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Health Care to Be Focus of Session, Manchin Wants Medical Providers to Simplify Billing

Posted on: Saturday, 31 December 2005, 00:00 CST

By JENNIFER BUNDY, THE ASSOCIATED PRESS

Gov. Joe Manchin throws up his hands and says although his hernia surgery was eight months ago, he still doesn't know how much it cost.

He received bills for months and then a refund for an overpayment - even though he paid the amount he was billed.

Mechanics charge for parts and labor in one bill. When contractors erect buildings they provide single statements even if they subcontract work, he argues.

Now, Manchin wants the health care industry to do the same.

The state - through Medicaid, workers' compensation and the Public Employees Insurance Agency, among others - is the largest client of health care services in West Virginia.

If a law required medical providers to simplify billing for those agencies, it would probably simplify it for everyone, said House Health and Human Resources Chairman Don Perdue, D-Wayne.

"It's something the hospitals are going to go nuts over," Perdue said. "That will be a contentious issue."

Manchin and lawmakers say they expect health care issues to dominate the 2006 legislative session, which begins Jan. 11. Other issues expected to be debated include creating a low-cost insurance plan for uninsured adults, measures to curtail child abuse and the creation of a state mental health plan.

Manchin said he has been working with the Affordable Insurance Workgroup, which was established by former Gov. Bob Wise, on ways to improve insurance coverage for working adults. The federal government and states have been trying for years to do that, he noted.

"This little state can step forward and say 'We're going to start somewhere.' We're going to have a product," Manchin said in a recent interview with The Associated Press.

The Affordable Insurance Workgroup has recommended the state offer a simple insurance plan targeting the 58,600 West Virginia adults under 65 whose household income is less than $30,000 a year.

The plan's premium would be up to $150 a month. People could chose from a basic plan that offers most standard insurance coverage or one that offers only preventive and primary care coverage, plus a small amount of hospital and outpatient coverage.

The group also wants to launch a three-year pilot program what would expand preventive and primary care services and encourage people to establish a "medical home." The program would be limited to primary care available at a clinic or doctor's office and would not cover specialists or hospital care.

Critics are already lining up even before the proposals have been written into legislation.

A group of health maintenance organizations operating in West Virginia thinks it can provide low-cost, basic health insurance that is cheaper and better than a state-managed plan.

Manchin also likely will propose, as part of larger purchasing reform legislation, a plan to allow the state to enter into multistate drug pacts to receive better prices on prescription drugs, said Manchin spokeswoman Lara Ramsburg.

Perdue and Senate Health and Human Resources Chairman Roman Prezioso, D-Marion, said other health care issues expected to be discussed during the session that starts Jan. 11 include:

* A Manchin initiative to eliminate the sale of junk food in public schools.

* Helping senior citizens understand their Medicare drug coverage options.

* Expanding a pilot project to reduce the number of children in out-of-state treatment centers.

* Monitoring federal cuts to Medicaid and other social service programs.

* Improving the use of electronic data systems for medical record keeping.

Legislative interim committees also have discussed four possible bills targeting child abuse.

One would extend the definition of child abuse to include a pregnant woman's abuse of drugs or alcohol. Another would create a registry of child abusers, a third would create a special State Police unit to aid child abuse investigations, and a fourth would strengthen the ombudsman's office that resolves disputes between families and the Department of Health and Human Resources.

The House Health and Human Resources Committee also will work to establish a committee to write a state mental health plan, said Delegate Barbara Hatfield, D-Kanawha.

Source: Charleston Daily Mail

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