In an effort to recoup money paid in Medicaid services, Tennessee’s Medicaid program will increase its efforts to go after beneficiaries’ estates. (Kaiser Network) As more retiring baby boomers start receiving Medicaid services, I suspect more states will follow Tennessee’s lead. In other Medicaid news, a radio program called Marketplace Morning Report examined Missouri’s Medicaid program and found that it went from being one of the best in the country to one of the worse. Over … [Read more...] about Medicaid News Roundup
Automatic Medicaid Enrollment of U.S.-Born Babies of Illegal Aliens Ends
Last week, President George W. Bush announced that U.S.-born babies of illegal aliens no longer will be automatically enrolled in Medicaid. Under the new policy, which took effect this past July, illegal aliens will be required to prove their baby’s citizenship. (Kaiser Network) Leslie Norwalk, acting administrator of the Centers for Medicare and Medicaid Services, told the New York Times, “When emergency Medicaid pays for a birth, the child is not automatically deemed eligible. But the … [Read more...] about Automatic Medicaid Enrollment of U.S.-Born Babies of Illegal Aliens Ends
Texas Comptroller To Lawmakers: End Accenture Contract
Carole Keeton Strayhorn, Texas Comptroller, chastised the Texas Health and Human Services Commission for its $800 million contract with Accenture, a group that administers Medicaid enrollment and other social services. Citing mismanagement, Stayhorn says the contract “must be ended.†According to the Houston Chronicle, Accenture’s call centers experience computer glitches and lost and backlogged applications. Strayhorn, who is running for governor, asked lawmakers to transfer project … [Read more...] about Texas Comptroller To Lawmakers: End Accenture Contract
Hearing on Proposed Provider Reimbursement Rates
The Texas Health and Human Services Commission (HHSC) announced in the October 20 Texas Register that there will be a public hearing for comments on proposed interim Medicaid reimbursement rates that will apply to large, state-operated Intermediate Care Facilities for Persons with Mental Retardation. Included are state schools operated by the Texas Department of Aging and Disability Services. The hearing will be held on Monday, November 6, 2006, at 2:00 p.m. in the Lone Star Conference Room … [Read more...] about Hearing on Proposed Provider Reimbursement Rates
The False Claims Act–A Significant Hammer!
For an example of how whistleblowers and the False Claims Act interact, read this article, Home Health Care Industry Reels from Medicare Scandal. Whistleblowers can bring qui tam lawsuits against providers and benefit hugely. In this particular case, the whistleblower benefits as follows: The False Claims Act permits individuals to file qui tam lawsuits against companies that defraud the government. Liable companies pay as much as three times the government's losses plus penalties for … [Read more...] about The False Claims Act–A Significant Hammer!
Provider Letter: HCSSA Presurvey
The Texas Department of Aging and Disability Services issued a provider letter that replaces PL #05-25, effective June 1, 2006. The revised letter reflects changes in presurvey requirements, pursuant to 40 Texas Administrative Code Chapter 97 amendment. From the letter: The administrator, alternate administrator, supervising nurse (if applicable), and alternate supervising nurse (if applicable) of a HCSSA applying for licensure must attend a presurvey conference per 40 TAC Section … [Read more...] about Provider Letter: HCSSA Presurvey
Geriatric Doctors In Short Supply
The long term care insurance industry is not the only one that will feel the aging baby boomer surge. Geriatric physicians are in short supply, an imbalance that will become more obvious as baby boomers retire and require specialized treatment. (New York Times - free registration required) Geriatrics is not a popular specialty in medical schools, and the fact that geriatric medicine doesn’t pay as well as other specialties means there’s no economic incentive to choose to focus on … [Read more...] about Geriatric Doctors In Short Supply
More Money for Doctors Reporting Quality of Care Data
Physicians who provide care to Medicare patients with chronic conditions will have an incentive to do more paperwork. The Kaiser Network reports that the Centers for Medicare and Medicaid Services will begin a three-year pilot program that will pay physicians to report quality of care data. An excerpt: The three-year program will begin next year in 800 small- or medium-sized practices in Arkansas, California, Massachusetts and Utah. During the first year, physicians will be paid for … [Read more...] about More Money for Doctors Reporting Quality of Care Data
CMS Offers Online Tools to Help Medicare Part D Beneficiaries
Medicare Part D beneficiaries with questions about the prescription drug program can now access more information online. At the Centers for Medicare and Medicaid Services (CMS) web site, a tool called the "Drug Plan Finder" should contain information about all available drug plans, according to the Kaiser Network. Users can compare plans across states and learn how to lower costs during gaps in coverage. Kaiser also reports that CMS released an analysis of prescription drug plan savings: … [Read more...] about CMS Offers Online Tools to Help Medicare Part D Beneficiaries
CMS Computer System Leaves Medical Records At Risk
According to a new Government Accountability Office (GAO) report, the computer system at the Centers for Medicare and Medicaid Services (CMS)has weaknesses that could result in unauthorized disclosures of medical records. (Source) Former CMS administrator Mark McClellan, who left his position last weekend, told the Associated Press that the GAO didn’t find evidence of compromised records, and that "we appreciate GAO's assistance in identifying important opportunities for the contractor to … [Read more...] about CMS Computer System Leaves Medical Records At Risk