Weekly Dose of Health News December 8 – 12 2014

There is little uniformity in the Affordable Care Act across states, as they have a great deal of discretion in plan design. Although health plans must adhere to a set of ten essential health benefits, there is little specificity attached to each benefit.

A new report describes the difficulty that Medicaid recipients have in accessing health care providers. Medicaid managed care plans provides lists of providers to enrollees. Investigators found that many on the list were not accepting Medicaid patients or were unavailable. This has implications for the millions of new Medicaid enrollees under the Affordable Care Act.

The Commonwealth Fund reports that employer health insurance premiums have slowed in growth between 2010 and 2013, following the implementation of the Affordable Care Act.

New York becomes the ninth state to require insurance coverage of gender reassignment surgery. Governor Cuomo sent a letter to the state’s health plans, requesting that they cover these procedures.

This opinion piece argues against homogenized health care in favor of more personalized medicine.

The legislative hearings calendar is still full of health-related items for the remainder of the year, including hearings on a single-payer health system and on the Office of Alcohol and Substance Abuse Service agency budget.

Governor Cuomo’s Ending the Epidemic Task Force is schedule to meet on Monday, December 15 in New York City. This is the fourth meeting, with the final scheduled for January 13 in Troy, New York. Prior meetings are archived here.

The November 24th Health Home and Managed Care working group meeting has archived materials here. Materials include information on the integration of dual eligibles (FIDA), managed long term care and behavioral health transition into managed care, as well as children’s health homes.

The L.A. Times writes that researchers have discovered a new class of laboratory-engineered stem cells, which may lead to more efficient stem cell reproduction.

The New York Times’ Upshot column discusses why many consumers will not shop around for new health insurance in state and federal exchanges, even though it pays to do so.

The temporary increase in fees for primary care providers under the Affordable Care Act, or Medicaid bump, is set to expire next year. The fee cut could mean a 50% reduction in payments for New York Medicaid providers.

The NYS Department of Health has posted several ‘white board’ presentations on the rollout of the program, which can be found here at the top of the page. The latest YouTube video, entitled ‘Final Tips’ can be found here.

New York’s FIDA demonstration is scheduled to begin in January 2015. For background information, please go to these two links: Western NY Law Center and

Memorandum of Understanding – CMS and NYS.