Medicaid News
U.S. States Streamline Medicaid as Federal Law Forces Changes, Report Says
A stipulation in the 2010 health- care law that bans U.S. states from dropping Medicaid patients has forced them to be more efficient in managing the program to save money, according to a report today. While Medicaid, the joint U.S.-state health plan for low- income people, is among the biggest expenses for states in a flagging economy, the law prevents them from dropping members or tightening eligibility. A Kaiser Family Foundation survey found that 29 states have streamlined their programs, with most using U.S. incentives to add new technology.
States face uphill climb in suit over health law's Medicaid expansion
The 26 states challenging President Obama’s healthcare law are facing several thorny dilemmas as they try to convince the Supreme Court to throw out the law’s Medicaid expansion.
Both of the lower courts that heard the Medicaid challenge ruled against the states, even as those judges struck down the healthcare law’s individual mandate. Legal experts on both sides of the debate over the mandate were surprised that the Supreme Court agreed to also hear the Medicaid piece of the states’ lawsuit.
States face uphill climb in suit over health law's Medicaid expansion
The 26 states challenging President Obama’s healthcare law are facing several thorny dilemmas as they try to convince the Supreme Court to throw out the law’s Medicaid expansion.
Both of the lower courts that heard the Medicaid challenge ruled against the states, even as those judges struck down the healthcare law’s individual mandate. Legal experts on both sides of the debate over the mandate were surprised that the Supreme Court agreed to also hear the Medicaid piece of the states’ lawsuit.
California Barred by Judge From Cutting Hospital Medi-Cal Rates
California can’t cut reimbursements hospitals receive for the skilled-nursing services they provide to low-income people, a federal judge ruled. U.S. District Judge Christina Snyder in Los Angeles yesterday granted the request from the California Hospital Association for an order to stop California from imposing the reductions, saying the hospitals had met their burden of showing irreparable harm if she didn’t halt the cuts temporarily.
Feds: Florida can continue 5-county Medicaid pilot
Federal officials on Thursday approved the expansion of a five-county Medicaid privatization pilot program that allows for-profit providers to determine the health care of recipients, but there's no indication whether a statewide expansion will be allowed. The Centers for Medicare and Medicaid Services was insisting on new protections, more accountability and quality reporting, spokesman Alper Ozinal said. "We are separately considering the state's request to expand this demonstration statewide, and we are care
Scott aides defend Medicaid cuts
Gov. Rick Scott’s proposal to pay less to hospitals to control spiraling Medicaid costs drew skepticism from some lawmakers and hostility from hospitals Thursday. Scott’s plan is central to his $66 billion budget proposal, and ensures that his own history as CEO of a for-profit hospital chain that paid a record $1.7 billion in fines for Medicare fraud would attract new attention. Explaining Scott’s plan to legislators, senior aides touted the governor’s background as having built Columbia/HCA into the nation’s biggest and most profitable hospital network.
Arizona Medicaid cut approved by feds
Federal health officials have approved an additional 5 percent reduction in the rates hospitals and other health-care providers are reimbursed for Medicaid patients, part of Gov. Jan Brewer’s budget-balancing package. The rate cut, retroactive to Oct. 1, follows another 5 percent reduction in April and a rate freeze imposed in 2007. It will save the state an estimated $95 million this year, savings hospitals say comes at the expense of health-care facilities and privately insured patients.
Puzzling Out How To Help States With Hard-Hit Medicaid Budgets
One of the biggest problems governors face during a recession is this: When the economy is going down, Medicaid enrollment is going up. So states have more people in their Medicaid program, but less tax revenue to pay for them. It is what economists call counter-cyclical.
Washington is sensitive to the problem. During the most recent recession, as part of theRecovery Act, Congress voted to increase the federal government’s share of Medicaid costs, known as the Federal Medical Assistance Percentage (FMAP). Under FMAP, states receive a set “match” amount, and depending on the state, that amount is normally 50 to 76 percent of the Medicaid costs. Because of the stimulus funding, that range increased to 62 to 85 percent of costs.
Medicaid cost cuts planned
Wisconsin is not alone in dealing with the thorny task of trying to lower the cost of its health care programs for low-income residents. Massachusetts no longer pays for restorative dental care and dentures. Washington no longer covers eyeglasses and hearing aids. Minnesota no long covers chiropractic care. Illinois, Iowa and other states planned to require a $50 co-payment for unnecessary visits to emergency departments. And California has proposed a $50 co-payment for all visits to emergency departments and a co-payment of $100 for hospital stays that last one day and $200 for longer stays.
Inspector general report faults oversight of Medicaid prescription drug program
Not one of 14 states recently audited had adequate controls in place to ensure that all of its Medicaid drug expenditures complied with federal law, according to a new Health and Human Services Office of Inspector General report. The potential cost to state and federal taxpayers: almost $260 million. The report found many drugs were ineligible for coverage, and faulted the federal Centers for Medicare and Medicaid Services (CMS)."These shortcomings in internal controls adversely affected the efficiency of the Medicaid outpatient prescription drug program," the report found.
Optional Medicaid benefits face state cuts
States are using a variety of strategies to control rising Medicaid costs even as they look ahead to a massive expansion of the state-federal health insurance program for the poor beginning in 2014. The weak economy is driving more jobless Americans into Medicaid, increasing enrollment at the same time that medical costs keep going up. To deal with the higher costs, states are pushing Medicaid recipients into managed-care plans run by private insurers, cutting reimbursement rates to hospitals and doctors and reducing benefits.
Supreme Court Begins New Term With Medicaid Case
The Supreme Court began its new term Monday by weighing who gets to object when a state makes Medicaid cuts — and soon is likely to plunge into a far bigger health dispute. That's the challenge to President Barack Obama's historic health care overhaul. For now, patients and providers are squaring off against California and the Obama administration to argue they should have the right to sue in federal court when a state cuts its payment rates in the Medicaid program for poor Americans.
GOP govs: Let states decide Medicaid spending
The nation's Republican governors, seeking a voice in Congress' upcoming debt debate, pushed Tuesday for looser restrictions on how states spend money on health care for poor and disabled Americans. States, they argued, should be allowed to design their own Medicaid programs and operate them with a lump payment every year from the federal government, and then be held accountable for the results. Outdated or inappropriate federal guidelines now make it more burdensome and frustrating to provide a health care safety net that's one of the biggest expenses for cash-strapped states, the governors said.
FMA warns of shortfalls in Medicaid overhaul
The Florida Medical Association has sent a letter asking federal health officials to correct "shortfalls" in the Medicaid overhaul before expanding statewide. The organization, which represents about 20,000 doctors, sent a letter to the Centers for Medicare and Medicaid Services on Friday. The FMA said it had worked with lawmakers while the bills were drafted, but "respectfully disagrees that a statewide mandatory managed care program is the best way to reduce costs while providing access to quality care for Medicaid patients."
Medicare pays more for drugs than Medicaid, report finds
Medicare pays much more for prescription drugs than Medicaid, according to a report from the inspector general of the Health and Human Services Department. The report says Medicaid rebates help keep prices low in the program. Medicaid and Medicare plans paid roughly the same up-front costs for prescription drugs, the report says, but Medicaid got far more of its money back through rebates from drug manufacturers. The program recaptured about 45 percent of its drug spending, compared with roughly 19 percent for Medicare's drug benefit.
Coburn’s cuts: Taking on Medicare and Medicaid
Coburn, a doctor, has some strong ideas about Medicare and Medicaid, which, he said, provide “health-care coverage for approximately one in five Americans and, along with Social Security, make up the backbone of the federal safety net.” Among his proposals: raising the entry age for Medicare; means-testing beneficiary payments; raising some premiums for all seniors; increasing funding for investigating fraud and abuse of both systems; and freezing for 10 years the Medicare reimbursement rates for doctors.
Suit claims MassHealth violated disabilities act
Disabled recipients of MassHealth are suing the state's Medicaid program, claiming it has failed to provide adequate communication options.In a lawsuit filed in federal court Tuesday six MassHealth recipients who are either blind, deaf, or have other disabilities allege the agency violated the Americans with Disabilities Act by not providing services they needed to participate in the program. The lawsuit claims the agency has failed to provide Braille or electronic forms that can be filled out without assistance, offer materials in American Sign Language, or list a phone number for the hearing impaired.
Report finds holes in state oversight of Medicaid incentives
Several states are at risk of paying millions of dollars in Medicaid incentives to hospitals and doctors' offices that they might not be eligible for, according to a new government report. The early review by the Department of Health and Human Services Office of Inspector General found that 12 out of 13 states did not plan to verify all the eligibility requirements for incentive payments tied to the adoption of electronic heath records. The 2009 recovery act set aside $13.4 billion for the Medicaid incentive program between 2011 and 2019.
Medicaid Enrollees Seek More Medical Care
Compared with the uninsured group, those in the Medicaid sample got 30 percent more hospital care, 35 percent more outpatient care and 15 percent more prescription-drug care. There were similar gains for preventive care; mammograms were up 60 percent and cholesterol monitoring rose 20 percent. The Medicaid recipients also had fewer unpaid bills sent to collection, were 25 percent more likely to report themselves in “good” or “excellent” health, and 10 percent less likely to screen positive for depression. The one surprise was that there was no evidence of “crowd-out”: Medicaid coverage didn’t make someone more or less likely to purchase private insurance.
Medicaid Enrollees Seek More Medical Care
Compared with the uninsured group, those in the Medicaid sample got 30 percent more hospital care, 35 percent more outpatient care and 15 percent more prescription-drug care. There were similar gains for preventive care; mammograms were up 60 percent and cholesterol monitoring rose 20 percent. The Medicaid recipients also had fewer unpaid bills sent to collection, were 25 percent more likely to report themselves in “good” or “excellent” health, and 10 percent less likely to screen positive for depression. The one surprise was that there was no evidence of “crowd-out”: Medicaid coverage didn’t make someone more or less likely to purchase private insurance.
GOP Governors Ask Washington to Give States More Flexibility on Medicaid
Frustrated with the rising costs of providing health careto their poorer constituents, Republican governors from 29 states sent a letter to lawmakers in Washington on Monday demanding greater flexibility in administering Medicaid dollars. "About 20 years ago, it used to be about 5 percent of the budget and now it's four times that amount, so it’s a huge concern," Virginia Gov. Robert McDonnell said. "We've got to find ways to reduce Medicaid spending." Governors of both parties have lots of ideas on how to better manage the program, which is used by 60 million Americans, with costs split between the federal and state governments.
Medicaid advocates say cuts would hurt kids
As they attempt to fend off a range of proposed spending cuts, Medicaid advocates are emphasizing the program’s role in covering children. Researchers at George Washington University released a report Monday that says Medicaid and the Children’s Health Insurance Program effectively cover vulnerable patients at a minimal cost. “Major cuts in Medicaid could seriously endanger the health and finances of millions of children and other vulnerable beneficiaries, including the elderly and disabled,” the report states.
Medicaid to Quit Paying for Preventable Events
The Centers for Medicare and Medicaid Services (CMS) has announced that hospitals and healthcare providers will no longer be reimbursed for treating their Medicaid patients for illnesses, injuries, or readmissions that should have been prevented. A final rule announced Wednesday enacts a portion of the Affordable Care Act (ACA) that prohibits states from making Medicaid payments to providers for conditions that are deemed "reasonably preventable." In 2008, Medicare stopped reimbursing hospitals for treating conditions, infections, or illnesses that were acquired in the hospital, and for any readmissions associated with treating those hospital-acquired conditions.
Medicaid Reform: New plan starts with ill children
State officials want to change the way they provide health care to the sickest and most expensive participants in the tax-funded Medicaid program, beginning with more than 37,000 disabled children. Under Gov. John Kasich's budget plan, the youngsters would be enrolled in managed-care plans beginning next year. Similar changes would come later for the mentally ill, nursing-home residents, those receiving home- and community-based services and so-called dual eligibles, the poor elderly and disabled served by both Medicaid and Medicare.
Medicaid physician pay swept up in battle over funding and access
Even as House Republicans started moving a bill that would give cash-strapped states more flexibility to roll back Medicaid eligibility standards, Obama administration officials were proposing new standards for states to maintain access to care for enrollees. The rule could create an obstacle to states that want to reduce Medicaid physician pay
Arizona Governor Proposes Revamping Medicaid Program
As part of a plan to revamp the state's Medicaid program, Arizona Gov. Jan Brewer announced on Thursday that she is proposing fees for adults who lead unhealthy lives.Childless adults who are obese or suffer from a chronic condition and who fail to work with their doctor to meet specific goals would be charged $50 annually. The $50 annual fee also would apply to all childless adult smokers. "
Battle Over Medicaid Block Grants Could Have Far-Reaching Impact
Mississippi Gov. Haley Barbour and other Republican governors recently demanded that Medicaid, the state-federal health program that covers 50 million poor and disabled, be transformed into block grants. "Y’all would save a lot of money if you let us run the program," Barbour told a congressional committee. Such statements are being embraced by House Republicans, who are vowing to tackle costly programs to reduce federal spending. But any effort to turn Medicaid into block grants – federal lump-sum payments to states – raises a host of questions.
Hospital associations oppose easing of Medicaid maintenance-of-effort rules
Relaxing maintenance-of-effort provisions will move many low-income Americans out of Medicaid programs and increase the number of the uninsured population, several hospital associations cautioned in a letter Tuesday to HHS Secretary Kathleen Sebelius. The American Hospital Association, the Association of Medical Colleges, the Catholic Health Association, the Federation of American Hospitals, the National Association of Children's Hospitals, the National Association of Public Hospitals and Health Systems, and VHA emphasized their strong support for the Medicaid maintenance-of-effort, or MOE, requirement included in the American Recovery and Reinvestment Act in 2009 and extended last year in the Patient Protection and Affordable Care Act.
Groups urge Congress to keep Medicaid requirements
Fresh off their defense against efforts to repeal the healthcare reform law, progressive groups are now gearing up for a showdown with state governors looking to slash Medicaid and children's health programs. The pro-reform Families USA and 129 groups have signed on to a new letter calling on House members to maintain the reform law’s requirement for states to maintain Medicaid and Children’s Health Insurance Program eligibility standards. The letter will be released Tuesday morning before governors ask the House Energy and Commerce Committee for a reprieve from healthcare reform’s Medicaid requirements as they grapple with massive budget deficits.
Senate Medicaid bill would cap costs, use HMO-like plans
The Florida Senate wants to cap soaring Medicaid costs by shifting millions of poor and sick people into HMO-like health plans, charging for doctor and hospital visits, and banning illegal immigrants from getting care through the rapidly growing program. The program, which sponsors said could save $1 billion next year, would increase payments to physicians who treat Medicaid patients and shield them from malpractice lawsuits. It would also require some beneficiaries to take smoking-cessation or weight-loss classes. The reform proposal unveiled Thursday also spells out a time-frame for seceding from the health-care plan by the end of 2011 if the federal government doesn't approve the cost-cutting measures.
Feds give states a menu for cutting Medicaid
Answering a fiscal 911 call from the nation's governors, the Obama administration Thursday gave cash-strapped states a menu for cutting Medicaid spending, one of their biggest budget headaches. It didn't have one item that many governors, particularly Republicans, are looking for. In a letter to governors, Health and Human Services Secretary Kathleen Sebelius was cool to the idea of cutting beneficiaries from the Medicaid rolls by restricting eligibility, as Arizona has requested and other states are considering.
$1.5 billion in Medicaid cuts and co-pays proposed by California governor
California Gov. Jerry Brown on Jan. 10 proposed a $127.4 billion fiscal 2012 budget with hundreds of millions in Medicaid cuts to physicians, plus limits on doctor office visits for Medicaid enrollees and a variety of new Medicaid co-payments. "These cuts will be painful, requiring sacrifice from every sector of the state, but we have no choice," Brown said in a statement. "For 10 years, we've had budget gimmicks and tricks that pushed us deep into debt."
Quinn signs Medicaid reform into law
Gov. Pat Quinn signed major reforms to Medicaid into Illinois law on Tuesday, calling it a "landmark achievement" as he was flanked by a bipartisan group of state lawmakers who said the changes aim to reduce costs, pay bills sooner and target fraud. But some health care advocates said they're concerned because the reforms to the program that provides medical care to the poor include requiring half of all patients on Medicaid be on managed care by 2015. "It is a landmark achievement, I think, for health care in Illinois," Quinn said.
Court to decide if California can reduce Medicaid
The Supreme Court will decide whether to allow California to reduce its Medicaid payments to help close its massive budget gap. The high court on Tuesday decided to hear an appeal from state officials. Lower courts stopped California from enacting a 10 percent cut in the MediCal fee-for-service program payments to physicians, dentists, adult day care centers and other providers of Medicaid services in that state.
States get Medicaid bonuses for enrolling children
Fifteen states are receiving a total of $206 million in performance bonuses for enrolling uninsured children in Medicaid. Alabama is again the largest recipient.
The bonuses were made available through the Children's Health Insurance Program Reauthorization Act, signed into law by President Obama in February 2009. Last year, the Dept. of Health and Human Services awarded $75 million in bonuses to 10 states. The rewards program will continue through 2013.
Medicaid Cuts Killing Ariz. Transplant Patients
A second person in Arizona has died while waiting for an organ transplant. Not because they couldn't find a donor but because state budget cuts took the patients off the transplant list. When CBS News first met 27-year-old Tiffany Tate in December 2010 she was in desperate need of a double lung transplant. Yet she and 98 other people in Arizona were kicked off the organ transplant list. The state decided it could no longer afford to pay for some transplants which can cost $200,000.
Texas officials seek flexibility on Medicaid coverage
Texas leaders are exploring ways to limit growth in state Medicaid spending, including asking the Obama administration for exemptions from the national health reform law or Medicaid law. But no quick or easy solutions are at hand. Texas Gov. Rick Perry has sharply criticized Democrats in Congress for not giving states more flexibility in the health reform law to cover people, especially with the 2014 Medicaid expansion to 133% of the federal poverty level.
The Dangers of the Medicaid Illusion
Forty-two years before the Patient Protection and Affordable Care Act, Earl K. Long Hospital opened its doors in Baton Rouge, La., promising access to health care for Louisiana’s poor and uninsured. As a provider of last resort, the state-run hospital’s principal mission is serving those who cannot get access or pay for care anywhere else.
Arizona Medicaid Cuts Seen as a Sign of the Times
With enrollments exploding, revenues shrinking and the low-hanging fruit plucked long ago, virtually every state has had to make painful cuts to its Medicaid program during the economic downturn. What distinguishes the reductions recently imposed in Arizona, where coverage was eliminated on Oct. 1 for certain transplants of the heart, liver, lung, pancreas and bone marrow, is the decision to stop paying for treatments urgently needed to ward off death.
Texas Gov. Perry Backs Away From Medicaid Dropout Threat
"Medicaid and the Children's Health Insurance Program are breaking the state's budget, but opting out of the federal programs would have a devastating effect on health care delivery in Texas, according to a state report issued Friday. The report said most of the methods for fixing Medicaid spending in Texas will require acts of Congress, not the Legislature, to give the state greater flexibility in how the programs are run and a greater share of the national Medicaid financing."
Medicaid managed care plan draws fire for lavish spending
Directors of Kentucky's only Medicaid managed care plan spent hundreds of thousands of dollars on limousines, expensive meals, lobbying and bonuses from 2007 to 2009, according to a report released Nov. 9 by Kentucky Auditor of Public Accounts Crit Luallen. The 273-page audit of the Passport Health Plan called for tighter controls on the plan's spending on travel, lobbying and executive salaries, among other areas. The audit, which was requested by a Kentucky state legislator, concluded that Passport leaders spent
Battle Lines Drawn Over Medicaid in Texas
A week after newly emboldened Republicans in the Texas Legislature floated a radical cost-saving proposal — opting out of the federal Medicaid program — health care experts, economists and think tanks are trying to determine just how serious they are, and if it would even be possible. The answer? It is complicated. But that is not stopping some conservative lawmakers in nearly a dozen other states, frantic over budget shortfalls and anticipating new costs from the federal health care overhaul, from exploring it.
Many physicians see Medicaid pay cut as enrollment rises
Twenty states cut Medicaid physician pay in fiscal year 2010 -- the most since 21 states did so in fiscal 2004 -- as states struggled to cope with strong Medicaid enrollment growth, according to an annual survey of state Medicaid programs. Meanwhile, 11 states, six of which also cut pay in 2010, and the District of Columbia have enacted physician pay cuts for fiscal 2011, which in many states began June 30.
New CMS chief to focus on quality, organization and costs
The agency that oversees Medicare and Medicaid needs to focus on three main goals -- better quality of care, a more organized health system and lower per capita costs, said Centers for Medicare & Medicaid Administrator Donald M. Berwick, MD. Dr. Berwick outlined his vision on Sept. 13 during a speech in Washington, D.C., his first major public address since President Obama appointed him in July.Speaking at a conference hosted by America's Health Insurance Plans, Dr. Berwick lauded the Affordable Care Act as "the most significant health care legislation since Medicare and Medicaid were created." He noted how the new health reform law invests heavily in versions of integrated care that the agency is moving toward, such as accountable care organizations and medical homes
Minn. gov to take $250M in federal Medicaid cash
Republican Gov. Tim Pawlenty informed state and federal leaders Tuesday that Minnesota will accept about $250 million in federal medical assistance, relieving health care providers and Democrats who feared he would turn it down. Last week, Pawlenty ordered his state agencies to avoid some grants associated with the federal health care overhaul. The Medicaid money was approved separately as part of a stimulus directed at states, but governors were required to formally request the aid.
Obama signs Medicaid measure
The House used a rare recess session on Tuesday to pass legislation—247-161—extending enhanced federal Medicaid payments through mid-2011. President Barack Obama later signed the measure only hours after it cleared the House, according to the Associated Press.The federal government since last year has been paying 6.2% more of its share of Medicaid as a means to help individual states stave off the effects of a sluggish economy. Under the bill, the enhanced payments would phase down over two quarters in 2011, first to 3.2% and finally to 1.2% through June.
Senate Vote On Medicaid Help For States Delayed Because Of Cost Underestimate
Senate Democrats Monday delayed a scheduled vote on a provision to aid states and local governments after the Congressional Budget Office said the bill would increase spending. The CBO analysis further complicates efforts to extend enhanced federal Medicaid funding to states. The Hill: "Democrats had scheduled a vote to end debate on their proposal to send $10 billion in funding to states and local governments to prevent public teacher layoffs.
Recession-Weary Workers, States Still Hope For COBRA And Medicaid Subsidies
With states facing a recession double-whammy of less revenue and more demand for health care services, Congress included extra money to Medicaid programs in the February 2009 federal stimulus package. Before the stimulus, the federal government's share of Medicaid costs was between 50 and 76 percent (depending on the per capita income of the state). The federal match increased to between 61 and 84 percent of all Medicaid spending.
Doctors Threaten to Pull Out of Texas Medicaid
Cuts to the reimbursements given to doctors who treat patients covered by the state's low-income health care program are raising fears that already declining physician participation will fall even further, according to a published report.The health care and insurance industries fear that a 1 percent cut in Medicaid fees scheduled to take effect Sept. 1 will be the first in a series of cuts as state agencies are asked to trim their two-year budgets by 10 percent to help cover an expected $18 billion revenue shortfall, The Dallas Morning News reported Sunday.
Move To Have Businesses Manage Medicaid Is Triggering Concern
Since Congress passed the health overhaul, businesses that manage Medicaid "are rushing to get a foothold in states that outsource Medicaid. … But the experience in some states suggests pitfalls ahead. A recent report found that 2.7 million children on Medicaid in nine states, most of them states that outsource Medicaid, are not receiving required screenings and immunizations.
Obama Fills Medicare and Medicaid Post Without Senate Approval
President Obama on Wednesday bypassed Congress and appointed Dr. Donald Berwick to head Medicare and Medicaid-- filling the job while Congress is in recess to get around Republican opposition that threatened to derail Berwick's confirmation. Berwick's supporters say he is the right man in the right place at the right time. Obama said in a written statement Wednesday that the recess appointment would allow Berwick and two other "extremely qualified candidates" to get to work "right away."
State aid to Medicaid drops 2.7%; fed spending jumps 17%
State financing for Medicaid declined an estimated 2.7% in fiscal 2010 as federal spending for the safety net insurer increased 17.2%, according to the latest survey by the National Association of State Budget Officers and National Governors Association.The lopsided growth, the result of $87 billion in federal Medicaid relief for states under the 2009 economic stimulus bill, is expected to reverse sharply in fiscal 2011 as the aid runs out, the survey suggests
Medicare: Congressional Tax Committees Release Bill with SGR Fix
Congressional leaders on the House Ways and Means and Senate Finance committees have released the purported “tax extenders” bill (HR 4213), which among other things would raise doctors’ Medicare reimbursements 1% to 2% through 2013.
Battle Looms in Senate Over Obama's Pick to Run Medicare and Medicaid
As all eyes watch Elena Kagan make the rounds of Senate office buildings, greeting senators, answering questions and building support, another of President Obama's nominees is taking the same route -- but with much less fanfare. And he very well could wield as much -- or even more -- influence on America's future as the Supreme Court nominee. Dr. Donald M. Berwick, if confirmed by the Senate, will run Medicare and Medicaid, the world’s second largest insurance provider, as the two health care giants transform to meet the requirements of the recently passed health care reform act.
Battle Looms in Senate Over Obama's Pick to Run Medicare and Medicaid
As all eyes watch Elena Kagan make the rounds of Senate office buildings, greeting senators, answering questions and building support, another of President Obama's nominees is taking the same route -- but with much less fanfare. And he very well could wield as much -- or even more -- influence on America's future as the Supreme Court nominee. Dr. Donald M. Berwick, if confirmed by the Senate, will run Medicare and Medicaid, the world’s second largest insurance provider, as the two health care giants transform to meet the requirements of the recently passed health care reform act.
Federal Officials Confirm A Shift In Medicaid Drug Rebates
The federal agency that oversees Medicaid confirmed Thursday that some money states receive as rebates from drugmakers will now be redirected to the federal government to help pay for the new health overhaul. However, federal officials said that states’ losses would be offset by other changes in Medicaid, the federal-state health care program for low-income people. The health law increases the rebates that drugmakers must offer state Medicaid programs from 15.1 percent to 23.1 percent for most brand name drugs, and by smaller amounts for other drugs and generics.
Medicaid funding extension moving through Congress
The tax extenders bill that the Senate approved on March 10 included a much-anticipated six-month extension of stimulus Medicaid funding in addition to the latest Medicare physician pay patch. The move sent the package back to the House for approval. The Senate measure would extend through June 2011 the enhanced federal Medicaid funding enabled by the most recent federal stimulus bill. That law required states to maintain existing eligibility and enrollment standards in exchange for receiving $87 billion in additional Medicaid funding over 27 months.
Obama to name new Medicare/Medicaid chief: official
President Barack Obama has picked a top health policy expert to run Medicare and Medicaid, an administration official said on Saturday, filling a role at the heart of his historic healthcare reform. Obama plans to nominate Dr. Donald Berwick as administrator of the Centers for Medicare and Medicaid Services, a unit of the Department of Health and Human Services, the official said
With Medicaid Cuts, Doctors and Patients Drop Out
Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat. As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years. She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.
South Carolina, Oklahoma And Arkansas Grapple With Medicaid Cuts To Help Balance Budget
States consider major cuts to Medicaid services and reimbursement rates to help fill gaps in the budget.
The Associated Press: "Lawmakers are considering cutting all services for nearly 26,000 people with disabilities as South Carolina tries to plug a $560 million budget hole. Parents say the proposed cuts to day care programs and other services would force them to give up much-needed jobs to stay home and care for their young and adult children." But "[l]awmakers say they have little choice.
Reid Planning To Start Debate On COBRA, Medicaid Help Extensions
Senate Majority Leader Harry Reid is planning to start debate Monday on a bill that would extend COBRA health coverage benefit subsidies for people who have been laid-off. The measure, part of a larger package of expired government programs, also would help states with Medicaid reimbursements.
Medicaid, CHIP payments to be reviewed by new federal commission
A newly appointed commission will examine how Medicaid physician pay affects access to care by Medicaid patients and those in the Children's Health Insurance Program, among other issues. The Medicaid and CHIP Payment and Access Commission, or MACPAC, will be chaired by Diane Rowland, ScD, executive director of the Kaiser Commission on Medicaid and the Uninsured. The U.S. comptroller general appointed the panel's 17 members Dec. 23, 2009.
Medicaid rolls grew 5% in 2008
Medicaid enrollment increased by an average of 4.8% nationally between December 2007 and December 2008 to reach 44.7 million, according to figures compiled by the Kaiser Family Foundation. Six states experienced double-digit increases: Colorado, Florida, Hawaii, Indiana, Maryland and Wisconsin. Wisconsin led all states with a 16.8% enrollment spike in the 12-month period, in part due to an expansion of Medicaid eligibility in BadgerCare Plus in February 2008.
Despite Subsidy, Cobra's Bite Still Stings for Many
The government is expanding a massive safety net to help the unemployed buy health insurance, but millions of people can't access the aid because of the way the program was designed. As a cornerstone of the economic stimulus plan, the administration of President Barack Obama allocated $25 billion to pay 65% of health-insurance premiums for workers laid off this year. Earlier this month, Congress extended the program for people laid off through February 2010 and expanded the aid to 15 months from nine.
Medicare, Medicaid spent $54 billion too much in 2009, White House says
Improper payments for health care made up a large portion of the $98 billion the federal government spent inappropriately in fiscal 2009. This total was an increase of $26 billion over the previous year, according to a report issued by the White House Office of Management and Budget. The Nov. 17 report concluded that Medicare fee for service improperly spent $24 billion in fiscal 2009, a rate equivalent to 7.8% of total outlays, and Medicaid improperly spent $18 billion, a rate of 9.6%. Medicare Advantage improperly spent $12 billion in 2009, a rate of 15.4% of total outlays on the private plans.
Michigan slashes Medicaid fees for doctors by another 8%
Michigan physicians won't be taxed more, but they are having their Medicaid fees slashed again. Michigan Gov. Jennifer M. Granholm on Oct. 30 signed a $45 billion, one-year budget that reduces Medicaid fees for doctors by $355 million, bringing their pay to about 55% of private insurance rates and about 50% of Medicare rates. These 8% cuts follow a 4% reduction in physician fees ordered by Granholm on July 1.
Medicaid pay could be cut again when stimulus money runs out
Federal stimulus funding has helped state Medicaid programs avoid drastic reductions in eligibility and physician fees, but program directors already are contemplating such cuts when the additional federal support runs out at the end of next year.
Holes in the safety net: Medicaid falls short just as some need it most
Doctors at the Maple City Health Care Center, a neighborhood clinic where the toddler's family receives most care, couldn’t diagnose the problem. The child needed to see a specialist, but no local dermatologist would agree to accept Medicaid, the government’s safety net plan. Instead, Antonia Mejorado, 33, has to drive nearly two hours to see a dermatologist willing to treat her daughter's potentially serious illness. With more and more doctors not accepting medicaid, covering the uninsured has become and increasing problem.
Bills Aim to Cut Medcaid, Medicare Fraud
Congress is attempting to step up efforts to combat fraud and abuse in the Medicare and Medicaid programs. Two new bills were introduced May 5 that aim to reduce the prevalence of identity theft in Medicare and increase transparency of Medicaid payment data.
Families USA, PhRMA join forces, push Medicaid expansion
Advocacy group Families USA and the Pharmaceutical Research and Manufacturers of America have unveiled a joint campaign that outlines several strategies for achieving universal health coverage, including a provision to expand Medicaid coverage.
Improving Coordination Between Medicare's
Special Needs Plans and Medicaid
Special Needs Plans (SNPs)
are intended to improve care coordination, improve quality of care, and
reduce the costs for treating high-risk, high-cost Medicare
beneficiaries, including those who qualify for both Medicare and
Medicaid benefits. Many SNPs, however, do not coordinate their benefits
with state Medicaid programs. Combined with negative perceptions of
managed care among some of the elderly, this has led to low plan
enrollment and limited impact.
