new challenge, and continue the legacy that John Bluford has built over 15 years." As TMC Lakewood's COO, Shields oversaw the addition of a birthing center, an imaging center, a center for breast cancer and the new Fairmount Family Medicare Care clinic, according to the news release announcing his appointment. "I am honored by the confidence shown in me," Shields said in a statement. "TMC is a valuable community asset, a great place to work and most important, a great place to receive care. We have a tremendously talented medical staff, dedicated employees, loyal volunteers and a board of outstanding community leaders. I couldn't be more excited about the opportunity to help lead this organization." Bluford has said he plans to remain "civically engaged." He will…...