February 23, 2004

MHA's Monday Executive Briefing
February 23, 2004

In this week's edition...
- State News -
1. High court changes mass litigation rules
2. Senate passes voter ID bill
3. Rep. Pelosi visits Health  Center
4. Doctors' coverage is focus of bill
5. Gov. Barbour’s Operation:Streamline
6. Mississippi Health Department names new state epidemiologist
7. White sworn in as state senator
8. Barbour’s Medicaid plan
- National News -
9.FDA chief to be nominated as next head of CMS
10. House fills key health slot
11. Patient safety video available for hospital trustees

- State News -

1. High court changes mass litigation rules
   The Mississippi Supreme Court on Friday amended its rules on how courts in the MagnoliaStatewill handle mass litigation lawsuits in the future. The changes, which are effective immediately, will narrow the criteria by which plaintiffs join into such cases. The rules also allow a trial judge to move a case to another county that is more convenient. "It is to address joinder problems which been raised before the court," court spokeswoman Beverly Pettigrew Kraft said.
   The amendments to the Mississippi Rules of Civil Procedure say combining multiple parties or causes of actions into one lawsuit requires "a distinct litigable event linking the parties." The court also removed a phrase from the rules that read: "The general philosophy of the joinder provisions of these rules is to allow virtually unlimited joinder at the pleading stage..." Further, the basis for joinder and motions challenging joinder should be filed as early as possible so the court can decide whether joining the cases is proper, the rule now reads. Courts also must recognize that consolidating cases may be prejudicial against defendants, and consolidation should be invoked carefully.
   The changes come on the heels of a decision Thursday in which the justices found in favor Janssen Pharmaceutica, the makers of the drug Propulsid. The court said joining the claims of 56 plaintiffs from across the state in a JonesCountylawsuit against the drug maker was improper. Justice Kay Cobb wrote that broad discretion had been given to courts in joinder cases before, but the Janssen raised issues the court has not seen before.
   The JonesCountycase involved 56 plaintiffs suing Janssen over Propulsid, which was pulled from the market after being linked to heart problems. The plaintiffs also sued 42 different physicians who prescribed the drug to the plaintiffs. Just one of the plaintiffs was from JonesCounty. Filing the lawsuit in JonesCountywas a case of forum shopping, Janssen claimed.

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2. Senate passes voter ID bill
   The Senate passed a bill requiring voters to present identification at the polls. The measure passed 30-18, and now goes to House for consideration. In previous years, debate over voter identification centered on how the law would be a reminder of the poll taxes and other tactics used to keep blacks from casting ballots in Mississippi. The political issue has divided lawmakers of both parties and races. None of the black senators voted for the bill Thursday.
   Senate Elections Committee Chairman Bobby Chamberlin, R-Hernando, said the legislation would prevent fraud at the polls.  The federal Help America Vote Act of 2002 requires first-time voters registering by mail to provide some form of identification. The federal act was designed to eliminate the kinds of voting snafus Floridaexperienced in the 2000 presidential election.
   The ID requirement must be in place by the March 9 primary elections, said David Blount, spokesman for the secretary of state's office. Under Mississippi's bill, voters could present one of 10 forms of identification, including a Mississippidriver's license, passport or pilot's license. Chamberlin said Alabama, Colorado, Montana, North Dakota, Tennesseeand South Dakotahave similar identification requirements for voters. The Senate amended the bill to make it a misdemeanor for anyone to use the identification law to intimidate voters.

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3. Rep. Pelosi visits Health  Center
    The Democratic leader in the U.S. House of Representatives toured one of Mississippi's health care centers for the working poor and uninsured. Representative Nancy Pelosi of Californiavisited the JacksonHindsComprehensiveHealthCenteroff Northside Drivein Jackson.
  Pelosi says she was invited by her colleague, Representative Bennie Thompson of Mississippi's Second Congressional District. Pelosi told a group of employees and doctors that there's still a major disparity in the quality of health care that the uninsured and working poor receive compared to those who are insured.
   The Congresswoman says we should expect to hear more about this as we get closer to November. Rep. Pelosi  said,"This issue is looming so large. And it's not just a health and we'll being issue but an economic issue in America's families."  After Thursday's press conference, both representatives sat down with employees from the center for a round table discussion on health issues.

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4. Doctors' coverage is focus of bill
   A special House committee on malpractice insurance is working on legislation that would create an insurance plan for doctors who serve large numbers of Medicaid recipients, the poor and state employees.Rep. Ed Blackmon Jr., D-Canton, co-chairman of the House select committee on malpractice insurance, presented a draft bill to legislators Wednesday that would provide state coverage to doctors whose practices are 65 percent or more Medicaid patents, CHIP recipients or state employees. The program, Blackmon said, would require an initial $10 million in state funding. It would provide medical malpractice insurance and some lawsuit protection for the doctors by classifying them as state employees.While Gov. Haley Barbour, Lt. Gov. Amy Tuck and other state leaders are focused on further tort reform to cut lawsuit costs, House Speaker Billy McCoy created the special insurance committee to address the issue from the insurance side.

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5. Gov. Barbour’s Operation:Streamline
Press release on plan available online  here. A summary of the plan is available  here.

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6. Mississippi Health Department names new state epidemiologist
   Dr. Mills McNeill was named state epidemiologist for the Mississippi Department of Health, replacing Dr. Mary Currier who resigned last month. State health officer Dr. Brian Amy announced Tuesday that McNeill will assume his new responsibilities in addition to his current role as medical director for the office of health protection and bioterrorism preparedness.
   McNeill, a native of Louisville, received his undergraduate training at MississippiStateUniversityand his medical degree from the University of Mississippi School of Medicine. As state epidemiologists, McNeill will study and control disease and illnesses that affect public health.Currier accepted a job with the MississippiHealthPolicyResearchCenter, which is affiliated with MississippiState. The HealthPolicyCenterdoes research and interprets health data.

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7. White sworn in as state senator
   State Sen. Richard White took the oath of office on Feb. 16, nearly a week after winning a revote in the Hinds County District 29 race. White, who has served in the Senate since 1989, challenged the November general election in which Democrat Dewayne Thomas was declared the winner by about 135 votes. The state Senate ordered the new election, which White won on Feb. 10 with 58.8 percent of the vote. White acknowledged the support he received from constituents and Republican Gov. Haley Barbour, who campaigned for the senator. White also said he wants lawmakers, Secretary of State Eric Clark and Attorney Jim Hood to examine Mississippi's election process and find ways to make it easier for residents to vote.

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8. Barbour’s Medicaid plan
  Barbour's Operation:Streamline budget proposes to spend $401.7 million on Medicaid--$100 million more from the General Fund on Medicaid than the Democrat-controlled Legislature. At the same time, Barbour's budget aims to save $130 million in Medicaid costs through controlling drug costs, an aggressive disease management strategy and an education program for Medicaid patients and providers. The budget does not directly address the CHIP program at all.
   Mississippi's Medicaid program operated at a $158 million deficit in Fiscal Year 2004 — including the use of one-time federal funding. Despite spending $131.8 million in Fiscal Year 2003 and $57.7 million in Fiscal Year 2004 in one-time state tobacco trust fund payments in addition to state general fund Medicaid appropriations, the program ate up $43 million in state budget contingency funds in FY 2003 and still operated at a $13.2 million shortfall.
   The program operated at a $90.2 million shortfall in FY 2004. Those shortfalls were paid using $113 million in federal funds made available to Mississippithrough President Bush's tax cut plan. In FY 2003, the program spent a total of $3.1 billion — $2.4 billion of which was federal matching funds and $710 million in state funds.
   Medicaid currently serves 712,453 recipients, while CHIP currently has just over 62,000 recipients. There are an additional 437,994 children receiving Medicaid who don't get CHIP. Barbour said during the press conference in which he unveiled his budget that Mississippi's Medicaid eligibility requirements would be "reviewed."

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- National News -

9. FDA chief to be nominated as next head of CMS 
   The Bush administration said it will nominate Food and Drug Administration Commissioner Mark McClellan to head the CMS, as the agency begins implementing the new Medicare reform law. If confirmed, McClellan would replace Tom Scully, who resigned as CMS administrator in December 2003. Dennis Smith, director of the CMS' Center for Medicaid and State Operations, has been serving as acting administrator. Before joining the FDA, McClellan was Bush's chief health policy adviser. His brother Scott is the White House press secretary. The Medicare reform law passed last year continues to be controversial, most recently tarred by news that its 10-year cost could exceed an earlier estimate by $139 billion.

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10. House fills key health slot
   Rep. Joe Barton (R-Texas) is expected to be confirmed as new chairman of the House Energy and Commerce Committee next week, a committee spokesman said. Barton would replace Billy Tauzin (R-La.), who has resigned the chairmanship and said he won't seek re-election to Congress. The Energy and Commerce Committee writes Medicaid policy, presides over health policy issues, such as quality and the uninsured, and shares jurisdiction over Medicare with the House Waysand Means Committee. Barton was nominated to the post by a House steering committee.

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11. Patient safety video available for hospital trustees
   Governance, Quality and Safety: The Impact of Joint Commission Accreditation on Healthcare Delivery, a patient safety video, was recently released by Joint Commission Resources. The video provides a background on JCAHO standards that apply to governing boards and highlights actions that trustees can use to improve patient safety at their organizations. To order, contact JCR customer service at 877-223-6866, order code V02/03AAH or go to www.jcrinc.com.

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