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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. States faced unprecedented financial pressures in fiscal 2009, which ended on June 30 for most states. They experienced a surge in new Medicaid enrollees and a historic decline in tax revenues. States coped by trimming or freezing Medicaid fees and restricting benefits, among other actions, according to a ninth annual survey of state Medicaid directors released Sept. 30 by the Kaiser Family Foundation and Health Management Associates. Medicaid enrollment grew by 5.4% in fiscal 2009 -- the highest rate in six years -- while total program spending increased by 7.9%, the fastest pace in five years. The enrollment spike was the main reason spending grew, according to report co-author Vernon K. Smith, PhD, principal with Health Management As [Read more]
Anti-abortion group wants Illinois to enforce parental notice -- now
An anti-abortion group is asking the Illinois Supreme Court to order immediate enforcement of a state law requiring physicians to notify a minor's parent or legal guardian at least 48 hours before performing an abortion. The Parental Notice of Abortion Act of 1995 was blocked from taking effect for more than a decade until the high court in 2006 finally issued mandated rules allowing young women to ask a court to bypass the notice requirement. It would be up to the court to decide if a waiver is in the minor's best interest. After additional litigation, the 7th U.S. Circuit Court of Appeals in July upheld the law's constitutionality in Zbaraz v. Madigan and dissolved a long-standing injunction preventing its implementation. The statute took effect Aug. 4. But concerns from the medical community about compliance prompted the state medical board to delay enforcement of the law by three months. Under the act, any doctor who does not act in good faith to obey the law would face a mis [Read more]
Medicaid claims lack key data that could help find fraud
Medicaid claims information submitted by states to the Centers for Medicare & Medicaid Services is slow in being released to the public and often does not contain many data elements that can assist in fraud detection, according to a report by investigators from the Dept. of Health and Human Services Office of Inspector General. In an Aug. 26 letter to Cindy Mann, the director of the CMS Center for Medicaid and State Operations, OIG states that CMS did not fully disclose or document information about the accuracy of data collected by the Medicaid Statistical Information System. Timely, accurate and comprehensive data can be used to help interagency efforts in combating health care fraud, the report notes. States must submit claims files to CMS within 45 days after the end of each quarter. The system is designed to serve as an accurate database pertaining to standardized enrollment, eligibility and paid claims of Medicaid beneficiaries. In a review of MSIS files, OIG determined [Read more]
California nursing association says insurers reject 22% of claims
California Attorney General Jerry Brown has launched an investigation into insurance companies' claims-processing practices, on the heels of a report that found health plans in the state reject about a fourth of all claims. Based on information from the state's Dept. of Managed Health Care, the California Nurses Assn. in September reported that claims denial rates for the largest plans averaged 22% between 2002 and 2009. The denial rates include any time a claim was not paid -- whether the claim was a duplicate, was sent to the wrong insurer, was made for an ineligible patient or had incomplete information. For the first half of 2009, the group reported that denial rates for the six biggest plans ranged from a high of 39.6% for UnitedHealth Group's PacifiCare to 6.4% for Aetna (www.calnurses.org/media-center/press-releases/2009/september/california-s-real-death-panels-insurers-deny-21-of-claims.html). In a Sept. 3 statement announcing his office's inquiry, Brown said, "These h [Read more]
U.S. uninsured total again tops 46 million
The number of uninsured Americans increased by about 600,000 in 2008, despite government health programs such as Medicare and Medicaid enrolling in excess of 4 million more people than they did the year before. (See correction) Although America's uninsured population reached 46.3 million in 2008, according to an annual U.S. Census Bureau report released Sept. 10, the percentage of Americans who are uninsured was virtually unchanged at 15.4%. Part-time workers and people approaching middle-age increased the uninsured numbers significantly, while there was a significant decrease in the number of children who are uninsured. American Medical Association President J. James Rohack, MD, said having so many people without coverage is unacceptable. "As Congress gets back to work, the plight of the growing number of uninsured should be front and center in the health reform debate." Still, Dr. Rohack said the exact number of uninsured people is not the most crucial issue at hand. "Wha [Read more]
Mass. turns spotlight on insurance executives' pay
Compensation for nonprofit health system executives and directors will be under a higher-powered microscope from now on, the Massachusetts attorney general told the state's biggest hospitals and insurers. Attorney General Martha Coakley on Sept. 2 presented a letter to four health plans and the Massachusetts Hospital Assn. informing them that her office will require nonprofit hospitals and health plans to expand their public reporting of pay for board members and executives (www.mass.gov/Cago/docs/nonprofit/bcbs_memo_090209.pdf). Coakley also asked the insurers -- Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, Tufts Health Plan and Fallon Community Health Plan -- to justify their compensation to their board members, given that paying directors is "extraordinarily rare" among other charitable organizations. Marylou Buyse, MD, president of the Massachusetts Assn. of Health Plans, said the justification is that hospitals and health plans are substantially d [Read more]
HHS releases $33 million for training health professionals
The Dept. of Health and Human Services announced Sept. 11 the release of $33 million in funding to help bolster training programs for health care professionals. Most of the money, part of the most recent economic stimulus package, will go toward establishing or expanding efforts to aid medical students, including providing scholarship, tuition and stipend programs. HHS Secretary Kathleen Sebelius estimated that 65 million Americans don't have access to a primary care physician due to local shortages. "That's why the reform effort also needs to look at expanding our very critical health care work force to give more Americans access to the care they need," Sebelius said. "But we can't wait for Congress to act." The grants are being distributed through six programs operated by the Health Resources and Services Administration: * $19.3 million for scholarships to full-time health professions students, with priority given to those with financial need. * $4.9 million for [Read more]
Harkin new head of Senate health committee
Senate Democrats moved quickly to fill the Senate Health, Education, Labor and Pensions Committee chair vacated by the late August death of Sen. Edward Kennedy (D, Mass.). Sen. Tom Harkin (D, Iowa) took over the helm. Although Sen. Chris Dodd (D, Conn.) was the committee Democrat with the most Senate experience -- he was elected in 1980 -- Dodd announced on Sept. 9 that he would instead retain the chair of the Senate Committee on Banking, Housing, and Urban Affairs. Committee chairs are distributed based on seniority, but senators can't hold more than one chair at a time. At Kennedy's request, Dodd chaired the HELP Committee's health reform hearings over the summer, concluding with the panel's party-line approval of the Affordable Health Choices Act in July. Dodd said he would continue to lead the committee's health reform effort. The bill is expected to be merged eventually with a measure from the Senate Finance Committee. After Dodd's demurral, Harkin announced on Sept. 9 th [Read more]
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