By BRYAN THOMPSON

Millions of veterans nationwide now have a card that’s supposed to improve their access to health care. But a Kansas senator and some other members of Congress doubt the U.S. Department of Veterans Affairs is really serious about the new Veterans Choice Program.

The program is meant to let veterans get care from private providers if they live at least 40 miles from a VA health care facility or if they face a wait of more than 30 days for an appointment.

Late last month, a bipartisan group of 42 U.S. senators, including Republicans Jerry Moran and Pat Roberts of Kansas, sent a letter to VA Secretary Robert McDonald expressing concerns about the program.

At a recent hearing, Moran told McDonald the VA seems to be putting its own welfare ahead of what’s best for veterans.

“The concern I have is that the VA has a mentality against outside care, even in the circumstances of (when veterans) can’t get care within 30 days or within 40 miles,” Moran said.

The Veterans Choice Program, launched in November, was in part a response to revelations that veterans were waiting months for VA care — and that VA officials even doctored the books to make it look as though they were meeting their targets.

Since the Veterans Choice, Access and Accountability Act of 2014 was signed into law in August, program cards have been distributed to approximately 8.5 million veterans nationwide. But according to the senators’ letter, only 0.37 percent of the recipients have been authorized to access non-VA care. The program’s rocky rollout has drawn some national media attention.

Moran told McDonald he understood the secretary had only been at the helm of the VA for a short time.

“But I will tell you the complaints that I have from veterans in Kansas about the quality of the service, the timeliness of their being seen by a physician, their ability to access care is no less today than it was a year ago,” he said.

Moran has long sought to allow veterans who live far from VA facilities to get their health care locally, from non-VA providers. He helped win passage of a pilot project, Access Received Closer to Home, that included a few sites in Kansas. The Veterans Choice Program replaced that project.

In their letter, Moran and the other senators called on McDonald to implement the program to the fullest extent possible.

“While many Veterans are satisfied with care provided through the VA Health Care System, trips to VA medical centers can be difficult for rural Veterans, especially those who are elderly or ill,” the letter said. “Because long drive times are a hardship for these individuals and can present a significant barrier to accessing care, many Veterans anticipated using their Choice Cards when Congress established the Choice Program last year,” the letter states.

Moran and the other senators said it’s not fair to measure the 40-mile distance as the crow flies rather than the actual road miles it takes to reach a VA health care facility. And veterans who live within 40 miles of any VA health care center — even one that doesn’t offer the services they need — are not allowed to use private providers for VA-funded care.

Moran expressed frustration at the inability of the VA to provide reliable cost figures for the program. He said Deputy VA Secretary Sloan Gibson told him the agency couldn’t afford to pay for non-VA care for veterans who live more than 40 miles from a VA clinic or hospital, yet the VA wants to shift funding from the program to other services.

“The suggestion that the money could be used for higher priorities within the VA is troublesome to me, because it again demonstrates the lack of interest in this program,” Moran said.

The letter from Moran and his fellow senators was blunt about this apparent contradiction.

“It is deeply disturbing that the Administration would try to reduce funding for this program before this program has even been allowed to work — being in existence for only a few short months — and as barriers to care continue to exist,” the letter states.

Moran has introduced legislation that would require the VA to use the authority Congress gave it to offer community care to veterans who are unable to receive the health care services they need from a VA medical facility within 40 miles of where they live.

“Why is the VA not bending over backwards to take care of veterans?” he asked. “By choosing to not use their authorities, the VA is forcing many rural veterans to travel hours to access care they could receive through the Choice Act in their communities — or go without care altogether.”

Bryan Thompson is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.

SHAWNEE, Kan. (AP) — Eastern Kansas police have arrested a 48-year-old man they suspect of poisoning a neighbor’s dog twice.

According to Jonson County District Court records, the poisoning incidents occurred in December and earlier this month. The dog is a 3-year-old shepherd-pointer mix named Ginger and survived after receiving emergency veterinary care.

Shawnee police arrested the man Thursday on a warrant, and he faces animal cruelty charges. He has been released from custody after posting a $25,000 bond.

His next court appearance has been set for March 25.

TOPEKA, Kan. (AP) — A Kansas legislative committee has broached the idea of reversing part of a big break for business owners and farmers to help close a budget shortfall.

The Topeka Capital-Journal reports (http://bit.ly/1x0eK5N ) that the Senate Assessment and Taxation Committee had a hearing Thursday on a bill to revive the state’s tax on passive business income, including income from rental property.

The measure would raise $65 million for the fiscal year beginning July 1.

Legislators must close a projected shortfall of nearly $600 million in the budget for the next fiscal year.

Lawmakers cut personal income taxes in 2012 and 2013 to stimulate the economy. One policy exempted 281,000 business owners and 53,000 farmers.

Some lawmakers now argue that the policy went further than intended.

But business groups criticized the bill.

WICHITA, Kan. (AP) — Kansas has established quarantine zones in Crawford and Cherokee counties in the wake of a case of avian influenza in neighboring Missouri.

The Department of Agriculture said in a news release that the quarantine areas are meant to allow them to respond “quickly and decisively” to eradicate any outbreak that might occur.

Transportation of poultry, eggs and other poultry products in or out of the designated zone is prohibited without first receiving an official permit. The map of the quarantined area is available online on the department’s website.

Kansas Animal Health Commissioner Bill Brown is encouraging all poultry owners to closely monitor their flocks and contact their local veterinarian if the birds appear sick.

STEPHEN OHLEMACHER, Associated Press

WASHINGTON (AP) — A federal investigator says fake IRS agents have targeted more than 366,000 people with harassing phone calls demanding payments and threatening jail time as part of a huge nationwide scam.

A deputy inspector general for the agency says more than 3,000 people have fallen for the ruse since October 2013. He says they have been duped out of a total of $15.5 million.

In testimony before Congress Thursday, Timothy Camus said it is the largest scam of its kind in the history of the agency. Camus said people in every state have been targeted.

He said two people in Florida have been arrested. They were accused of being part of a scam that involved people in call centers in India contacting U.S. taxpayer

By DAN MARGOLIES
A federal judge has thrown out Centene Corp.’s abuse-of-process claim against a former employee who alleged she was fired after complaining about the managed care company’s business practices.

Centene is the parent company of Sunflower State Health Plan Inc., one of three for-profit companies managing KanCare, Kansas’ privatized version of Medicaid.

The employee, former Sunflower executive Jacqueline Leary, filed a federal whistleblower lawsuit against Centene and Sunflower in October, alleging Sunflower had ordered employees to shift KanCare members away from high-cost health care providers. Leary called the practice unethical and possibly illegal.

Centene and Sunflower fired back in a counterclaim two months later, contending Leary had demanded a $3 million payment in return for not reporting the companies to the Kansas attorney general’s Medicaid fraud unit.

Calling her allegations “spurious,” Centene and Sunflower alleged Leary was trying to extort them.

In dismissing the abuse-of-process claim, U.S. District Judge John Lungstrum on Tuesday ruled that even if Leary’s lawsuit was filed to extort or harass the defendants, “the mere filing or maintenance of a lawsuit, even for an improper purpose, is not a proper basis for an abuse of process action; abuse of process contemplates some overt act done in addition to the initiating of the suit.”

Lungstrum, however, declined to throw out Centene’s and Sunflower’s additional counterclaim against Leary for defamation. That was based on the companies’ contention that Leary, after her termination, told an executive at a Topeka hospital that Centene and Sunflower had directed her to do “something inappropriate” and that she was fired after she contacted their compliance department.

Lungstrum ruled that dismissal of the defamation claim was not proper because it and Leary’s whistleblower claim arose out of the same set of facts and the evidence underlying both will overlap.

Attorneys for Leary and for Centene and Sunflower could not immediately be reached for comment.

Leary was vice president of contracting and network development for Sunflower before she was terminated in January 2014. Her central allegation is that Sunflower, motivated by financial losses, ordered her to steer Sunflower members away from health care providers that had contracted to be reimbursed at rates higher than 100 percent of standard Kansas Medicaid rates.

Sunflower maintains that Leary was fired for poor job performance. It notes that the Occupational Safety and Health Administration investigated her claims and concluded she was not fired in retaliation for expressing concerns about Sunflower’s business practices.

Kansas’ $3 billion KanCare program put private companies in charge of managing the state’s Medicaid program. The program was launched by Gov. Sam Brownback in early 2013 and moved nearly all of the state’s Medicaid enrollees into health plans run by Sunflower and two other managed care organizations, Amerigroup and UnitedHealthcare.

Dan Margolies, editor of the Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

By ANDY MARSO

Kansas legislators are trying to determine what they should do, if anything, to regulate hookah.

But first, several of them have to determine exactly what hookah is.

“Having lived a very sheltered life in southeast Kansas, I had to Google this to even find out what it was,” Rep. Jim Kelly, a Republican from Independence, said during an informational hearing on the subject last week.

Hookahs are water pipes used to smoke flavored tobacco.

To Hani Chahine, they’re also a focal point for social gatherings and commerce.

Chahine and his family own hookah lounges in Topeka and Lawrence, two of only a handful across the state.

The idea for the business, he said, was born out of the lack of social options for people over 17 but under 21. Growing up in Lawrence, he said he and his brothers grew tired of hanging out with friends at bowling alleys and movie theaters.

So they invited friends over to their house, where their family had hookah pipes. Their friends were intrigued, the brothers saw a possible business niche and they convinced their father to invest in them.

“It’s just our way of having fun without including alcohol,” Chahine said Monday while working at the Hookah House lounge in Topeka. “Police never have to worry about someone driving drunk.”

Appealing to youths?

Public health advocates have other concerns, though, including the appeal that hookah has for the younger crowd.

Susan Mosier, the acting secretary of the Kansas Department of Health and Environment, estimated that almost one-third of Kansans age 18 to 24 have tried hookah.

“As a public health practitioner, I am concerned about the health risks of hookah use because of the toxins that users are exposed to, as well as hookahs serving as another type of tobacco to which children and young adults will become addicted,” Mosier said in a memo to the House Health and Human Services Committee. “The sweet flavors and the social aspect of hookah smoking are appealing to many young Kansans.”

In addition to Mosier, representatives from the American Cancer Society, the American Lung Association and Won Choi, a doctor from the University of Kansas School of Medicine, expressed concerns about hookah.

They included the length of smoking time during a hookah session and how much exposure to nicotine that might cause, the exposure to secondhand smoke for others in the lounge and the possibility of patrons spreading diseases like flu as they pass around the hookah mouthpiece.

Hookah lounge owners say that all depends on the choices of their customers.

Mohammed Iskandrani, owner of Aladdin’s Café and hookah lounge in Lawrence, said he offers some brands of tobacco with little to no nicotine, pulling one brand off the shelf that contained 0.05 percent of the addictive agent.

He also offers those who come into the lounge their own disposable plastic mouthpiece.

“It’s up to them if they want to use it or not,” Iskandrani said. “We can’t force them.”

Chahine’s family also offers the disposable mouthpieces, which come individually wrapped in plastic, at its lounges.

“It’s a standard, common-sense thing,” Chahine said. “I’ve never seen anybody that doesn’t offer it.”

Iskandrani said he moved to address the issue of secondhand smoke years ago, after the city of Lawrence banned smoking in restaurants. At that point he moved the hookah lounge next door to another room with an entrance and ventilation system separate from the cafe.

Likewise, Chahine said his family’s establishments are “smoke shops,” not eating establishments or stores, and so when it comes to secondhand smoke, patrons know what risks they’re taking.

“People are here to smoke,” he said. “So if they’re not smoking, what are they here for?”

Iskandrani said he’s considering closing his smoke shop because it requires staffing at later hours than his café and it’s not particularly lucrative under current state and local regulations.

On the radar

Rep. Dan Hawkins, a Wichita Republican who chairs the House health committee, said there’s no bill to change hookah laws right now.

“For me, it’s just kind of come on my radar,” Hawkins said. “I didn’t even know what it was.”

He was not alone.

Rep. Kevin Jones, a Republican from Wellsville, said he found an unidentified “device” at a property he manages and later learned it was a hookah pipe.

“Where in the world is the history of this?” Jones asked Choi. “Where did it come from? Did somebody just come up with it?”

Choi said the pipes originated in the Middle East.

“In this country, the history is obviously fairly recent,” Choi said. “But there is a long history in the Middle East and India, that they use it in the culture.”

Jones also asked whether the devices can be used to smoke marijuana, and Choi confirmed that they can be.

Rep. Blake Carpenter, a Republican from Derby who is one of the Legislature’s youngest members, was the only member of the House health committee to profess some prior knowledge of hookah.

“I’m actually quite familiar with it,” Carpenter said at the end of last week’s briefing. “I’ve got a lot of college buddies.”

No one from the hookah industry was present at the hearings.

Chahine said any legislators who want to learn more are welcome to stop by the shop in Topeka, which sits about two miles from the Statehouse next to the Washburn University campus.

Along with the rows of tobacco and pipes, the store features a wall-to-wall mural depicting a desert scene painted by local artist Thomas Richmond and a flat-screen television connected to several video game systems.

After Chahine used tongs to place heated coals atop a hookah pipe for a customer, he said he understood the need for some regulation of the state’s small but growing hookah industry.

“It needs to be (restricted to) people who actually know what they’re doing,” Chahine said.