Medicaid program
ALSO NOTED: Minnesota law requires panel to disclose pharma ties; CDC, Emory track EMS performance; and much more...
> A new Minnesota law is requiring panels that advise its Medicaid program on drug formularies to disclose financial relationships with pharmaceutical companies. Read more...
Minn. critics blast Lilly med monitoring program
Questions continue to dog the medication monitoring program managed by a contractor for drugmaker Eli Lilly, that has been working to cut costs for psychiatric medications for 20 Medicaid programs.... Read more...
NY: Home care industry riddled with fraud
New York Attorney General Andrew M. Cuomo is on the warpath when it comes to home health care agencies. The AG issued subpoenas to nearly 60 home health agencies this week, suggesting that not only... Read more...
Aetna spends $535M to buy Medicaid firm
Beefing up its Medicaid managed care offerings, Aetna has acquired Phoenix, AZ-based Medicaid management firm Schaller Anderson for $535 million. Schaller Anderson serves more than 1.3 million beneficiaries and manages more than $3 billion in benefits. It has about 1,800 employees in nine states. The company was started by Joseph Anderson and Dr. Don Schaller, who founded the company more than 20 years ago after helping to create Arizona's Medicaid program. The buy follows a previous deal …
... Read more...Physicians drop out of new Medicaid plan
Cut or keep reimbursement at a flatline, increase paperwork, and doctors will like Medicaid even less. That's what's been happening in Florida since authorities kicked off a new pilot program moving beneficiaries into HMOs, according to new research by the Georgetown University Health Policy Institute. In 2005, former Florida governor Jeb Bush (R) signed a law creating the pilot program, which also caps spending growth at 8 percent over five years. Since that time, it appears that …
... Read more...CT keeps disclosure pressure on Medicaid HMOs
Connecticut legislators continue to debate a measure which would force the state's Medicaid HMOs to share more information on rates and services, though the bill has been watered down since it was filed. The Medicaid HMOs have fought this measure every step of the way, arguing that these data points are trade secrets. And they seem to be having some success: while the original bill would have defined HMO contracts with the state as subject to freedom of information laws, making …
... Read more...NY overpays providers by $26M
A new audit by the New York Department of Health has found that the state's Medicaid program overpaid providers by almost $26 million over a five year period. The problems occurred, auditors found, because controls within the Department's electronic claims processing system were not being used, and what's more, that the clinics weren't following the state's Medicaid billing guidelines. The payments, which took place from 2001 through 2006, went to clinic services for hospitalized Medicaid …
... Read more...GAO says U.S. can't afford more healthcare
While it's all well and good to expand health coverage to more uninsured Americans, doing so would impose an untenable burden on the federal budget, according to a top government official. Government Accountability Office head David Walker says that existing federal government commitments such as Social Security and Medicare are already breaking the federal bank. While some have suggested that …
... Read more...SPOTLIGHT: Cancer care docs face financial crisis
A group of doctors who, since 1991, have traditionally cared for poor cancer cases in California's Santa Barbara County, are still feeling lucky. They barely survived a billing dispute with the state's Medicaid program, Medi-Cal, after finding that they very nearly wouldn't get their bills paid in time to survive. The billing dispute involved a huge stack of bills unpaid by the Santa Barbara Regional Health Authority, billing intermediary for Medi-Cal for this part of the state. The Santa …
... Read more...Universal insurance in the works in NJ
It's hard to keep count these days of how many states are planning universal health initiatives. One of the latest is New Jersey, which, in its case, would eventually require all residents to carry health insurance. State officials predict that the plan's first year costs could hit $1.7 billion, a number that might not get past the legislature, but should, given the costs of caring for the uninsured inefficiently, proponents say. After all, they note, the state already pays almost $600 …
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