After suffering a case of the flu that had reached her brain and caused blindness, Jade DeLucia, 4, has fully recovered and can see again, in today's bite-sized hospital and health industry news from Illinois, Iowa, and Michigan.
- Illinois: Insurance company Health Care Service Corp. (HCSC) is suing the U.S. government, claiming the company is owed $2 billion as part of the Affordable Care Act's (ACA) risk corridors program. The ACA's risk corridors provision called for federal payments to health insurers to help offset the costs they might incur by enrolling a higher-than-expected number of sick people through the exchanges. Under the program, which launched in 2014 and ended in 2016, HHS was expected to reimburse a designated amount of insurers' losses on exchange plans. However, the program faced a significant funding shortfall and CMS has been unable to reimburse insurers in full, prompting lawsuits from several insurers seeking their full payments. In response, several insurers have filed lawsuits to recoup missed payments, and the Supreme Court in December 2019 heard arguments in a case. A spokesperson for HCSC said the company is "not speculating on how the SCOTUS will rule" (Herman, Axios, 3/9; Baker, Axios, 12/10/19; Cox et al., Kaiser Family Foundation, 8/17/16).
- Iowa: Jade DeLucia, 4, ended up at University of Iowa Stead Family Children's Hospital in December fighting to survive a case of the flu that gave her seizures and caused brain swelling that led to blindness. Now, months later, DeLucia has recovered and is able to see again. Theresa Czech, a doctor at Stead Children's, said Jade has made "a good recovery" and that she is "a bright, cheerful girl who's full of love" (Miller/LeBlanc, USA Today, 3/9).
- Michigan: Gov. Gretchen Whitmer (D) in her proposed 2020-21 executive budget has requested $5 million to fund a five-employee office within the state's Department of Health and Human Services aimed at overhauling how the state pays for care through Medicaid. Specifically, the office's goal is to develop a series of value-based reimbursement systems for health plans, hospitals, nursing homes, and home and community-based providers, according to Robert Gordon, the director of Michigan's Health and Human Services department (Greene, Modern Healthcare, 3/9).