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Roughly 61,000 Ohioans in Medicaid are expected to lose their coverage this weekend after failing to take steps to renew their health benefits as required, the state’s Medicaid director said Thursday. Those recipients who did not update their household income or other eligibility information as requested are poised to be terminated from the program Saturday. Federal law requires states to “redetermine” annually whether recipients remain eligible for Medicaid. The federal-state program for the poor and disabled provides coverage to nearly one out of every four Ohioans. The process was on hold in Ohio for a year as the federal health...

There is unprecedented demand for physician assistants as insurance payment and the Affordable Care Act encourage a team-based approach to managing the care of patient populations. A snapshot of this trend can be seen in a new report by The Medicus Firm, a national physician recruiter, which said physician assistants (PAs) rose to No. 5 among its top 10 most frequently placed medical care providers in 2014, outstripping several categories of medical doctors. Primary care doctors continue to hold the top three spots with family physicians at No. 1, followed by hospitalist doctors and internists at No. 3. Just a...

Federal law generally bars illegal immigrants from being covered by Medicaid. But a little-known part of the state-federal health insurance program for the poor has long paid about $2 billion a year for emergency treatment for a group of patients who, according to hospitals, mostly comprise illegal immigrants. The lion’s share goes to reimburse hospitals for delivering babies for women who show up in their emergency rooms, according to interviews with hospital officials and studies. The funding — which has been around since the late 1980s and is less than 1 percent of the cost of Medicaid — underscores the...

The Government Accountability Office added two more federal programs to its "high risk" list in a report released this week, bringing the total up to 32. Those high risk programs are ones the GAO deems to be extremely vulnerable to fraud, waste, abuse and mismanagement, putting billions of dollars of taxpayer money at risk.

A bill has been introduced into the U.S. House by a Wisconsin Congressman which would stop abortion providers from “unbundling” abortion services so they can submit separate claims to Medicaid. U.S. Representative Sean Duffy (R-WI) said that he introduced the ‘‘Medicaid Abortion Funding Prohibition Accountability Act“ to target Medicaid providers who improperly submit reimbursement claims to pay for abortions, and related services. “These companies submit separate claims for abortion related procedures in order to receive increased Medicaid reimbursements. It is a process known as “unbundling” and is in violation of federal law,” Rep. Duffy said in his press release. “All...

On Friday, the Wyoming State Senate voted 19-11 against a proposal to expand Medicaid under the Affordable Care Act. The House Labor, Health and Social Services Committee then pulled its version of the bill. “With all of the Senate’s work, they still fundamentally believe this is not the right thing for Wyoming,” Committee Chairwoman Rep. Elaine Harvey stated. The proposal, known as the SHARE plan, would have called for a federal waiver permitting the state to charge monthly premiums and co-payments to low-income individuals participating in the program. However, the proposal would have almost assuredly been rejected by federal officials,...

In Rebuke of Tennessee Governor, Koch Group Shows Its Power "In December, Tennessee Gov. Bill Haslam, a Republican, got the deal he wanted from the Obama administration: Tennessee would accept more than $1 billion in federal funding to expand Medicaid, as allowed for in the Affordable Care Act, but Obama aides would allow Haslam to essentially write staunchly conservative ideas into the program's rules for the state. He dubbed the reformed Medicaid program "Insure Tennessee." But the state's chapter of Americans for Prosperity, the national conservative group whose foundation is chaired by controversial billionaire David Koch, argued Haslam was just...

A proposal to expand Medicaid under the Affordable Care Act failed 4-7 in Tennessee’s Senate Health Committee during a special session Wednesday as lawmakers expressed concern with increasing the federal government’s role in state affairs. The proposal, Insure Tennessee, had been in development since early 2013 when Governor Bill Haslam signaled interest in negotiating an expansion with federal officials. The two-part proposal included the Volunteer Plan, providing premium assistance to those with employer sponsored coverage, and the Healthy Incentives Plan, establishing health savings accounts and incentivizing healthy behaviors like physicals and appropriate emergency room use. Critics of the plan, however,...

Gov. Bill Haslam said he sees no point in returning to federal officials to ask for more concessions on his health care plan after the state legislature killed the proposal Wednesday, according to the Commercial Appeal. “I think it feels a little pointless right now to come back with the same plan. And so there has to be something that would show change (among lawmakers),” the governor told reporters after the defeat. ..Asked if he would return to the regular legislative session, which opens Monday for a three-month run, with the same plan or a modified version, the governor said:...

Health insurance giant Anthem Inc. said late Wednesday that hackers had breached its computer system and the personal information of tens of millions of customers and employees was possibly at risk. [Snip] The data breach extended across all of Anthem's business, possibly affecting customers at large employers, individual policyholders and people enrolled in Medicaid managed-care plans. Anthem has more than 37 million members in California and 13 other states. But the company warned that it also had information in its database on other Blue Cross Blue Shield patients from all 50 states who had sought care in its coverage area.

It should have been Mike Pence's strongest moment as Indiana governor -- a chance to showcase his style of executive leadership on the national stage. Instead, the week turned into a calamity of Team Pence's own making. The leaked details of a bizarre proposal to create what sounded like a state government-run news agency sucked all the oxygen out of Indiana's political media, right when Pence was supposed to explain a complicated conservative approach he's taking to expanding Medicaid. Pence immediately backtracked, but the damage was already done. (SNIP) Indiana's Republican House speaker, Brian Bosma, even taunted Pence a bit,...

In 2010, Planned Parenthood of the Inland Northwest agreed to pay the state $345,000 after settling a 2009 audit that uncovered the clinic used incorrect codes and provided insufficient documentation for some claims billed to Medicaid. The original audit finding estimated the Spokane family-planning organization improperly billed Medicaid more than $629,000 for 333 patient procedures from March 2004 through February 2007. During that time, the clinic collected about $7.6 million from Medicaid. Planned Parenthoods in New Jersey were also investigated that same year. In 2012, a published report said that Illinois Medicaid’s inspector general was investigating the billing practices of...

In his recent State of the Union address, President Obama was upbeat and inspiring, particularly if a listener had no prior knowledge of his many speeches that were quite similar but bore no fruit. It almost appeared that he was living in an alternate universe that bore no resemblance to present-day America and the current global stage. He boasted that the economy was doing very well and that unemployment had been cut in half since he took office. Perhaps someone should educate him about the labor force participation rate, which is at its lowest point in the past 36 years...

Indiana Republican Gov. Mike Pence is moving ahead to extend Medicaid coverage to hundreds of thousands of Hoosiers under the federal health law after securing a key concession from the Obama administration. The deal, to be announced Tuesday, could pave the way for half a dozen more states to seek similar deals, boosting Medicaid expansion proposals in Republican-led states including Florida, North Carolina and Wyoming. Indiana and Washington officials had been locked for months in negotiations over an issue that could shape the future of Medicaid, the 50-year-old federal-state health program that covers more than 60 million low-income Americans. Mr....

Lillian Palermo tried to prepare for the worst possibilities of aging. An insurance executive with a Ph.D. in psychology and a love of ballroom dancing, she arranged for her power of attorney and health care proxy to go to her husband, Dino, eight years her junior, if she became incapacitated. And in her 80s, she did... But one day last summer, after he disputed nursing home bills that had suddenly doubled Mrs. Palermo’s copays... Palermo was shocked to find a six-page legal document waiting on her bed. It was a guardianship petition filed by the nursing home, Mary Manning Walsh,...

Governor Andrew M. Cuomo today announced new regulations to include transgender health care services under New York State’s Medicaid program. The proposed regulations provide treatment for hormone therapy and gender reassignment surgery.... New York will join California, Massachusetts, Oregon, Vermont, and Washington D.C., which cover transgender health care through their Medicaid programs. In May, the federal government also ended its decades-long exclusion of coverage for certain services related to gender transition under Medicare. The introduction of this Medicaid regulation follows last week’s announcement that New York State law requires private health insurance companies to cover transgender health care on the...

Nationally, 724 hospitals have had their Medicare funding reduced after the Centers for Medicare and Medicaid Services found that each had high rates of potentially avoidable “hospital-acquired conditions,” including falls, bed sores, and certain infections, including ventilator acquired pneumonia and catheter-associated urinary tract infections. CMS scored hospitals on the prevalence of three risk factors to their Medicare population patients: central line bloodstream infections, catheter-associated urinary tract infections, and serious complications, a catch-all group made up of eight types of injuries, including blood clots, falls, and bed sores. Funding can be reinstated for hospitals whose scores improve in the targeted areas.

Medi-Cal applicants who have been waiting for more than 45 days can receive temporary health benefits while officials determine eligibility for the public insurance program, a state Superior Court judge ruled this week. The suit, which was filed in Alameda County Superior Court by a coalition of health advocates and legal services groups, cited delays in enrolling pregnant women, children and adults with life-threatening conditions. Advocates said many either had to postpone treatment or pay cash to see doctors. Medi-Cal is California’s version of Medicaid, the publicly funded insurance program for poor and disabled residents. Prompted by the Affordable Care...

In his State of the Union Tuesday, President Obama claimed that Obamacare has helped cut the deficit by two thirds by slowing the rate of health care spending growth. Not only is this claim false, but Obamacare has created a deficit time bomb that will explode just as he is leaving office.Now it is true that the growth of health care spending has fallen during Obama's presidency. But that slowdown began not only before Obama passed Obamacare, but even before Obama took office. The reality is that larger economic factors, including the growth of cost-sharing health care plans, began slowing health care spending...

Under President Obama’s new program to protect millions of illegal immigrants from deportation, many of those affected will be eligible to receive Social Security, Medicare and a wide array of other federal benefits, a White House official said Tuesday. In his speech Thursday night, the president touted his plan as a means of bringing accountability to a broken immigration system, under which 11 million or more people are estimated to be living in this country illegally. “We’re going to offer the following deal: If you’ve with been in America more than five years. If you have children who are American citizens...

Marilyn Tavenner, head of the U.S. Centers for Medicare and Medicaid Services, plans to step down at the end of February, she told her staff in an e-mail.As Bloomberg reports, Tavenner didn’t say why she was leaving.In November, she acknowledged that her agency had made a mistake in its calculation of the number of people enrolled under Obamacare. As a reminder... from November The Obama administration said it erroneously calculated the number of people with health coverage under the Affordable Care Act, incorrectly adding 380,000 dental subscribers to raise the total above 7 million. The accurate number with full health-care plans...

Hey, are you one of the 9.7 million Americans who have been put onto the Medicaid rolls since 2013 mostly as a result of theAffordable Care Act? Congratulations! But that and $2.75 will get you one ride on the New York City subway. That's because finding a doctor who accepts Medicaid payments – never all that easy to do even before 2013 – is getting harder than ever thanks to a steep drop in reimbursement rates for doctors who treat patients on Medicaid. When I say "steep," I mean it. We're talking an average of 43 percent nationwide and almost...

PALM BEACH GARDENS, Fla. — Rita Gorenflo’s 7-year-old son Nathaniel was in severe pain from a sinus infection. But since the boy was covered by Medicaid, she couldn’t immediately find a specialist willing to see him. After days of calling, she was finally able to get Nathaniel an appointment nearly a week later near their South Florida home. That was in 2005. Last month, ruling in a lawsuit brought by the state’s pediatricians and patient advocacy groups, a federal district judge in Miami determined Nathaniel’s wait was “unreasonable” and that Florida’s Medicaid program was failing him and nearly 2 million...

Thirty-six states that rely on private managed care programs to provide medical services to all or some of their Medicaid recipients are facing an added ObamaCare tax. According to a report by Milliman consulting actuaries, states that contract with Medicaid managed care plans face up to $15 billion in added costs over 10 years for their share of the law’s tax on private health insurance. States will pay even if they strongly oppose ObamaCare and are refusing to establish health insurance exchanges or expand Medicaid. The health law imposes an annual tax on private health insurance plans – a tax...

The Obama administration announced new rules under Obamacare on Monday that target nonprofit hospitals’ efforts to get paid by their patients.Nonprofit hospitals, which serve a charitable purpose and are often religiously affiliated, will now be subject to strict rules on when and how they can collect payments from customers, thanks to regulations included in the health-care law. As a condition of their tax-exempt status, these hospitals must “take an active role in improving the health of the communities they serve,� Treasury Department deputy assistant secretary for tax policy Emily McMahon wrote in a blog post Monday. Under the new IRS...

While states debate expanding their Medicaid programs under Obamacare, they're wrestling with a looming 2017 deadline — when their taxpayers begin paying for the cost of the expansion. Beginning in 2014, states that agree to expand Medicaid to persons with incomes of up to 138 percent of the poverty line will have the federal government pay 100 percent of the cost. But beginning in 2017, the federal share will fall to 95 percent, and it drops to 90 percent in 2020. This has officials — many of them in Republican-dominated states across the country — worried that they will not...

Azealia Banks is still bothered by America’s history with slavery and took to Twitter to let everyone know about it! The 23-year-old rapper believed that America owed money to blacks for putting them into slavery and stopping them from being successful in society. “I don’t know why all the white people on my Twitter are saying I’m “playing the victim” cause I’m not… I really just want my [expletive] money,” the 23-year-old rapper tweeted on Saturday (December 27). Azealia decided to voice her opinion after she stirred up some controversy by saying that she wanted to find descendants of slave...

This is a .pdf format document. Full Title: Reversing the Medicaid Fee Bump: How Much Could Medicaid Fees For Primary Care Fall in 2015?

WASHINGTON — Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.

Andy Pasternak, a family doctor in Reno, Nev., has seen more than 100 new Medicaid patients this year after the state expanded the insurance program under the Affordable Care Act. But he won’t be taking any new ones after Dec. 31. That’s when the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expires, resulting in fee reductions of 43 percent on average across the country, according to the nonpartisan Urban Institute. The challenge is to convince physicians not just to continue accepting such patients but to take on more without getting paid what they’re...

California's health exchange is violating the law by canceling private coverage for up to 95,000 people because they might qualify for Medi-Cal, the state's insurance commissioner says. At issue is health insurance for some of the poorest Californians whose incomes aren't high enough to even qualify for subsidized policies in the Covered California exchange. The state marketplace is notifying thousands of policyholders that their federal premium subsidies for Obamacare coverage will end Dec. 31 and their private health plan won't be renewed starting in January. Instead, these people will be put into Medi-Cal, the state's Medicaid program for low-income residents....

An entire nation votes, tens of millions of Americans come out to their local polls to tell Washington it is going in the wrong direction on amnesty and Obama Care, and endless deficits, and cowardice in the face of terrorism…and what do the Republicans leaders do? They give the president everything he could ask for, while turning on one of the few in the Republican ranks that understands we are fighting for the very life of the nation. The Republican Party simply is not up to the task of changing the course of this nation. Too many in the Republican...

While enrollment on government-run Obamacare exchanges gets the bulk of media attention, sign-ups for Medicaid have been even greater, in no small part due to another part of the Affordable Care Act. Since October 2013, enrollment in Medicaid and the related Children's Health Insurance Program had grown by about 9.7 million people as of this past October, according to data released Thursday by the federal government. That's 17 percent higher than what was the average monthly enrollment level seen from July through September 2013. That bump brings total enrollment in the programs that provide coverage without a premium charge to...

Tennessee Republican Gov. Bill Haslam became the latest red-state governor to approve a twist on Obamacare’s Medicaid expansion Monday.Haslam is supporting a private-option version of Obamacare’s Medicaid expansion, which was pioneered by Arkansas in 2014. The proposal will have to be approved by the Department of Health and Human Services and the Republican-controlled legislature; if it goes through, Tennessee will be just the 28th state to move forward with the expansion of the welfare program through Obamacare.“We made the decision in Tennessee nearly two years ago not to expand traditional Medicaid,� Haslam said Monday. “This is an alternative approach that...

Gov. John Kasich’s Obamacare expansion has put 450,941 Ohioans on Medicaid, outpacing his administration’s projections by 24 percent. Instead of tempering leftist support for the expansion, budget-busting enrollment is portrayed as good news for Ohio; Obamacare sticks federal taxpayers with 100 percent of Medicaid expansion benefit costs through 2016. Kasich — who expanded Medicaid over the General Assembly’s express disapproval — told attendees at a Dec. 4 infant mortality summit to march in favor of more Obamacare expansion spending, but critics are encouraging legislative opponents to stand their ground. “Kasich is threatening to organize protests to ensure the state continues...

Jonathan Gruber’s health care forecasting is failing in Colorado as Vermont’s Gov. Peter Shumlin prepares to use the economist’s math for single-payer health care. As Vermonters anxiously await a Gruber-modeled financing plan for Green Mountain Care, modeling done for Colorado’s health exchange by Jonathan Gruber Associates has proven wildly erroneous. In 2011, following Colorado’s decision to set up a state health exchange for Obamacare, the state hired Gruber to forecast enrollment trends from which the state and federal government could estimate costs. According to a presentation delivered to the Colorado Health Benefit Exchange Board on Sept. 16, 2011, and provided...

The same day ObamaCare architect Jonathan "Stupid Americans" Gruber swore before Congress that there wasn't any deception involved in getting it passed, an inspector general report showed how the law continues to mislead the public. Writing off an advance copy of the report, the New York Times said the Health and Human Services IG found "half of the providers" listed as serving Medicaid patients "could not offer appointments to enrollees."

LEXINGTON — Rural hospitals in Kentucky are facing some of the biggest challenges in their histories and some may be forced to close their doors state auditor Adam Edelen told the Kentucky Chamber on Monday. Edelen, who will be releasing an audit on the plight on the states rural hospitals in January, told members of the Kentucky Chamber of Commerce who were attending their annual legislative preview conference, that the difficult economy and managed care are the primary drivers of the difficulty in rural health care. Generally, Medicare reimburses hospitals around 90 percent of cost while Medicaid reimbursement is around...

It's not even under investigation, but Planned Parenthood is worried it is coming to the end of the line in Scott Walker's Wisconsin. Investigators with the state's Department of Health Office of Inspector General (OIG) say that two family planning facilities alone have charged the Medicaid program more than twice their allowable cost for birth control, overbilling taxpayers by millions of dollars a year. A spokesperson for Planned Parenthood Wisconsin admitted, if the state will demand that they follow the law as written, it would have to shut down its locations across the state.

In 2012, the Department of Health and Human Services estimated that 72.2 million Americans were receiving Medicaid benefits for at least a month. Medicaid is a government health insurance program aimed at helping the poor and disabled. Enrollment into the program is going up dramatically, according to the Institute for Policy Innovation (IPI). Both Medicaid and ChildrenÂ’s Health Insurance Program (CHIP) are up 15 percent, or 8.7 million people, since Obamacare began enrolling people in the fall of 2013; states that expanded Medicaid coverage are seeing 22 percent growth or more. For many states, Medicaid is the largest item of...

Ohio taxpayers are being treated to an unwelcome taste of DC, as Governor John Kasich brings President Obama’s favorite policies and tactics to the Buckeye State. Narrowly elected as a small-government conservative in 2010, Kasich has veered sharply to the left despite Republican supermajorities in both houses of the Ohio General Assembly. Candidate Kasich warned that the Obamacare Medicaid expansion would “stick states with large and unsustainable costs.” But after failing to trim public unions’ power in 2011, Kasich decided last winter that he’d show what a caring moderate he is by hanging the millstone of Medicaid expansion around Ohio’s...

The state of North Carolina has given Jonathan Gruber the boot, firing the ObamaCare architect after he was caught on camera repeatedly calling American voters “stupid.” Rep. Mark Meadows (R-N.C.) went “On The Record” tonight, explaining that Gruber was hired one year ago to help with a health care plan that dealt with Medicaid recipients and the uninsured. Meadows said that Gruber was supposed to be an unbiased individual, but after these reports, the auditor decided that he’s not so unbiased after all. …

Roughly one million undocumented immigrants in California qualify for President Obama’s executive action of deferred deportation that he announced on Thursday. Of those 40% will be eligible for the states free Medi-Cal health services, while the remaining will be ineligible under the program’s income requirements. Medi-Cal is the state’s name for Medicaid, a federal health services program for people who have low income. According to KQED News, the newly protected illegal immigrants do not qualify for other benefits of the Affordable Care Act and are not eligible for subsidies on the Covered California exchange. “They’ll be in the same situation...

--SNIP-- Gruber said during an event at Simmons College in February. ”Ted Kennedy had managed to figure out a way to rip off the federal Medicaid program to the tune of about $500 million a year through a series of strange manipulations. “Here was Mitt Romney’s dirty little secret that we don’t like to talk about in Massachusetts, which is the way we passed our law is the federal government paid for it. “George Bush said why am I sending this Democrat $500 million a year, I’m taking it back,” Gruber explained, adding “Mitt Romney to his credit went to...

Immigrants and their U.S.-born children make up more than 40 percent of new Medicaid recipients at a cost of $4.6 billion, according to an analysis of government data. The Center for Immigration Studies, a low-immigration advocacy group, released a report early Thursday that found both legal and illegal immigrants and their minor children made up 42 percent of Medicaid growth from 2011 to last year. Part of the increased enrollment came as a result of the new healthcare law’s expansion of Medicaid to impoverished and low-income adults. [SNIP] According to CIS officials, most of the immigrants tallied in the report...

People who weren’t even born in America are taking significant advantage of one of Obamacare’s single-most expensive benefits, the expansion of Medicaid, a new report from the Center for Immigration Studies (CIS) shows. In fact, immigrants have accounted for 42 percent of the growth in Medicaid enrollment since Obamacare began being implemented in 2011, the report finds. “The high rate and significant growth in Medicaid associated with immigrants is mainly the result of a legal immigration system that admits large numbers of immigrants with relatively low-levels of education, many of whom end up poor and uninsured,” report co-author Steven Camarota...

The administration on Monday said fewer than 10 million Americans will enroll in Obamacare’s health exchanges this go-around, well short of the 13 million target congressional scorekeepers deemed critical to its economics, suggesting another rocky rollout in the law’s second year of full operation. Policy advisers at the Health & Human Services Department estimated that 9 million to 9.9 million people would enroll through the exchanges — or only a slight increase over the 8 million that the administration says were active at the end of the first enrollment period this April. The Congressional Budget Office, which is the government’s...

Medicaid chiefs from red and blue states are urging Congress to stem the cost of revolutionary new drugs for hepatitis C, cancer, and other diseases. In a letter Tuesday to key congressional committees, the National Association of Medicaid Directors said lawmakers should consider everything from outright price controls on manufacturers to federal help for states trying to pay for the new medications. The bipartisan group did not endorse any particular course of action. …

The federal government has sued New York City, saying it ripped off Medicaid for millions of dollars by submitting tens of thousands of false claims. […] The lawsuit says the city and a computer company used computer programs to dodge a requirement that Medicaid be billed only after private insurance coverage is exhausted. The lawsuit says false diagnosis codes were submitted to Medicaid. …

A Bristol mother is upset after she says her baby was denied a flu vaccination, even though the health department had flu shots on the shelf. When Annie Howard took her 14-month-old son to get his flu shot last week, she ran into what she calls a big problem. "My child is being denied the vaccination outright, denied the vaccination because we have insurance. That baffles me," she says. Howard's physician ran out of the preservative-free vaccination for infants, so she made an appointment at the Sullivan County Health Department. "I called asking them if they have the infant vaccination,...