Issue link: https://www.epageflip.net/i/313248
ByAndrewDemillo The Associated Press LITTLE ROCK, ARK. Ajudge cleared the way on Thursday for gay marriages to resume inArkansas,strikingdownall state laws that prevent same- sex couples from wedding. A day after the state Su- premeCourteffectivelyhalted gaymarriagesinthestate,Pu- laski County Circuit Judge Chris Piazza expanded his ruling striking down a consti- tutionalbantoalsoincludethe prohibition on clerks issuing same-sex marriage licenses. Justices had ruled Wednes- day that Piazza's decision on the gay marriage ban did not change that license law. Piazza also rejected a re- questtosuspendhisruling,say- ingthere'snoevidencethestate would be harmed by allowing gaymarriagestocontinue. "The same cannot be said of the plaintiffs and other same-sex couples who have not been afforded the same measure of human dignity, respect and recognition by this state as their similarly situated, opposite sex coun- terparts," Piazza wrote. "A stay would operate to fur- ther damage Arkansas fam- ilies and deprive them of equal access to the rights as- sociated with marriage sta- tus in this state." Attorney General Dustin McDaniel's office said he would appeal and was ask- ing the high court to suspend Piazza's latest order. COURT Ju dg e st ri ke s all Arkansas bans on gay marriage By Ricardo Alonso- Zaldivar The Associated Press WASHINGTON The Obama administration has given the go-ahead for insur- ers and employers to use a new cost-control strategy that puts a hard dollar limit on what health plans pay for some expensive proce- dures, such as knee and hip replacements. Some experts worry that such a move would surprise patients who pick more ex- pensive hospitals. The cost difference would leave them with big medical bills that they'd have to pay them- selves. That could undercut key financial protections in President Barack Obama's health care law that apply not just to the new health insurance exchanges, but to most job-based coverage as well. Others say it's a valuable tool to reduce costs and help check premiums. Some federal regulators appear to be concerned. A recent administration pol- icy ruling went to unusual lengths, acknowledging that the cost-control strat- egy "may be a subterfuge" for "otherwise prohibited limitations on coverage." Nonetheless, the depart- ments of Labor and Health and Human Services said the practice — known as reference pricing — could continue. Plans must use a "reasonable method" to ensure "adequate access to quality providers." Regula- tors asked for public com- ment, saying they may pub- lish additional guidance in the future. HHS spokeswoman Erin Shields Britt said in a state- ment that the administra- tion is monitoring the ef- fects of reference pricing on access to quality ser- vices and will work to en- sure that financial protec- tions for consumers are not undermined. One way the new ap- proach is different is that it sets a dollar limit on what the health plan will pay for a given procedure. Most insurance now pays a per- centage of costs, and those costs themselves can vary from hospital to hospital. Now if you pick a more ex- pensive hospital, the insur- ance still pays the same percentage. The new strategy works like this: Your health insurance plan slaps a hard limit on what it will pay for certain procedures, for example, hospital charges associated with knee and hip replace- ment operations. That's called the reference price. Say the limit is $30,000. The plan offers you a choice of hospitals within its pro- vider network. If you pick one that charges $40,000, you would owe $10,000 to the hospital plus your reg- ular cost-sharing for the $30,000 that your plan cov- ers. The extra $10,000 is treated like an out-of-net- work expense, and it doesn't count toward your plan's an- nual limit on out-of-pocket costs. That's crucial because under the health care law, most plans have to pick up the entire cost of care after a patient hits the annual out- of-pocket limit, currently $6,350 for single coverage and $12,700 for a family plan. Before the May 2 ad- ministration ruling, it was unclear whether reference pricing violated this key fi- nancial protection for con- sumers. Some experts are con- cerned. "The problem ... from the patient's perspective is that at the end of the day, that is who gets left holding the bag," said Karen Pollitz of the nonpartisan Kaiser Family Foundation. Previ- ously she was a top con- sumer protection regula- tor in the Obama adminis- tration. Thenewpricingapproach is not yet on consumers' ra- dar, but it's gaining ground. The Mercer benefits con- sulting firm said 12 percent of the largest employers were using reference pric- ing last year, nearly double the 7 percent in 2012. AFFORDABLE CARE ACT New health cost controls get go-ahead from feds By Matthew Daly The Associated Press WASHINGTON Facing calls to resign, Veterans Affairs Secretary Eric Shinseki said Thursday that he hopes to have a preliminary report within three weeks on how widespread treatment de- lays and falsified patient scheduling reports are at VA facilities nationwide, fol- lowing allegations that up to 40 veterans may have died while awaiting treatment at the Phoenix VA center. Shinseki resisted calls from a Democratic senator to bring in the Justice De- partmentandFBIforacrim- inal investigation. Shinseki saidhefirstwantedtoseere- sultsoftheauditandareport ontheVAinspectorgeneral's office on its investigation of the Phoenix hospital. Sen. Richard Blumenthal, D-Conn., said there appears to "solid evidence of wrong- doing within the VA system" that could be criminal. "It's a pattern and prac- tice, apparently, of manipu- lating lists and gaming the system — in effect, cook- ing the books, creating false records," Blumenthal said, adding that the VA's inspec- torgenerallackedtheproper resources to pursue a crimi- nal investigation. "The more I learn about the misconduct and impro- priety at the VA medical fa- cility, the more concerned I am there's evidence of crim- inal wrongdoing," said Blu- menthal, a former state at- torney general and federal prosecutor. Shinseki said he is "mad as hell" over allegations of treatment delays and pre- ventable deaths at a Phoenix veterans hospital and vowed to hold employees account- able for any misconduct. "Any adverse event for a veteran within our care is one too many," Shinseki said at a Senate hearing Thurs- day on the Phoenix allega- tions and other problems at the VA. "We can, and we must do better." Shinseki's testimony marked his first extended comments since allegations surfaced last month that the Phoenix VA hospital main- tained a secret waiting list to hide lengthy delays for sick veterans. A former clinic di- rectorsaysupto40veterans may have died while await- ing treatment. Some Republicans and veterans groups have called for Shinseki to resign. Pushing back against sometimes hostile questions, Shinseki said he welcomes a White House review of his beleaguered department. "If allegations about manipula- tion of appointment schedul- ing are true, they are com- pletely unacceptable — to veterans, to me and to our dedicated VA employees," he said. The hearing before the Senate Veterans Affairs Committee comes as Presi- dent Barack Obama has as- signed White House deputy chief of staff Rob Nabors to work on a review focused on policies for patient safety rules and the scheduling of patient appointments. The move signaled Obama's growing concern over prob- lems at the VA. VETERANS Shinseki says report on VA due within three weeks CLIFFOWEN—THEASSOCIATEDPRESS Veterans Affairs Secretary Eric Shinseki speaks Thursday a er testifying before the Senate Veterans Affairs Committee to examine the state of Veterans Affairs health care. $ 37,995 2012 GMC ACADIA DENALI DVD,LEATHER, MOON ROOF. ALL PRICES PLUS SALES TAX, LICENSE FEES, DOC FEES, ANY FINANCE CHARGE, ANY DEALER PREPARATION CHARGE, ANY EMISSION CHARGE, ANY DOCUMENTATION PREPARATION CHARGE, ANY SMOG FEES AND ANY TIRE FEES. ALL VEHICLES SUBJECT TO PRIOR SALE & CREDIT APPROVAL. 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