The Edmond Sun

Local News

April 8, 2013

Lankford outlines upcoming health care changes

EDMOND — The Centers for Medicare and Medicaid are adjusting requirements for the two programs as the Affordable Care Act becomes more ingrained in the nation’s health care system, Congressman James Lankford said at a recent gathering of the Edmond Area Chamber of Commerce.

“They are making a lot of decisions right now that are dealing with the smaller providers of health care,” Lankford said. “They’re pushing them out, and pushing them towards the hospitals.”

The Affordable Care Act is shifting the payment rate ratio of insurance for 20- to 30-year-olds from 6-1 to 3-1, Lankford said. More companies are shifting from providing insurance copays to increasing deductibles, he added.

Nonprofit health care navigators are being hired to go door-to-door, beginning this fall, to help people fill out 21-page eligibility forms for insurance exchange programs, Lankford said. The White House says these exchanges make insurance companies more competitive.

Oklahoma is one of 26 states to default to federally run insurance exchanges, according to The Washington Post. In November, Gov. Mary Fallin rejected $54 million in federal funding to set up an exchange.

Some aspects of the Affordable Care Act likely will be delayed, Lankford said, because agencies cannot keep up with the paperwork.

“When we approach October when everybody is supposed to know what’s going to happen — in January when its supposed to kick-in in full — we won’t know all the answers,” Lankford said.

Congressional members are also mandated to enlist in the health care exchanges with a few exemptions, he said. These exemptions include the committee staff members who helped write the Affordable Care Act.

Entitlement spending for Medicare and Medicaid has the potential of bankrupting the country, said Dr. James Kennedye, an emergency care physician.

“Medicaid and Medicare is up to 18 percent of GDP right now and is projected to hit over 20 percent in the next few years,” Kennedye said. He asked how to address the problem.

Much tinkering has taken place with the Medicare and Medicaid systems, Lankford said. Any more changes in Medicare and Medicaid would harm the systems for current beneficiaries, Lankford said.

“There’s a perception from that — that we will not do anything for current beneficiaries,” Lankford said. “I will assure you, with the Affordable Care Act, it’s not true.”

The 15-member Independent Family Advisory Board is set to begin in January, but nobody yet fully understands what the consequences of IFAB will be, he said. IFAB will recommend cost control measures for Medicare, Lankford said. IFAB’s decisions would remain in effect unless Congress removes them with a super majority vote, he added.

“They cannot change the premiums that people pay,” Lankford said. “But they can say, ‘This medicine or this device is too expensive. There’s something else that replaces that ….’”

Capping reimbursements is not the way to control health care costs, Lankford said. Earlier this month the White House reversed its plans to cut Medicare Advantage reimbursement rates by 2.2 percent and increased them by 3.3, according to The Washington Post.

Medicare Advantage should be accelerated to provide better cost options to seniors as companies compete for business, Lankford said.

Edmond resident Cheryl Medawattage, RN, director of business development at Sooner Hospice, said Monday that reimbursement cuts would change the ability of a hospice to serve patients without resources.

“For our patients here that have Advantage, it’s an invaluable asset for these patients who cannot afford care givers, cannot afford their medicine,” Medawattage said. “If you take away that Medicaid program, those patients are going to end up in the hospital. Guess who is going to be paying the bill? Either the public or Medicare. So I think it’s a very wise move not to cut it.”

Medawattage said she expects the Affordable Care Act will increase referrals to home health and hospice.

“The goal would be to keep them out of that hospital setting because the hospital is going to get penalized if that patient walks right back in after 30 days, because it’s all quality initiatives,” she said.

jcoburn@edmondsun.com | 341-2121

1
Text Only
Local News
  • jc_Earp Marlin 2 - photo credit Noel Winters.jpg Shootout of a sale

    An original article of the Wild West will be made available at auction Thursday. The rifle of legendary lawman Wyatt Earp will be part of the J. Levine Auction & Appraisal’s Summer Quarterly Auction in Scottsdale, Ariz.
    Earp was an Arizona deputy sheriff and deputy town marshal in Tombstone, Ariz. He is legendary for playing a key role in the gunfight at the O.K. Corral. He died in 1929 at age 80.
    Wyatt Earp collector Barry Tapp of Edmond will be selling his 1895 Wyatt Earp Marlin rifle at the auction. The rifle has an estimated value between $50,000 and $75,000. It includes authentication documentation from Tombstone Heritage Museum, according to the auction house

    July 28, 2014 2 Photos

  • 11.6.12 Mother and Cub (2).jpg UCO forensic researcher answers key question

    After working a few human recovery cases on a volunteer basis with a variety of police departments, a question kept bugging Kama King.
    “You spend the whole day,” the UCO W. Roger Webb Forensic Science Institute student said, “sometimes days, searching for someone and only find a skull or a few bones and it just ate at me. Are we not finding this or is it not there to be found?”

    July 28, 2014 1 Photo

  • sales tax holiday.jpg Oklahoma sales tax takes a holiday

    Beginning at 12:01 a.m. on Friday, Aug. 1 and ending at midnight Aug. 3, Oklahomans will be able to participate in a sales tax holiday giving shoppers the opportunity to purchase certain clothing and shoes free of sales tax.
    Yes, retailers may not charge tax, including state and local sales taxes on items that are tax-exempt during the sales tax holiday weekend. The sales of clothing and shoes priced at less than $100 are exempted from sales taxes.

    July 28, 2014 1 Photo

  • Karan & Rwanda.jpg Peace through Business empowering women entrepreneurs

    Peace Through Business is part of the Institute for Economic Empowerment of Women (IEEW) based in Oklahoma City. It is a program that connects small business entrepreneurs in Afghanistan and Rwanda with business owners in Oklahoma. One such entrepreneur found out about the program from a friend, applied, and was accepted to take part in this year’s session.
    Upon earning a master’s degree in Civil Engineering from the Universite de Sciences et Technique de Lille in Belgium, Lyliose Nduhungirehe began her career working for a construction company in Brussels, but she quickly switched paths to Information Technology.

    July 28, 2014 1 Photo

  • MS_new pastor_Page_1.tiff Local church welcomes new pastor

    For one of Edmond’s newest pastors, faith and family intersect on a personal level.
    Sam Powers, pastor at Edmond 1st United Methodist Church, 305 E. Hurd St., and his family arrived in mid-May and his first Sunday in the pulpit was the second one in June. He and his wife Sheryl Heaton Powers, have two children — Kyla will be an eighth-grader at Cheyenne Middle School and David will be a fifth-grader at John Ross Elementary.

    July 28, 2014 1 Photo

  • pm_Ramona Paul.jpg Keith, 5 others to receive service awards

    The 2014 Door-Opener Awards Gala dinner and silent auction Sept. 4, benefitting ASTEC Charter Schools, will recognize five outstanding Oklahomans and one Kansan for lifetime contributions made toward helping others in society maximize potential and achieve dreams.
    Those selected to receive a Door-Opener Award at the Skirvin Hilton Hotel event include Dr. Harvey Dean, Pittsburg, Kan.; Toby Keith and Tricia Covel, Norman; Former Gov. George P. Nigh, Edmond; the late Dr. Ramona Paul, Edmond; and Natalie Shirley, Oklahoma City.

    July 28, 2014 2 Photos

  • Anderson Properties continues to grow

    Berkshire Hathaway HomeServices Anderson Properties recently announced the acquisition of Tulsa-based Prudential Alliance Realty, an eight-office, 150-agent brokerage operating in Tulsa and Oklahoma City and Edmond.
    The transaction gives Anderson Properties, a full-service real estate agency a total of 38 offices and more than 600 agents.

    July 28, 2014

  • Logan County pays off jail tax early, seeks new one

    Logan County is paying off a sales tax ahead of schedule and needs a new one to be able to afford funding jail operation and maintenance, officials said.
    Citizens vote on the county sales tax which is split for redistribution by state law. The tax is collected by the Oklahoma Tax Commission and redistributed back to the county as specified by voters.
    In 2005, citizens passed a 10-year sales tax, scheduled to end next month, to fund the building, operation and maintenance of the county jail, which operates on a $1.3 million budget. Jail capacity is 188 without anyone in a holding cell or a temporary bunk. Thursday it was holding 130 inmates, said Logan County Chief Deputy Richard Stephens.

    July 26, 2014

  • MS_Andy Billups.jpg Local man relies on experience in July 4 emergency

    Andy Billups just happened to have gained experience as a combat zone firefighter/medic while he was serving as a civilian contractor in Iraq.
    The Edmond businessman just happened to have a friend with a place on Grand Lake where he has been viewing Independence Day fireworks for a number of years, and he just happened to be there July 4.
    And he just happened to be relaxing on a hammock when he heard a some kids making a commotion.
    Located two blocks east of Disney on State Highway 28 in the foothills of the Ozark Mountain Range in northeast Oklahoma, the 59,000-plus surface acre Grand Lake is known for its state parks, marinas, restaurants, motels and fishing.

    July 26, 2014 1 Photo

  • -1.jpg 5-year-old learns valuable lessons

    It is never too soon to learn about giving and receiving. An Edmond 5-year-old recently learned about both.
    Kendall Kingry will be entering kindergarten at Will Rogers Elementary this fall and she is already looking forward to November.
    “I get to go to Disneyland in November,” Kendall said.

    July 26, 2014 2 Photos

Featured Ads
NDN Video
'Hunger Games: Mockingjay Part 1' Sneak Peek NOW TRENDING: Peyton Manning dancing at practice Chapter Two: Designing for Naomi Watts Golden Sisters on '50 Shades' trailer: 'Look At That Chest!' "The Bachelorette" Makes Her Decision Thieves pick the wrong gas station to rob Staten Island Man's Emotional Dunk Over NYPD Car - @TheBuzzeronFOX GMA: Dog passes out from excitment to see owner Baseball Hall of Famers Inducted Florida Keys Webcam Captures Turtles Hatching Morgan Freeman Sucks Down Helium on 'Tonight Show' Robin Wright Can Dance! (WATCH) She's Back! See Paris Hilton's New Carl's Jr. Ad Big Weekend For Atlanta Braves In Cooperstown - @TheBuzzeronFox Chapter Two: Becoming a first-time director What's Got Jack Black Freaking Out at Comic-Con? Doctors Remove 232 Teeth From Teen's Mouth Bradley Cooper Explains His Voice in 'Guardians of the Galaxy' Deja vu: Another NYPD officer choke-holding a suspect 'Fifty Shades of Grey': Watch the Super Sexy First Trailer Now!
Poll

The runoff race for the 5th District congressional seat is set for Aug. 26. If the voting were today, which candidate would you support?

Al McAffrey
Tom Guild
Undecided
     View Results