Community Health Centers Face Uncertain Financial Future

Federally Qualified Community Health Centers (FQHCs) in Connecticut have expanded services, upped their staffing and renovated their facilities mostly due to increased revenue streams from the Affordable Care Act (ACA). Connecticut and the 30 other states that opted for the ACA Medicaid expansion program have benefitted from billions of dollars in additional core grant funding, with Connecticut receiving $150.7 million from 2011 to 2016, according to a January report by the Congressional Research Service. Health centers in Connecticut used some of that funding to hire professionals to enroll thousands of residents in health insurance—residents who were previously uninsured and used the centers for their health care. Now the centers are serving about 70,000 more insured patients, mostly covered by Husky Health plans. The cost of treating uninsured patients has declined by about $10 million since 2012, according to Deb Polun, director of government affairs and media relations at the Community Health Center Association of Connecticut.

Medicaid, ACA Uncertainty Threaten Success Of Ex-Offenders’ Health Care Programs

Since 2011, Connecticut has issued more than 39,000 new Medicaid cards to prisoners returning to communities, connecting them to health care services with the goal of keeping them healthy and out of prison. This initiative, which gives ex-offenders the opportunity to see a primary care physician on a regular basis and access critical mental health and drug-abuse treatment programs, exists because of the Affordable Care Act (ACA), and Medicaid pays most of the costs. Recidivism data show that the initiative is working, state officials say. Yearly, the Court Support Services Division (CSSD) refers approximately 20,000 adults on probation to various behavioral health programs and tracks them for 12 months. In 2016, CSSD reported that 23.1 percent of adults who completed their referral program were rearrested, a five-year low since CSSD started tracking in 2012.

Medicaid Offers Birth Control Right After Delivery

Low-income women in Connecticut who have just given birth and know they don’t want to get pregnant again anytime soon are now offered a long-acting birth control option postpartum. Medical providers say the policy by the U.S. Department of Health and Human Services will reduce the number of unplanned pregnancies, as well as lead to better maternal health outcomes by ensuring pregnancies are spaced a healthy length of time apart. Connecticut’s HUSKY program is one of 26 state Medicaid programs nationwide that reimburses hospitals for administering long-acting reversible contraception (LARC)—namely, intrauterine devices (IUDs) and subdermal implants—to Medicaid patients. HUSKY started reimbursing for the devices last year. “It’s a great thing,” said Dr. Elizabeth Purcell, an obstetrician and gynecologist practicing in Hartford.

It’s Time To Stop Segregating Reproductive Rights

Now is the time to repeal a 40-year-old law that perpetuates inequality among women. The Hyde Amendment, which bans the use of federal funds to pay for abortions except in certain circumstances, is unfair. The amendment targets women who rely on Medicaid for their health care coverage. According to the federal Centers for Medicare and Medicaid Services, roughly two out of three adult women enrolled in Medicaid are between the ages of 19 and 44—the reproductive years. Abortions can run upward of $1,000, which places the (legal) procedure out of reach for most women living in poverty.

As Smoking Rates Drop, Medicaid Recipients Twice As Likely To Smoke

People who are uninsured or on Medicaid are more than twice as likely to smoke tobacco compared to those covered by other insurance, according to a national study by the Centers for Disease Control and Prevention. About 28 percent of uninsured adults and 29 percent of adults on Medicaid smoke nationwide, according to the Centers for Disease Control and Prevention (CDC), compared with just 13 percent of adults on private insurance plans and 12.5 percent on Medicare. The CDC, which examined data from the 2014 National Health Interview Survey, published the findings in November. The CDC found that cigarette-smoking rates were higher among people who live below the poverty level (26.3 percent) and people with a GED certificate (40 percent). Overall, the prevalence of cigarette smoking among adults declined from 20.9 percent to 16.8 percent from 2005 to 2014, according to the CDC.

Southington Dentist Will Pay Settlement In Medicaid Fraud Case

A dentist will pay $55,000 to settle claims he defrauded the state’s Medicaid program, Attorney General George Jepsen announced Monday. Dr. Thomas DeRienzo, a licensed practicing dentist in Southington, will pay the money to settle civil healthcare fraud allegations that he submitted fake claims for Medicaid payments. Jepsen alleged that DeRienzo carried out a “long-term scheme” in which he submitted claims to the state Department of Social Services, which administers Connecticut’s Medicaid program, for dental services he did not provide to patients enrolled in the Connecticut Medical Assistance Program (CMAP).  CMAP, run by DSS, includes family, children’s and low-income Husky programs.

Jepsen accused DeRienzo of submitting claims to DSS for resin-based composite fillings that he never gave to CMAP patients. In addition to agreeing to pay $55,000 to resolve those allegations, DeRienzo has entered a separate agreement with DSS in which he is permanently barred from participating as a dentist in the CMAP, according to Jepsen.

Reached at his practice Monday, DeRienzo denied any wrongdoing.

Access Health Enrollment Starts Sunday; Uninsured To Face Steeper Fines

Open enrollment for consumers to buy health insurance through the Access Health CT marketplace begins Sunday, and 2016 will bring considerably steeper fines for consumers who lack insurance. Access Health CT (AHCT), now in its third year, enrolled close to 100,000 individuals in private insurance plans in its first two years, according to Andrea Ravitz, director of marketing. About 500,000 enrolled in Medicaid through AHCT, during the first two years. The marketplace aims to enroll between 105,000 and 115,000 in private plans by the end of open enrollment, Ravitz said. AHCT concentrated on attracting new enrollees its first two years but this year it has been focusing on retaining enrollees, she added.