The Trump administration’s top Medicaid official has been increasingly critical of the entitlement program she has overseen for three years. Seema Verma, administrator of the Centers for Medicare & Medicaid Services, has warned that the federal government and states need … Read More
Cash-strapped rural Texas hospitals have been closing at an alarming rate, but health care advocates are warning that the trend likely will accelerate under a proposed rule change for federal Medicaid funding that’s also forecast to deal big financial blows … Read More
A collaboration between the Texas Health and Human Services Commission and the Centers for Medicare and Medicaid Services will provide comprehensive women’s health services through a Medicaid demonstration waiver over the next five years. The Healthy Texas Women demonstration waiver … Read More
The Trump administration wants to dramatically alter the way the federal government gives money to states for Medicaid. On Thursday, Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, announced a new pathway for states to receive … Read More
January 28, 2020 – 1:30pmHealth and Human Services Commission Brown-Heatly Building Public Hearing Room Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comment on proposed Medicaid payment rates for the 2020 … Read More
As Florida lawmakers prepare to start the 2020 legislative session, the state is being confronted with a $70.4 million loss in the coming months in the amount of Medicaid money it gets to fund hospitals, train future physicians and treat … Read More
CHIP outreach materials have been updated. The materials include a new brochure, poster, and income limit card. Hard copies of the materials can be ordered online for free by providers and community organizations. Email Susana.Penate@hhsc.state.tx.us with your questions. Source: CHIP … Read More
Texas health officials violated state law when they said they would award a multibillion dollar series of health insurance contracts to for-profit companies while overlooking nonprofit health plans, a lawsuit brought by two nonprofit health insurers alleges. Up for grabs … Read More
10-21-2019 | Audit (A-06-16-01001) | Complete Report | Report in Brief Why OIG Did This Review Federal regulations effective July 1, 2011, prohibit Medicaid payments for services related to treating provider-preventable conditions (PPCs). The Centers for Medicare & Medicaid Services … Read More
Currently, there is a drastic decline in the number of health insured children in the United States. Sources report that Medicaid is dropping more and more of its clients without hesitation due to unrealistic paperwork deadlines. The New York Times … Read More
10-01-2019 | Audit (A-05-17-00049) | Complete Report | Report in Brief We estimated that Minnesota made unallowable capitation payments totaling at least $3.7 million ($3.2 million Federal share) to MCOs on behalf of deceased beneficiaries during our audit period. Of … Read More
We estimated that Illinois did not recover unallowable MCO payments made on behalf of deceased beneficiaries during our audit period, totaling at least $4.6 million ($3.2 million Federal share). We confirmed that 80 of the 94 beneficiaries associated with the … Read More
TEXAS, USA — Texas Attorney General Ken Paxton announced that his office filed a civil Medicaid fraud lawsuit against two pharmaceutical companies for using the opioid drug, Duragesic. Pharmaceutical manufacturer Johnson & Johnson, and its subsidiary Janssen Pharmaceuticals, Inc. are … Read More
A 55-year-old Rockledge woman who Florida law enforcement authorities said bilked Medicaid out of $45,000 for in-home care not provided, was arrested Tuesday. Laura Leace, a participant in the Consumer Directed Care Plus program geared toward assisting people with disabilities, … Read More
The Minnesota Department of Human Services (DHS) is intensifying pressure on two Indian bands to repay $25.3 million in Medicaid overpayments, despite mounting evidence that state officials were largely to blame for the billing error. In letters sent to the … Read More
Following a detailed account of how scam artists can easily gain access to health care cash, six Democratic senators this week sent a letter to federal regulators urging them to “close loopholes” that allow “bad actors” to commit fraud. The … Read More
A potential class-action lawsuit filed this week alleges Florida did not properly determine whether Medicaid beneficiaries could continue qualifying for coverage after initially losing eligibility for the health-care program. The lawsuit was filed Wednesday in federal court in Jacksonville against … Read More
WASHINGTON — The ranking member of the U.S. Senate health committee has complained for months about the Trump administration’s failure to look into Medicaid contractors that have reaped big profits while sometimes failing to provide crucial patient services. So last … Read More
ALEXANDRIA, Va. (AP) — Just over 300,000 low-income Virginia adults have enrolled in the state’s expanded Medicaid program. Gov. Ralph Northam made the announcement Wednesday at a health center in Alexandria. State officials have previously estimated that roughly 400,000 adults … Read More
The HHS inspector general could soon call on Florida to refund the federal government $436 million in Medicaid funds that were improperly paid to the country’s largest public hospital, according to a draft report obtained by POLITICO. The independent auditor’s … Read More
Mass.-based laboratory-testing service and its owners paid more than $1.5 million to resolve allegations that they overbilled Connecticut’s Medicaid program, prosecutors say. Clinical Science Laboratory Inc. (CSL), of Mansfield, Mass., and its owners Stanley Elfbaum and Louis Amoruso entered into … Read More
The Centers for Medicare & Medicaid Services (CMS) released renewed guidance on Medicaid eligibility determinations and spending integrity the organization announced. According to CMS, Medicaid eligibility for adults in expansion states are not being assessed within federal and state requirements … Read More
TEXARKANA, Texas – A Texarkana, Texas, physician has agreed to pay $118,000 to settle allegations of improper billing practices for his Medicare patients at his three clinics, announced U.S. Attorney Joseph D. Brown today. Dr. Donald S. Douglas, 50, operates … Read More
A proposed bill would allow Medicaid recipients to take the Uber and Lyft ride-sharing companies to the doctor or Emergency Room for non-emergency appointments–and charge the government– and the taxpayer for it. HB 1576, sponsored by Rep. Dade Phelan, R-Beaumont, … Read More
Katherine Edmundson didn’t know her 7-year-old son was off Medicaid until she took him to the dentist for his annual cleaning in February. An employee at the front desk told her that his coverage was invalid and that her son … Read More
The Supreme Court of Iowa ruled in favor of appellee Robert F. Colwell, DDS, over the Iowa Department of Human Services in the Supreme Court of Iowa, No. 18-0464, on February 8, 2019, in a case that addressed the way … Read More
Imagine suddenly losing your health care coverage over some undelivered paperwork. Recent reports suggest this is happening to thousands of Texas’ poorest children, jeopardizing their ability to get basic medical care and yanking away a ladder proven to help families … Read More
AUSTIN — About 50,000 Texas children are losing Medicaid coverage each year because their families fail to quickly send proof to the state they are still poor enough to qualify, state data show. Yet one in three children kicked off … Read More
PROVIDENCE, R.I. (WPRI) – More than 1,000 dead Rhode Islanders received over $11 million in Medicaid benefits last year, according to a financial audit reviewed by the Target 12 investigators. It’s one of the findings in the state’s 443-page annual … Read More
Medicare made more than $23 billion in improper payments in 2017 due to insufficient documentation, according to a new Government Accountability Office report. The GAO also found in its review that Medicaid paid out more than $4 billion for services … Read More
Efforts in several states to require Medicaid recipients to work, study, volunteer or search for a job have stalled amid court challenges and questions from lawmakers, but the Trump Administration vowed to continue approving similar work requirements. A federal judge … Read More
A federal judge heard legal challenges Thursday to a Trump Administration policy that allows states to implement work requirements in order for residents to qualify for Medicaid. U.S. District Judge James Boasberg heard oral arguments in two separate cases challenging … Read More
AUSTIN — Texas would soon start relying on Uber, Lyft and other ridesharing services to shuttle Medicaid patients to and from the doctor, if a new House bill becomes law. The state is one of several eyeing rideshare as a … Read More
There are the days Lilia Valadez spends in pain — vomiting, pacing, aching, screaming — and the days she spends anticipating when the pain might come again, keeping her from work and potentially requiring an emergency room visit she can’t … Read More
FRANKFORT, Ky. (WTVQ) –A Prestonsburg woman was sentenced and ordered to repay the state Medicaid program more than $12,000 after pleading guilty to theft charges and engaging in a scheme to defraud the program, according to the state attorney general’s … Read More
Idaho, Maine, Nebraska and Utah voters approved Medicaid expansion through ballot initiatives. Now Texas legislators have filed bills for a vote over whether the state should expand coverage for the joint federal-state health insurance program. Olga Kauffman is tired of … Read More
“Federal appeals court lifts order blocking Texas from kicking Planned Parenthood out of Medicaid” was first published by The Texas Tribune, a nonprofit, nonpartisan media organization that informs Texans — and engages with them — about public policy, politics, government … Read More
Texas is leading the charge in a federal lawsuit seeking to end the Affordable Care Act, known as “Obamacare,” arguing the law is no longer constitutional after Congress ended the individual mandate. The state also has the highest uninsured rate … Read More
A former Texas Health and Human Services executive commissioner has been tapped to be the acting director of the federal Center for Medicaid and CHIP Services. Chris Traylor will oversee how states are running Medicaid, the joint federal-state health insurance … Read More
An Idaho think tank has filed a lawsuit asking the state’s Supreme Court to block a scheduled expansion of Medicaid. The suit, brought by the Idaho Freedom Foundation, says the expansion— which was passed through a ballot initiative during the … Read More
