According to the New Jersey Hospital Association, 77 hospitals provided $1.3 billion in charity care and received $716 million in state reimbursements for the care. Over the last 15 years, hospitals have absorbed $6 billion in losses related to charity care. Gov. Jon Corzine (D) on June 30 signed a $32.9 billion fiscal year 2009 state budget that includes $605 million for charity care, a decrease of $111 million from last year.

The Web site for Muhlenberg Regional Medical Center — a Plainfield, N.J., hospital profiled by the Post and scheduled to be shuttered later this year — states, “The health care system in New Jersey is clearly broken,” and “hospitals that serve a high percentage of poor and uninsured cannot survive under these pressures.”

Some health care professionals say that the recent increase in ambulatory care centers in the state has led many insured patients to seek care outside of hospitals. A “wave” of undocumented immigrants “is another problem” because by law, they cannot apply for charity care, but hospitals are required by law to treat them, the Post reports. According to the Post, “[A]lmost everyone agrees that a key underlying problem is the lack of universal health insurance” (Richburg, Washington Post, 7/7).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

By: kaisernetwork.org – Mon, 07/07/2008 – 16:37

According to the Inquirer, Gov. Jon Corzine (D) has suggested that the move could help fund the expansion of public health programs, which both Corzine and the state Legislature support. The Inquirer reports that the value of the insurer in the open market — which Horizon President and CEO William Marino estimated at $1 billion — would go toward a charitable foundation that current law mandates would provide care for low-income residents. Marino in a conference call with reporters said, “We’re optimistic that the benefit of creating a foundation of $1 billion or more and the benefits that that can provide the underserved population — in other words, the good that that can do — will be easily understood.”

Marino said converting to a for-profit company would raise capital and allow for competition with other insurers. However, Michael Kornett, chief executive officer of the Medical Society of New Jersey, said, “The emphasis will go from patients and employers right to the shareholders.” He added, “Their whole mission is going to change.”

Horizon’s application will be reviewed by the state Department of Banking and Insurance, which is required to hold a series of public meetings on the plan. Marino said he hopes a decision will be handed down during the first half of 2009 (Tamari/Burling, Philadelphia Inquirer, 8/16).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

By: kaisernetwork.org – Tue, 08/19/2008 – 16:49

The legislation would prohibit insurance reimbursement for treatment related to 12 hospital-acquired conditions, including objects left inside a body during surgery, surgical-site infections, urinary tract infections from a catheter and receiving incompatible blood.

A separate proposal, sponsored by Moriarty and other Assembly members, would require the state Department of Health and Senior Services to release an annual report of preventable errors that occurred at individual health facilities. The bill also would allow patients to compare health care facilities in specific categories (Santi, AP/Bergen Record, 11/3).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

By: kaisernetwork.org – Tue, 11/04/2008 – 17:39

The consolidation, effective January 1, 2009, improves access to a wider range of in-home long-term supportive services for a greater number of seniors and adults with physical disabilities who meet the income, asset and nursing facility level of care requirements established by Medicaid. GO participants will have the options to hire and direct their own service providers.

The move to GO gives care managers greater flexibility in modifying individual care plans as needs and preferences change over time. It also simplifies administrative processes for federal, state and local officials.

“This approval is good news for New Jersey seniors, adults with disabilities and family caregivers who provide countless hours of care and comfort but sometimes need help to keep their loved ones at home,” said Governor Jon S. Corzine. “Through GO, these individuals will have easier access to important home and community-based services.”

DHSS has mailed letters to everyone enrolled in the current programs – including Assisted Living/Adult Family Care (AL/AFC), Caregiver Assistance Program (CAP) and Community Care Program for the Elderly and Disabled (CCPED) – explaining that the switch to GO will be automatic and seamless. These individuals do not need to complete new applications and the services they are currently receiving will continue. Nearly 10,200 people are currently receiving services through these programs.

Commissioner Howard called the approval “an important milestone in our drive to rebalance New Jersey’s long-term care system so that low-income seniors, adults with physical disabilities, and their caregivers have more options and more control over the services they need to remain safely in the community.”

“The move to GO is good for consumers and fiscally responsible for the State,” added Human Services Commissioner Velez, whose department oversees the Medicaid Program. “This change will allow more individuals to receive care in the community, an option that is more desirable for the consumer and less costly for the State than institutional care.”

Federal approval of GO furthers efforts initiated by Governor Corzine to make the state’s long-term care system more flexible and consumer-friendly. In 2006, he signed into law the Independence, Dignity and Choice in Long-Term Care Act that required, among other provisions, the rebalancing of Medicaid long-term care funding to improve support for in-home services.

GO is designed to supplement – not replace – the assistance already being provided by family, friends and neighbors. By providing a flexible package of services and supports, the new program strengthens the ability of caregivers to continue in their vital role as primary support providers.

GO participants work with a care manager to create an individualized plan of care based on a comprehensive assessment of the participant’s healthcare needs. Once the plan of care is approved, community-based services are put in place and monitored to ensure quality and effectiveness.

By: New Jersey Department Of Health – Wed, 01/07/2009 – 13:37

Governor Jon S. Corzine today sent a letter to President Bush vowing to continue to enroll New Jersey children in the popular State Health Insurance Program (SCHIP), FamilyCare, despite recent federal efforts to limit such enrollments. Corzine also said in his letter that he was prepared, if necessary, to pursue legal action to further the goal of protecting our most vulnerable children.

The text of the letter is below:

The Honorable George W. Bush
President
White House
1600 Pennsylvania Avenue
Washington, DC 20500

Dear Mr. President,

I write to express my grave concern regarding the Center for Medicare and Medicaid Services (CMS) August 17, 2007 letter, which would have the effect of denying health care coverage to as many as 10,000 children in New Jersey. We have provided health coverage to 122,000 children through our successful State Children’s Health Insurance Program (SCHIP), FamilyCare, and I am deeply concerned about the devastating impact that this misguided policy will have on our efforts to address the growing problem of the uninsured.

New Jersey has been at the forefront of enrolling children in the SCHIP program since its inception. Through the SCHIP program, we have been able to protect and improve the health of our most vulnerable children, who would otherwise have no access to quality medical care. Ensuring that children have this access to health insurance will give them a healthy start in life and reduce health care expenditures later in life. I have made children’s health a top priority, and in the last year and a half we have already enrolled over 100,000 additional children in both the Medicaid and SCHIP program.

In the letter, CMS indicates that you will deny State requests to extend eligibility under the State Children’s Health Insurance Program (SCHIP) to children in families with effective family income levels above 250 percent of the Federal poverty level (FPL). This is in direct opposition to the position that CMS has consistently taken in recent years. In fact, SCHIP was designed with bipartisan support to provide states with the tools and the flexibility to address the distinct needs of each of our populations. In New Jersey, where we face a high cost of living, this has allowed us to expand coverage up to 350% of poverty to insure more children in need since 1998. We have undertaken this coverage pursuant to multiple approvals from CMS – most recently just last year.

Although the letter purports to clarify existing requirements, the simple fact is that it sets forth entirely new and unreasonable conditions for the SCHIP program. Not only are these onerous conditions contrary to the existing statutory and regulatory framework, but there can be no doubt that the imposition of these conditions will curtail the ability of New Jersey to design and operate health care programs to best serve our children. Although the letter was issued under the guise of preserving employer sponsored insurance, the practical effect of the new policy would be that thousands of innocent children will lose or be denied health insurance coverage and will be forced to join the growing ranks of the uninsured.

The letter imposes specific conditions that would harm our children and that would make the administration of the program practically impossible, including:

the requirement that children lack coverage for at least one year before enrollment in the program without allowing any exceptions ” a harsh and unnecessarily long wait that is four times longer than our current "crowd out" requirement, which was approved by your CMS in November 2005; the condition that would bar the provision of coverage to children in families above 250 percent of the FPL, unless there has been less than a 2 percent decrease in employer-based coverage over the past five years – an unreasonable and unattainable requirement given the current negative national trend in employer-based coverage; and, the condition that SCHIP expansion is allowed only where the State has been able to enroll 95 percent of all eligible low-income children in SCHIP or Medicaid – a requirement that no state will be able to meet. These restrictions will effectively gut our successfully FamilyCare program and will only increase the ranks of the uninsured.

Since the conditions imposed by the letter contravene the fundamental objectives underlying SCHIP, violate the terms of its statutory and regulatory framework, and overstep CMS’s authority by altering regulations without utilizing appropriate procedural safeguards, New Jersey will continue to provide health care to children in families with income up to 350 percent of the FPL in accordance with terms of its State Plan Amendments and Waiver approved by the federal government in 1998, 2005 and 2006. We will vigorously continue our commitment to enrolling all children eligible for our current program.

I ask you to reconsider your position given the critical importance of this issue. Please also know that I am prepared, if necessary, to pursue legal action to further the goal of protecting our most vulnerable children.

Sincerely,

Jon S. Corzine

Cc: Health and Human Services Secretary Michael Leavitt

By: Government of New Jersey – Fri, 09/14/2007 – 14:48

Under the program, families would pay monthly health insurance premiums toHorizon at the same rate paid by those who qualify for FamilyCare, the state’s version of SCHIP (Chen, New York Times, 12/20). Families withone child would pay $137 per month, families with two children would pay $274per month and those with three or more children would pay $411 per month. Bycomparison, a parent would pay $400 per month per child for coverage under theSmall Employer Health Insurance administered through the state Department of Banking and Insurance, according to state Sen. Joseph Vitale (D).The program would not provide health coverage for adults (Livio, Newark Star-Ledger, 12/19).

The program requires that families with more than one child enroll all of theirchildren in the plan. In addition, families must provide proof that theirchildren were uninsured during the previous six months (New York Times,12/19). Between 50,000 and 60,000 children would be eligible for the program,according to Vitale. A Rutgers University study indicated that about 15,000children would enroll, according to state Department of Human Services Commissioner Jennifer Velez (Tamari, Gannett/AsburyPark Press,12/20).

Horizon President and CEO Karen Clark said the company will absorb the cost ofthe program, which she estimated to be up to $1 million in the first year (NewYork Times, 12/20). Horizon spokesperson Tom Rubino said, "We’vegone into this to work with the state to reduce the number of the uninsured.We’re going to be meeting with the state about the progress of the plan, andthe ultimate goal is to make it break even" (McCoy, PhiladelphiaInquirer,12/20). Horizon will begin accepting applications in January 2008 (Newark Star-Ledger,12/19).

According to the Times, the program "sets the stage" fora universal health coverage plan for all state residents that would be phasedin over several years, which Corzine and Vitale said could be unveiled as earlyas next month (New York Times, 12/20).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser FamilyFoundation. All rights reserved.

By: kaisernetwork.org – Thu, 12/20/2007 – 18:38

Gov. Jon Corzine (D) lastsummer set aside $10 million in state funds to pay for the increases,and the state will receive an additional $10 million in matchingfederal funds. State Human Services Commissioner Jennifer Velez in astatement said that the rate increases are a %26quot;big step toward providingmore access for our clients,%26quot; adding, %26quot;These new rates will benefitexisting Medicaid providers%26quot; and attract new providers.

An April 2007 study by Public Citizen’s Health Research Groupfound that New Jersey provided the lowest Medicaid reimbursements ofall the states, although the analysis included adult and childservices. State Department of Human Servicespokesperson Suzanne Esterman said, "Hopefully, this will place NewJersey in a much higher standing than we have been" (Johnson, AP/LongIsland Newsday, 1/2).

Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report ispublished for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation. 2007 Advisory Board Companyand Kaiser Family Foundation. All rights reserved.

By: kaisernetwork.org – Fri, 01/04/2008 – 17:55

Members of the New Jersey Senate Budget Committee during a meeting on Mondayasked the state to explain proposed changes. Opponents of the copays, includingsome lawmakers and an advocacy group, testified that the proposal would causesome beneficiaries who cannot afford the fees to forgo care. Velez said,%26quot;I do think it’s a valid concern; I couldn’t tell you that it’s not%26quot;(Reitmeyer, Bergen Record,4/28).

Meanwhile, Corzine on Tuesday planned to meet with the New Jersey Hospital Association to discuss a proposed 14% cut in funding forhospitals. The association argues that the funding cuts could result in 26hospitals losing all state funding and could reduce funding for 37 additionalhospitals. Overall, Corzine has proposed $2.7 billion in budget cuts for FY2009 (AP/Newark Star-Ledger, 4/29).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser FamilyFoundation. All rights reserved.

By: kaisernetwork.org – Wed, 04/30/2008 – 17:15