Chicago-based Accretive Health has agreed to pay $2.5 million to settle charges with the Minnesota Attorney General that it pressured patients to pay for care prior to its delivery, reported the Chicago Tribune.

Accretive also will wind down operations in Minnesota within the next 90 days. The debt collector it is barred from doing business in the state for the next two years, and will need legal permission to reenter the Minnesota market for four years after that, according to the New York Times.

"A hospital emergency room is a place of medical trauma and emotional suffering for patients and their families. It should be a solemn place, not a place for a financial shakedown of patients," State Attorney General Lori Swanson told the Tribune.

Although Accretive repeatedly asserted it had engaged in legal practices, the settlement was announced just a couple of weeks after Swanson's office released a lengthy accounting of patients and family members claiming to have been pressured by Accretive employees to pay up. In one instance, a patient was pressured to produce her credit card as she was laying on a gurney after suffering a stroke.

"Even though we believe the claims against us were either baseless or exaggerated, we have used this opportunity to carefully examine our own practices in order to ensure we are setting the very highest standards for our own performance and achieving the best possible outcomes for hospitals, patients and communities," Accretive CEO Mary Tolan said Monday in a statement. "Entering into this settlement ... allows our company to put this matter behind us and prevents further distraction from the important work that we do for our hospital clients."

Swanson's office had asserted the publicly-traded firm was taking part in overly aggressive collection tactics at hospitals operated by Minneapolis-based Fairview Health Services. It said employees were placed at Fairview facilities posing as hospital employees and pressuring patients and their families to pay for care.

Fairview employees also were pressured to use special software to track patient accounts and ensure they were asked for payments upfront, according to investigators.

Accretive said it did not expect the settlement to have any adverse effect on its operations--the firm has more than $200 million in cash on hand, the Tribune reported.

To learn more:
- read the Chicago Tribune article
- here's the New York Times article
- read Accretive's statement

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Ohio is moving its Medicaid program to the rank of a freestanding, cabinet-level agency, reported the Cleveland Plain Dealer.

The change by Gov. Kasich's administration highlights the priority many states are giving to the program since the Patient Protection and Affordable Care Act was upheld as constitutional by the U.S. Supreme Court. Elsewhere, governors are mulling whether to expand Medicaid under the auspices of the ACA--and therefore raise the profile of their specific programs--or stand put against expansion.

Meanwhile, Republican leadership has a plan to dramatically scale back Medicaid nationally if it wins the White House and Congress in November, according to the Los Angeles Times.

Kasich's plan to bump up the status of Medicaid comes as the state's spending on the program is projected to reach nearly $19 billion in 2012--Ohio government's single biggest expense, the Plain Dealer reported.

Kasich, a Republican, had planned to make Medicaid reform a top priority of his administration, although there are no plans to make any major cuts to the program.

"This is a change that is overdue," Greg Moody, director of the Governor's Office of Health Transformation, told the newspaper. "Gov. Kasich believes it is time to act and time for Medicaid beneficiaries and Ohio taxpayers to begin seeing the improvements that this transformation will provide."

To learn more:
- here's the Plain Dealer article
- read the Los Angeles Times article

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Pharmaceutical giant McKesson Corp. will pay $151 million to 29 states and the District of Columbia to settle charges of price fixing drugs intended for the care of Medicaid patients, reported MarketWatch.

San Francisco-based McKesson agreed to settle the charges after it was accused of inflating the prices of drugs for Medicaid patients by as much as 25 percent. Pricings for as many as 1,400 drugs may have been affected, including Ambien, Lipitor and Prozac, according to the article.

It is unknown whether the pricier drugs may have kept patients from adhering to their medication regimens. Failing to take prescription drugs has been linked to higher rates of hospitalization and higher overall healthcare costs.

McKesson denied it inflated prices. "Given the inherent uncertainty of litigation, we determined that this settlement was in the best interest of our employees, customers, suppliers and shareholders," company spokesperson Kris Fortner told the Associated Press, noted MarketWatch.

California received a $23.5 million settlement, according to the San Francisco Business Times. Georgia received $5 million, reported the Atlanta Business Chronicle.

For more:
- read the San Francisco Business Times article
- here's the MarketWatch article
- read the Atlanta Business Chronicle article

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Open houses and wine country weekends don't sound like controversial fund-raising techniques, but Sonoma Valley (Calif.) Hospital, apparently, doesn't agree, according to the Santa Rosa Press-Democrat.

For months hospital officials and the Sonoma Valley Hospital Foundation had been in dispute over how best to raise money for the hospital. The foundation mainly used community events to secure donations but claimed the hospital had been impeding its efforts to fundraise and imposing strict restraints upon such activities.

Moreover, hospital representatives sent "very nasty" emails to the foundation, asked for its donors list and then said its services were no longer required, Foundation Executive Chairperson Carolyn Stone told the newspaper.

The clash over philanthropy style prompted all 12 members of the charitable foundation to abruptly resign last week, reported the North Bay Business Journal.

However, Sonoma County Hospital spokesperson Bonnie Durrance said the hospital was actually pleased about the change, noting that the foundation could not meet its current needs. "They raise in the thousands. Our needs are now in the millions," she told the Press-Democrat.

According to Sonoma Valley Hospital District Vice Chairman Madolyn Agrimonti, the hospital itself raised $4.1 million in the past year, compared to only $250,000 provided by the foundation. She noted that having the hospital and the foundation fundraise was diluting the overall effort, according to the Press-Democrat.

After the resignation, the control of the foundation immediately reverted to the hospital.

For more:
- read the Business Journal article
-read the Press-Democrat article

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Skilled nursing facilities, which receive many of their patients directly from hospitals, will receive a 1.8 percent payment bump in fiscal 2013 from the Medicare program, the Centers from Medicare & Medicaid Services announced last week.

Altogether, the payment increase totals 2.5 percent, although 0.7 percent has been eliminated as part of a projected uptick in productivity that was part of a cost-cutting measure contained in the Patient Protection and Affordable Care Act, AHA News Now noted. On a regional basis, the increases will range from 0.3 percent to 2.7 percent, according to Long Term Care News.

The total increase represents about $670 million for the fiscal year, which begins on Oct. 1, according to the CMS.

"After years of reimbursement volatility, today's update to Medicare payments is welcome news to skilled nursing providers," Mark Parkinson, CEO of the American Health Care Association, told Long Term Care News.

According to the publication, many providers had feared cuts in the prospective payment system rate, which totaled 9.9 percent for fiscal 2012.

For more:
- here's the CMS announcement (.pdf)
- here-s the AHA News Now brief
- read the Long Term Care News article

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