Medicaid

Medicaid expansion plans fade in several states

Medicaid expansion plans fade in several states

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Several so-called "red states" are leaning toward or have outright abandoned plans to allow expansion of their Medicaid programs, bucking a nationwide groundswell of program enrollment under the president's signature healthcare reform law.

Medicaid expansion leading HCBS programs to rethink strategy: Researchers

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Researchers on Wednesday proposed ways to better identify the most susceptible nursing home candidates in order to ease the expected burden on programs designed to keep the chronically ill and frail elderly at home.

Swelling Medicaid rolls have states, providers worried

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California's Medicaid-eligible rolls are swelling as part of a nationwide expansion of the program under the Affordable Care Act, a finding that should give other states' Medicaid agencies pause over the coming year.

Federal judge orders the return of $90 million in Medicaid credits

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The state of Georgia may be the mouse that roared after convincing a federal court last week to force the government to return a bungled $90 million credit, even after ruling Health & Human Services had every right to reject the state's request.

Private insurers improperly costing Medicaid funds: GAO

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Efforts to stop improper Medicaid payouts for people with private insurance need to be intensified or the program could lose millions of dollars as it continues to expand, the Government Accountability Office warns in a recent report to Congress.

State disputes OIG findings, won't seek $9 million via competitive bidding

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The New York Department of Health will not competitively bid durable medical equipment despite a new OIG report that says the state could have saved its Medicaid program nearly $9 million over a two-year period.

Also in the news for Friday, February 6

CATO blogger calls nursing home lobbyists parasites ... Tennessee Medicaid expansion plan fails ... HHS to release draft adult immunization plan Friday.

Feds want Medicaid payments returned for common ambulance services

Feds want Medicaid payments returned for common ambulance services

Medicaid programs are taking pause to ensure their non-emergency medical transportation services are operating properly after one state agency was told to return nearly $400,000 for improper bills.

Also in the news for Wednesday, January 28

Longevity gene related to planning and decision-making...Indiana to expand Medicaid... Penn researchers identify molecule related to diabetes and wounds

Lawmakers demand better adherence to Medicaid's eligibility and asset transfer rules

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Two federal lawmakers are calling on the Centers for Medicare & Medicaid Services to crack down on states that don't enforce eligibility and asset-transfer regulations.

Study to examine Medicaid-centric nursing homes that excel

Study to examine Medicaid-centric nursing homes that excel

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Evidence-based reasons for why some nursing homes serving Medicaid-heavy populations outperform others will soon be available.

Tackling risk with bundled payments in Jan. 29 webinar

Tackling risk with bundled payments in Jan. 29 webinar

Hear from Avalere experts on navigating BPCI milestones in 2015.

Bulk of Medicaid to be managed care in two years: Avalere

Bulk of Medicaid to be managed care in two years: Avalere

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More than three-quarters of Medicaid beneficiaries will be enrolled in a managed care plan as of 2016, according to an Avalere Health analysis released Thursday. The numbers reveal that managed care growth is especially strong in states that are expanding Medicaid.

40 states plan to increase nursing home Medicaid rates

40 states plan to increase nursing home Medicaid rates

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Reversing a trend of rate cutting during the Great Recession, most states are increasing Medicaid reimbursements for nursing homes, according to a recently released report. However, states also are accelerating efforts to reduce the number of nursing home residents, the report shows.

State News for October 2014

State News for October 2014

ILLINOIS — Gov. Pat Quinn (D) has signed a new law making it easier for people to lodge complaints against nursing homes.

Medicaid provider agreement remains legitimate during bankruptcy proceedings, judge rules

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Medicaid must continue to make payments to a Florida nursing home undergoing bankruptcy proceedings, a federal judge rule recently.

Three states to examine risk, reform in Medicaid project

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Alabama, Washington and Nevada are participating in a yearlong Medicaid project that could help share risk between states and the federal government, the National Governors Association said this week.

Also in the News for August 26, 2014

House Republican demands New York given back $15 billion in Medicaid overpayments ... Faith-affiliated companies can tell government they object to contraceptive mandate under new Obama accommodation ... States with higher Medicaid payments for office visits result in beneficiaries being more likely to be screened for cancer, study finds.

NY nursing home agrees to $2.2 million settlement in case of false documentation

NY nursing home agrees to $2.2 million settlement in case of false documentation

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Nursing home operator Ralex Services Inc. has agreed to a $2.2 million settlement in a whistleblower case involving forged documents at a facility in New Rochelle, New York.

Also in the news for August 21, 2014 . . .

OH Supreme Court hears case of woman who transferred property then paid for nursing home through Medicaid ... Nursing home video education project part of new $19 million round of NIH funding ... Researchers identify neuron issue leading to Alzheimer's sleep issues, may lead to new therapies

Bed taxes and other troubling compromises

Bed taxes and other troubling compromises

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As my colleague Tim Mullaney reported last week, the Government Accountability Office has been taking a closer look at Medicaid bed taxes lately. And the investigative arm of Congress doesn't seem to care much for the view.

Harkin: Divert funds from SNF settings

Harkin: Divert funds from SNF settings

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Medicaid funds would more easily flow toward people wanting home- and community-based services — and away from nursing homes — under a new bill unveiled by Sen. Tom Harkin (D-IA).

Finally, a Medicaid funding plan that actually makes sense

Finally, a Medicaid funding plan that actually makes sense

When politicians talk about Medicaid funding and nursing homes these days, an unsettling theme often emerges: the need to spend less of the former on the latter.

AOD acquires Stratis Business Systems, Inc.

AOD Software has bought Stratis Business Systems Inc., a home health and home care cloud-based software system.

Medicaid overbilling allegations were 'inaccurate' and 'misleading,' Signature HealthCARE says

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Authorities have asserted that Signature HealthCARE billed Medicaid for $2 million in unapproved costs, but this was an oversimplification that presented the company in an unfair light, the large long-term care provider contends.

Also in the news for July 7, 2014 . . .

Huge HIPAA breach inevitable, providers 'behind' crooks ... Nursing home doc has to pay back $57K to Medicaid ... Alzheimer's drug development not looking good ... Insulin pumps better than injections for diabetes care

Medicaid paying 32% less than Medicare Part D for medications

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Medicaid is paying the lowest average price for 78 high-use and high-expenditure brand-name and generic drugs, a new federal report finds.

Signature HealthCARE charged with $2 million in unapproved Medicaid billings

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Long-term care provider Signature HealthCARE billed Medicaid about $2 million for unapproved costs, auditors with the Tennessee Comptroller's Office charged Monday.

Take this to the bank: How to reduce money stress for LTC residents

Take this to the bank: How to reduce money stress for LTC residents

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In my conversations with hundreds of long-term care residents over the years, I've found money to be an almost universally sore subject among them. Financial concerns continue to be a stressor for our residents even though they're living in the mostly money-free society of LTC. With some adjustments we can — and should — reduce our residents' financial distress.

You'll never guess where the latest Medicaid relief is coming from

You'll never guess where the latest Medicaid relief is coming from

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If you are a long-term care provider relying on Medicaid dollars to make ends meet, Illinois is probably one of the last places where you'd want to be doing business. But Illinois also might have a program worth emulating wherever you are.

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