Kentucky Spirit can't terminate its Medicaid contract with the state a year early without facing fines, judge rules

By Molly Burchett
Kentucky Health News

A Frankfort circuit judge ruled Friday that Kentucky Spirit, one of three companies hired by the state in November 2011 to manage health care for more than 540,000 Medicaid recipients, cannot pull out of its contract with the state a year early with no financial penalty.

Kentucky Spirit, a subsidiary of St. Louis-based Centene Corp., announced in October 2012 that it was pulling out of Kentucky's managed-care system because it was losing money, but the company could face fines if it terminates its three-year contract before expiration in July 2014, Franklin Circuit Judge Thomas Wingate said in his ruling.

Kentucky Spirit argued in its lawsuit that the state rushed to privatize Medicaid in 2011 and provided incorrect cost information to the bidders, causing the firm to lose about $120 million. It made the lowest bid, and on average, gets about $100 less per month for each patient than the other two MCOs, Coventry Cares and WellCare.

The Cabinet for Health and Family Services replied that Kentucky Spirit had breached its contract with the state. Wingate said it had not, because it gave notice of early termination, but it will be subject to fines if it pulls out of the state before July 2014, reports Beth Musgrave of the Lexington Herald-Leader.

Kentucky Spirit had argued that its contract allows it to to be terminated with six months notice. The six-month provision could only be interpreted to mean six months prior to the end of the three-year contract, said Wingate, because there has to be enough time for the state to move hundreds of thousands of Medicaid patients from Kentucky Spirit to another managed-care provider.

Jill Midkiff, a spokeswoman for the cabinet, told Musgrave that state officials were thrilled with Wingate's decision. "The cabinet's priorities are the members who receive health care through Medicaid and the taxpayers who pay for the program," she told Musgrave. "This is the right decision for both."

Friday's decision came three days after another Franklin Circuit Court judge ruled that Kentucky Spirit must reimburse health departments for services provided by school nurses to Medicaid-eligible children, which is estimated include about $8 million in back payments.

Centene officials say they are considering options for both cases, which include appeals.

Kentucky Spirit's legal battles are part of ongoing tensions between health-care providers and managed-care companies, and providers have repeatedly complained that the companies are delaying payments for services. The cabinet is hosting a series of forums across the state designed to help providers resolve such issues with the managed care companies.

By Molly Burchett
Kentucky Health News

A Frankfort circuit judge ruled Friday that Kentucky Spirit, one of three companies hired by the state in November 2011 to manage health care for more than 540,000 Medicaid recipients, cannot pull out of its contract with the state a year early with no financial penalty.

Kentucky Spirit, a subsidiary of St. Louis-based Centene Corp., announced in October 2012 that it was pulling out of Kentucky's managed-care system because it was losing money, but the company could face fines if it terminates its three-year contract before expiration in July 2014, Franklin Circuit Judge Thomas Wingate said in his ruling.

Kentucky Spirit argued in its lawsuit that the state rushed to privatize Medicaid in 2011 and provided incorrect cost information to the bidders, causing the firm to lose about $120 million. It made the lowest bid, and on average, gets about $100 less per month for each patient than the other two MCOs, Coventry Cares and WellCare.

The Cabinet for Health and Family Services replied that Kentucky Spirit had breached its contract with the state. Wingate said it had not, because it gave notice of early termination, but it will be subject to fines if it pulls out of the state before July 2014, reports Beth Musgrave of the Lexington Herald-Leader.

Kentucky Spirit had argued that its contract allows it to to be terminated with six months notice. The six-month provision could only be interpreted to mean six months prior to the end of the three-year contract, said Wingate, because there has to be enough time for the state to move hundreds of thousands of Medicaid patients from Kentucky Spirit to another managed-care provider.

Jill Midkiff, a spokeswoman for the cabinet, told Musgrave that state officials were thrilled with Wingate's decision. "The cabinet's priorities are the members who receive health care through Medicaid and the taxpayers who pay for the program," she told Musgrave. "This is the right decision for both."

Friday's decision came three days after another Franklin Circuit Court judge ruled that Kentucky Spirit must reimburse health departments for services provided by school nurses to Medicaid-eligible children, which is estimated include about $8 million in back payments.

Centene officials say they are considering options for both cases, which include appeals.

Kentucky Spirit's legal battles are part of ongoing tensions between health-care providers and managed-care companies, and providers have repeatedly complained that the companies are delaying payments for services. The cabinet is hosting a series of forums across the state designed to help providers resolve such issues with the managed care companies.

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Judge orders Medicaid managed-care firm to pay for school health services, including $8 million in claims; appeal possible

Medicaid managed care company Kentucky Spirit must cover preventive care services provided by local health departments in schools, a judge has ruled.

Circuit Judge Phillip Shepherd of Frankfort said the company must pay $8 million for the services already provided by school nurses, which would be only .07 percent of its estimated profit for 2013, according to the updated earnings report of Centene Corp. of St. Louis, the parent company for Kentucky Spirit. The company is the only one of the five managed care organizations in Kentucky  that had disputed the coverage of school health services.

Kentucky Spirit stopped providing coverage for school health services last summer, saying its state contract didn't require payment for such services,but Shepherd noted that the state reimbursed health departments for school services before it transitioned to managed care, reports Tom Loftus of The Courier-Journal. “Kentucky Spirit is not free to disregard this longstanding interpretation of Medicaid eligibility and unilaterally re-interpret these to the detriment of local health departments,” Shepherd wrote.

Health departments and school districts will now find some relief because many school nurse programs were threatened by cutbacks and closings as a result of Kentucky Spirits failure to pay for services. “It’s great news because there have been dozens of districts that have had to either say they are going to cut back on nurses, or that they are going to close clinics, or that they are going to dip into their reserves to try to cover the additional costs,” Kentucky School Boards Association spokesman Brad Hughes told Loftus.

Gov. Steve Beshear said Kentucky Spirit had “sought a loophole” in its contract to avoid paying for school health services covered by Medicaid, writes Loftus. Centene released a statement later Tuesday saying that the company is reviewing options and considering an appeal.

This isn't the only payment Centene is trying to avoid. A ruling is expected soon in a lawsuit the company filed against the state last year seeking to end its contract a year early, saying the state rushed to privatize Medicaid in 2011 and provided incorrect cost information to the bidders, causing the firm to lose about $120 million.

Appalachian Regional Healthcare, the largest health-care system in Eastern Kentucky, filed suit in April of this year against Kentucky Spirit for $5.9 million in unpaid claims. This suit is still pending, and was filed just before Centene raised its full-year forecast for premium and service revenue to $10.1 billion to $10.4 billion, Reuters reports.

Medicaid managed care company Kentucky Spirit must cover preventive care services provided by local health departments in schools, a judge has ruled.

Circuit Judge Phillip Shepherd of Frankfort said the company must pay $8 million for the services already provided by school nurses, which would be only .07 percent of its estimated profit for 2013, according to the updated earnings report of Centene Corp. of St. Louis, the parent company for Kentucky Spirit. The company is the only one of the five managed care organizations in Kentucky  that had disputed the coverage of school health services.

Kentucky Spirit stopped providing coverage for school health services last summer, saying its state contract didn't require payment for such services,but Shepherd noted that the state reimbursed health departments for school services before it transitioned to managed care, reports Tom Loftus of The Courier-Journal. “Kentucky Spirit is not free to disregard this longstanding interpretation of Medicaid eligibility and unilaterally re-interpret these to the detriment of local health departments,” Shepherd wrote.

Health departments and school districts will now find some relief because many school nurse programs were threatened by cutbacks and closings as a result of Kentucky Spirits failure to pay for services. “It’s great news because there have been dozens of districts that have had to either say they are going to cut back on nurses, or that they are going to close clinics, or that they are going to dip into their reserves to try to cover the additional costs,” Kentucky School Boards Association spokesman Brad Hughes told Loftus.

Gov. Steve Beshear said Kentucky Spirit had “sought a loophole” in its contract to avoid paying for school health services covered by Medicaid, writes Loftus. Centene released a statement later Tuesday saying that the company is reviewing options and considering an appeal.

This isn't the only payment Centene is trying to avoid. A ruling is expected soon in a lawsuit the company filed against the state last year seeking to end its contract a year early, saying the state rushed to privatize Medicaid in 2011 and provided incorrect cost information to the bidders, causing the firm to lose about $120 million.

Appalachian Regional Healthcare, the largest health-care system in Eastern Kentucky, filed suit in April of this year against Kentucky Spirit for $5.9 million in unpaid claims. This suit is still pending, and was filed just before Centene raised its full-year forecast for premium and service revenue to $10.1 billion to $10.4 billion, Reuters reports.

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Nursing homes push for lawsuit protection with fast-moving bill and broadcast ads; newspaper editorials excoriate sponsor, industry

A state Senate committee has approved a bill that would require lawsuits against nursing homes to clear a review panel before going to court, a move that has drawn very sharp criticism from the editorial pages of the state's two largest newspapers. Meanwhile, the nursing-home industry is running television and radio ads urging calls to legislators in favor of the measure, which the Senate Health and Welfare Committee approved 7-4 last Wednesday without hearing from its opponents.

"Slimy action on questionable bill" read the headline over Tuesday's Lexington Herald-Leader's editorial, which began, "Good ideas can withstand criticism. So, when lawmakers move a piece of legislation without hearing from any of its opponents, you have to wonder whether they're sneaking through a stinker."

The chairman of the committee and the bill's sponsor, Sen. Julie Denton, R-Louisville, said some members had to leave for other meetings. "But somehow they had time to listen to industry spokesmen before voting," the Herald-Leader noted. "The nursing home industry claims that it is under siege from frivolous lawsuits drummed up by attorneys advertising for clients and that this legal threat pushes up nursing homes' insurance and legal costs, taking money that otherwise could go into patient care." (Read more)

The Courier-Journal editorial, which first reported the committee's action, accused Denton of "a brazen abuse of her power as committee chairman" and said sarcastically that she was "humane" to spare members of he committee "the ugly details of nursing home neglect and abuse. . . . Why should members, before lunch, have to consider graphic testimony about bedsores, near-starvation, dehydration and bowel obstructions suffered by elderly, helpless people? But for members of the General Assembly who are interested in the facts, here are some:

• Kentucky currently has about 23,000, mostly frail, elderly people who are residents in about 280 nursing homes. About half the homes have been cited by federal inspectors for a serious deficiency since 2009.
• 40 percent of the homes are rated at below average by the U.S. Center for Medicare and Medicaid Services when it comes to basic health and safety.
• In 2012, Kentucky ranked first in overall federal fines for violations and one Kentucky nursing home racked up the nation’s highest fines for the year.
• Kentucky ranks first in serious nursing home deficiencies that threaten the safety of residents. (Read more)

Sen. Ray Jones, D-Pikeville, who called Denton's move "blatantly wrong." has filed several floor amendments to the bill, which remained in the Senate Rules Committee Monday.

The Kentucky Association of Health Care Facilities is pushing the bill with TV and radio commercials urging calls to legislators. It placed $9,464 worth of ads on Lexington TV stations through Feb. 14.

A state Senate committee has approved a bill that would require lawsuits against nursing homes to clear a review panel before going to court, a move that has drawn very sharp criticism from the editorial pages of the state's two largest newspapers. Meanwhile, the nursing-home industry is running television and radio ads urging calls to legislators in favor of the measure, which the Senate Health and Welfare Committee approved 7-4 last Wednesday without hearing from its opponents.

"Slimy action on questionable bill" read the headline over Tuesday's Lexington Herald-Leader's editorial, which began, "Good ideas can withstand criticism. So, when lawmakers move a piece of legislation without hearing from any of its opponents, you have to wonder whether they're sneaking through a stinker."

The chairman of the committee and the bill's sponsor, Sen. Julie Denton, R-Louisville, said some members had to leave for other meetings. "But somehow they had time to listen to industry spokesmen before voting," the Herald-Leader noted. "The nursing home industry claims that it is under siege from frivolous lawsuits drummed up by attorneys advertising for clients and that this legal threat pushes up nursing homes' insurance and legal costs, taking money that otherwise could go into patient care." (Read more)

The Courier-Journal editorial, which first reported the committee's action, accused Denton of "a brazen abuse of her power as committee chairman" and said sarcastically that she was "humane" to spare members of he committee "the ugly details of nursing home neglect and abuse. . . . Why should members, before lunch, have to consider graphic testimony about bedsores, near-starvation, dehydration and bowel obstructions suffered by elderly, helpless people? But for members of the General Assembly who are interested in the facts, here are some:

• Kentucky currently has about 23,000, mostly frail, elderly people who are residents in about 280 nursing homes. About half the homes have been cited by federal inspectors for a serious deficiency since 2009.
• 40 percent of the homes are rated at below average by the U.S. Center for Medicare and Medicaid Services when it comes to basic health and safety.
• In 2012, Kentucky ranked first in overall federal fines for violations and one Kentucky nursing home racked up the nation’s highest fines for the year.
• Kentucky ranks first in serious nursing home deficiencies that threaten the safety of residents. (Read more)

Sen. Ray Jones, D-Pikeville, who called Denton's move "blatantly wrong." has filed several floor amendments to the bill, which remained in the Senate Rules Committee Monday.

The Kentucky Association of Health Care Facilities is pushing the bill with TV and radio commercials urging calls to legislators. It placed $9,464 worth of ads on Lexington TV stations through Feb. 14.

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Pike court will keep lawsuit county and attorney general filed against Purdue Pharma over damage done by its OxyContin

A state court will hear the Kentucky attorney general's 2007 lawsuit against OxyContin manufacturer Purdue Pharma, against the wishes of the company. The U.S. Court of Appeals for the 2nd Circuit affirmed a lower court's order returning the suit to Kentucky from New York's Southern District, where Purdue wanted the case heard. The suit was filed in Pike Circuit Court, in Kentucky's easternmost county.

"After years of delay tactics, Purdue will now answer to a Kentucky court and a Kentucky jury," Attorney General Jack Conway said. Purdue Pharma spokeswoman Libby Holman said the company is disappointed by the decision, but now it is "fully prepared to vigorously defend this action on its merits, and we expect to prevail."

Then-AG Greg Stumbo and Pike County sued Purdue Pharma in October 2007, alleging that the company's "aggressive and deceptive marketing campaign saddled taxpayers with millions of dollars in social, health care and other costs," Laura Ungar of The Courier-Journal in Louisville reports. The suit also alleges the company misled health-care providers, consumers and the government about the highly addictive nature of OxyContin. The suit is largely based on admissions of guilt made by the company and several top-ranking company officials in a May 2007 Virginia federal court settlement. Purdue Pharma, its president, chief legal counsel and former medical director pleaded guilty to misleading doctors, regulators and patients about OxyContin during that case.

The nation's prescription-drug epidemic apparently began in the region, largely because of the introduction and high rate of prescription of OxyContin. Kentucky has nearly 1,000 overdose deaths a year. Conway's office said the suit against Purdue Pharma seeks reimbursement for drug-abuse programs, law-enforcement actions and prescription payments through Medicaid and the Kentucky Pharmaceutical Alliance Program. (Read more)

A state court will hear the Kentucky attorney general's 2007 lawsuit against OxyContin manufacturer Purdue Pharma, against the wishes of the company. The U.S. Court of Appeals for the 2nd Circuit affirmed a lower court's order returning the suit to Kentucky from New York's Southern District, where Purdue wanted the case heard. The suit was filed in Pike Circuit Court, in Kentucky's easternmost county.

"After years of delay tactics, Purdue will now answer to a Kentucky court and a Kentucky jury," Attorney General Jack Conway said. Purdue Pharma spokeswoman Libby Holman said the company is disappointed by the decision, but now it is "fully prepared to vigorously defend this action on its merits, and we expect to prevail."

Then-AG Greg Stumbo and Pike County sued Purdue Pharma in October 2007, alleging that the company's "aggressive and deceptive marketing campaign saddled taxpayers with millions of dollars in social, health care and other costs," Laura Ungar of The Courier-Journal in Louisville reports. The suit also alleges the company misled health-care providers, consumers and the government about the highly addictive nature of OxyContin. The suit is largely based on admissions of guilt made by the company and several top-ranking company officials in a May 2007 Virginia federal court settlement. Purdue Pharma, its president, chief legal counsel and former medical director pleaded guilty to misleading doctors, regulators and patients about OxyContin during that case.

The nation's prescription-drug epidemic apparently began in the region, largely because of the introduction and high rate of prescription of OxyContin. Kentucky has nearly 1,000 overdose deaths a year. Conway's office said the suit against Purdue Pharma seeks reimbursement for drug-abuse programs, law-enforcement actions and prescription payments through Medicaid and the Kentucky Pharmaceutical Alliance Program. (Read more)

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Judge rules University of Louisville's hospital is public and subject to Open Records Act; it may appeal

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

The University of Louisville's hospital is a public entity, a Jefferson Circuit Court judge has ruled in a lawsuit filed to get access to the university's deals with other health providers.

Judge Martin McDonald ruled yesterday in favor of The Courier-Journal, WHAS-TV and the American Civil Liberties Union, noting that the university makes or approves all appointments to University Hospital's board of directors. The university had argued that the board, and thus the hospital, was not a public agency under the state Open Records Act.

The hospital said it might appeal the ruling. McDonald gave it 30 days to give him the records being sought, along with arguments about why they should be exempt" under exceptions to the law, reports The C-J's Andrew Wolfson. "He gave the news organizations at the ACLU 20 days to respond to any claimed exemptions." The hospital has said revealing contracts would put it at a competitive disadvantage.

The suit began after the university refused to let the plaintiffs see records related to its proposed merger with Jewish Hospital & St. Mary's HealthCare and Lexington-based St. Joseph Health Care System. Gov. Steve Beshear vetoed the merger on grounds that a public hospital should not be bound by a religious organization's health-care policies. This month the hospital announced a new deal with KentuckyOne Health, which includes the faith-based entities, but said reproductive services would not be affected despite a policy of "respect" for Catholic health directives. (Read more)

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Suit alleging unnecessary procedures at London hospital is the 31st by plaintiff's attorney in past year

More than 300 former heart patients at the Saint Joseph London hospital have sued it, its cardiologists and agencies involved with its operation and billing services, alleging the patients were subjected to unnecessary medical procedures.

"The lawsuit was filed by Louisville attorney Hans Poppe, who has previously filed similar lawsuits," 30 in the past year, Nita Johnson reports for The Sentinel-Echo of London. "This last lawsuit is a compilation of 339 cases that Poppe has had investigated."

Claims in a lawsuit state only one side of a case. A hospital spokesman said, "We are aware of the lawsuits and take the allegations seriously, but we cannot comment any further on pending litigation." (Read more)

More than 300 former heart patients at the Saint Joseph London hospital have sued it, its cardiologists and agencies involved with its operation and billing services, alleging the patients were subjected to unnecessary medical procedures.

"The lawsuit was filed by Louisville attorney Hans Poppe, who has previously filed similar lawsuits," 30 in the past year, Nita Johnson reports for The Sentinel-Echo of London. "This last lawsuit is a compilation of 339 cases that Poppe has had investigated."

Claims in a lawsuit state only one side of a case. A hospital spokesman said, "We are aware of the lawsuits and take the allegations seriously, but we cannot comment any further on pending litigation." (Read more)

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Beshear to have outside panel review cases of children killed or life-threatened by abuse

An independent panel of experts will review cases of children who have been killed or severely hurt by child abuse or neglect, Gov. Steve Beshear announced Monday. The panel will have 17 members and be based in the Justice and Public Safety Cabinet. Its aim will be to assess if the state's child-protection workers did all they could to protect children who died as a result of abuse. It will also determine causes of death.

The Cabinet for Health and Family Services "released thousands of pages of documents Monday that detail the state's involvement with dozens of children who were killed or nearly killed as a result of abuse of neglect," reports Beth Musgrave for the Lexington Herald-Leader. "Still, the cabinet continues to withhold some case files and has redacted large portions of others."

The release is the result of a lengthy court battle between the cabinet and the state's two largest newspapers, the Herald-Leader and The Courier-Journal. The newspapers argued documents pertaining to these cases were subject to open record laws and Franklin Circuit Court Judge Phillip Shepherd agreed. The cabinet released 76 of about 140 files, but with key information omitted. In February, Shepherd ruled the cabinet had 90 days to hand over remaining case files, fined the cabinet $16,000 for withholding the records and ordered it to pay $57,000 in attorney fees for the newspapers.

The cabinet appealed the ruling in the Court of Appeals, but on July 9, the court sided with the newspapers, refusing to allow the documents from being withheld. More than 40 similarily-redacted cases were released yesterday but the cabinet filed an appeal with the Kentucky Supreme Court. "We disagree on how much personal information about the children and private individuals included in caseworker files should be made public," Cabinet Secretary Audrey Haynes said.

Also yesterday, Beshear issued an order to create the panel, which will meet four times a year and will issue an annual report that details issues it finds. "When a child dies or is critically injured because of abuse or neglect, we must carefully review the practices of all government entitites involved to make sure that our system performed as it was supposed to — and if not, that review allows us to take disciplinary action," Beshear said.

Panel members will include law enforcement, prosecutors and medical experts, Musgrave reports. While the meetings will be open to the public, the records consulted during them will not be subject to open records laws. (Read more)

An independent panel of experts will review cases of children who have been killed or severely hurt by child abuse or neglect, Gov. Steve Beshear announced Monday. The panel will have 17 members and be based in the Justice and Public Safety Cabinet. Its aim will be to assess if the state's child-protection workers did all they could to protect children who died as a result of abuse. It will also determine causes of death.

The Cabinet for Health and Family Services "released thousands of pages of documents Monday that detail the state's involvement with dozens of children who were killed or nearly killed as a result of abuse of neglect," reports Beth Musgrave for the Lexington Herald-Leader. "Still, the cabinet continues to withhold some case files and has redacted large portions of others."

The release is the result of a lengthy court battle between the cabinet and the state's two largest newspapers, the Herald-Leader and The Courier-Journal. The newspapers argued documents pertaining to these cases were subject to open record laws and Franklin Circuit Court Judge Phillip Shepherd agreed. The cabinet released 76 of about 140 files, but with key information omitted. In February, Shepherd ruled the cabinet had 90 days to hand over remaining case files, fined the cabinet $16,000 for withholding the records and ordered it to pay $57,000 in attorney fees for the newspapers.

The cabinet appealed the ruling in the Court of Appeals, but on July 9, the court sided with the newspapers, refusing to allow the documents from being withheld. More than 40 similarily-redacted cases were released yesterday but the cabinet filed an appeal with the Kentucky Supreme Court. "We disagree on how much personal information about the children and private individuals included in caseworker files should be made public," Cabinet Secretary Audrey Haynes said.

Also yesterday, Beshear issued an order to create the panel, which will meet four times a year and will issue an annual report that details issues it finds. "When a child dies or is critically injured because of abuse or neglect, we must carefully review the practices of all government entitites involved to make sure that our system performed as it was supposed to — and if not, that review allows us to take disciplinary action," Beshear said.

Panel members will include law enforcement, prosecutors and medical experts, Musgrave reports. While the meetings will be open to the public, the records consulted during them will not be subject to open records laws. (Read more)

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Work of UK prof was cited in decision on health care

Professor Nicole Huberfeld.
University of Kentucky photo.

The work of a University of Kentucky law professor helped shape the U.S. Supreme Court's ruling on the constitutionality of the federal health-care reform law. 

Two of the major issues in question was whether the government could be force people to buy health insurance — often referred to as the individual mandate — and if the federal government could use its fiscal powers top make states expand Medicaid eligibility to 133 percent of the federal poverty level. The mandate was upheld, as was the Medicaid expansion, though the ruling will allow states to choose whether or not they want to expand their programs.

Justice Ruth Bader Ginsburg cited the work of UK professor Nicole Huberfeld "in a portion of her concurring opinion dealing with the expansion of Medicaid," reports Brian Powers for Business Lexington. In her work, Huberfeld has focused on the program for the poor and disabled and had researched "the intersection of constitutional law and health-care law," Powers reports.

When Huberfeld was told her work had been cited she said it was "amazing," as well as "thrilling ... humbling." She added, "We sometimes feel that we perform our research and publish it and get it out there, and to know that someone is actually reading it is really gratifying. When you write, you hope that someone reads your research." (Read more)

Professor Nicole Huberfeld.
University of Kentucky photo.

The work of a University of Kentucky law professor helped shape the U.S. Supreme Court's ruling on the constitutionality of the federal health-care reform law. 

Two of the major issues in question was whether the government could be force people to buy health insurance — often referred to as the individual mandate — and if the federal government could use its fiscal powers top make states expand Medicaid eligibility to 133 percent of the federal poverty level. The mandate was upheld, as was the Medicaid expansion, though the ruling will allow states to choose whether or not they want to expand their programs.

Justice Ruth Bader Ginsburg cited the work of UK professor Nicole Huberfeld "in a portion of her concurring opinion dealing with the expansion of Medicaid," reports Brian Powers for Business Lexington. In her work, Huberfeld has focused on the program for the poor and disabled and had researched "the intersection of constitutional law and health-care law," Powers reports.

When Huberfeld was told her work had been cited she said it was "amazing," as well as "thrilling ... humbling." She added, "We sometimes feel that we perform our research and publish it and get it out there, and to know that someone is actually reading it is really gratifying. When you write, you hope that someone reads your research." (Read more)

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State takes Medicaid contractor Coventry's side at hearing over dispute with Appalachian Regional Healthcare

"Appalachian Regional Healthcare argued for a federal injunction against Medicaid contractor Coventry Cares on Tuesday as negotiations for a new agreement between the two have stalled," reports Mike Wynn of The Courier-Journal.

At a hearing before District Judge Karl Forester, "Witnesses for ARH testified that Coventry will no longer provide an adequate network of hospitals and doctors if a contract is not renewed with ARH, which operates eight hospitals and additional clinics in the area. But Coventry and the state Cabinet for Health and Family Services dispute those claims and called witnesses to defend Coventry’s network of health care providers." (Read more)

Forester asked ARH and Coventry to submit proposed findings by tomorrow, reports Valarie Honeycutt Spears of the Lexington Herald-Leader, giving the case background: "After Coventry said it would sever its contract with ARH, the hospital company filed a lawsuit in U.S. District Court in Lexington. Coventry agreed to continue its contract until June 30 while renegotiating for long-term coverage." (Read more)

"Appalachian Regional Healthcare argued for a federal injunction against Medicaid contractor Coventry Cares on Tuesday as negotiations for a new agreement between the two have stalled," reports Mike Wynn of The Courier-Journal.

At a hearing before District Judge Karl Forester, "Witnesses for ARH testified that Coventry will no longer provide an adequate network of hospitals and doctors if a contract is not renewed with ARH, which operates eight hospitals and additional clinics in the area. But Coventry and the state Cabinet for Health and Family Services dispute those claims and called witnesses to defend Coventry’s network of health care providers." (Read more)

Forester asked ARH and Coventry to submit proposed findings by tomorrow, reports Valarie Honeycutt Spears of the Lexington Herald-Leader, giving the case background: "After Coventry said it would sever its contract with ARH, the hospital company filed a lawsuit in U.S. District Court in Lexington. Coventry agreed to continue its contract until June 30 while renegotiating for long-term coverage." (Read more)

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New law will allow officers to make arrests in emergency-room assaults that they do not witness

Emergency-room workers who treat individuals under the influence of drugs or alcohol will have greater legal protection, and those who misbehave in ERs will have less protection, under a law that will take effect next month.

The measure, sponsored by Sen. John Schickel, R-Union, will allow peace officers to make an arrest or issue a citation for a fourth-degree assault that occurs in a hospital emergency room, even if the officer didn’t witness the crime, as long as the officer has probable cause to believe the offense occurred.

“Hospital emergency personnel treat individuals in the worst of conditions – and sometimes that means putting themselves at risk, if a patient comes in intoxicated or high,” Gov. Steve Beshear said at a ceremonial signing of the bill today.  “This law gives medical staff the security of knowing that an offender will be held accountable for an assault that takes place when they’re brought in for care.”

Under current law, a hospital worker has to swear out a warrant alleging assault. Fourth-degree assault is a Class A misdemeanor, punishable by up to a year in jail.

Emergency-room workers who treat individuals under the influence of drugs or alcohol will have greater legal protection, and those who misbehave in ERs will have less protection, under a law that will take effect next month.

The measure, sponsored by Sen. John Schickel, R-Union, will allow peace officers to make an arrest or issue a citation for a fourth-degree assault that occurs in a hospital emergency room, even if the officer didn’t witness the crime, as long as the officer has probable cause to believe the offense occurred.

“Hospital emergency personnel treat individuals in the worst of conditions – and sometimes that means putting themselves at risk, if a patient comes in intoxicated or high,” Gov. Steve Beshear said at a ceremonial signing of the bill today.  “This law gives medical staff the security of knowing that an offender will be held accountable for an assault that takes place when they’re brought in for care.”

Under current law, a hospital worker has to swear out a warrant alleging assault. Fourth-degree assault is a Class A misdemeanor, punishable by up to a year in jail.

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