medicaid patients

In Indiana, doctors and hospitals are protesting a plan to transfer the state's Medicaid patients to three private insurers. Providers are vehemently resisting the change because the insurers have proposed a 30 percent cut to physician reimbursement for Medicare patients. Doctors and hospitals say that the steep cuts will force physicians to limit the number of Medicaid patients they treat, leaving a high number of indigent patients to receive expensive emergency care. Insurance company …

According to the Agency for Healthcare Research and Quality (AHRQ), in 2004, Americans spent $790 billion on hospital care, more than half of which was billed to Medicare and Medicaid patients. Hospital visits account for 60 percent of all U.S. healthcare spending. The priciest procedure was coronary atherosclerosis, or hardening of the arteries--spending on the disease totaled $44 billion. Diseases that contribute to the condition include diabetes, obesity, and high cholesterol. …

In a Q&A with UPI, William Plested III, president of the AMA, discusses the impact of Medicare reimbursement rate cuts on physicians. He says that their primary concern is that physicians--particularly geriatricians--won't be able to afford taking on more elderly patients if Medicare doesn't reimburse them properly. According to an AMA study, 45 percent of physicians say the cuts will …

A dozen Georgia physicians have filed a suit against three private HMOs--Peach State Health Plan, AMGP Georgia Managed Care Company and Wellcare of Georgia--claiming that the plans owe millions of dollars in Medicaid reimbursements to doctors, hospitals and other providers. The providers allege that the HMOs knew before they bid on a $3 billion state contract that they'd be unable to …

> Daniel Lohmeier, president of Specialized Pharmacy (a subsidiary of Omnicare) has been indicted on 148 counts of fraud, including fraudulently billing Medicaid and illegally dispensing medications to Medicaid patients. Omnicare's billing practices have been called into question in a number of states, including Michigan, Massachusetts and Ohio. Lohmeier could serve up to four years in prison if he's found guilty. …

It's battling studies time. In one corner is the Center for Studying Health System Change, which is reporting that decreasing Medicaid reimbursement rates are causing providers to turn away more and more Medicaid patients. According to the Center, in the mid-1990s, 19.5 percent of doctors weren't accepting Medicaid patients; that number has climbed to 21 percent in the last several years. Physicians and health officials have previously expressed concern that doctors might be more …

Burglars have stolen 10 computers with names and Social Security Numbers of 15,000 to 18,000 people from and HCA office in Nashville. The computers contain information on Medicare and Medicaid patients with uncollected bills, along with some DRG information. The patients whose information was stolen are based in Colorado, Kansas, Louisiana, Mississippi, Oklahoma, Oregon, Texas and Washington. According to the company's Web site, "The computers were stolen from a secured building, …

Joining the recent roll-out of a number of P4P programs, Pennsylvania-based Unison Health Plan, a Medicare and Medicaid provider, has begun enrolling doctors in Unison Gold Star. The program will measure efficiency of medical practice, patient satisfaction and other commonly used quality measures. This is the state's first P4P program aimed at Medicare and Medicaid providers. Eight hundred practices are eligible …

Former Bush HHS secretary Tommy Thompson, now a consultant, plans to release a white paper tomorrow addressing chronic problems with Medicaid. Specifically, he plans to recommend that the federal government take over long-term care for the elderly--a service that leads many otherwise law-abiding citizens to try to game Medicaid by monkeying with their assets to appear poor--and leave the states to handle acute care for the under-65 group, especially children. He'll also advocate making …

A lawsuit filed yesterday claims that a law that requires Medicaid patients to present evidence of U.S. citizenship before receiving treatment is unconstitutional. Families USA filed the suit on behalf of 11 patients yesterday. Patient advocacy groups have argued that the requirement could mean low-income patients who are U.S. citizens but do not have access to the required documentation could be denied access to care. Others have argued that the requirement could prevent those in need of …