Medicaid Uncertainty Means Drug Treatment Expansion On Hold In N.H.
The state is also scheduled to hold more public hearings on a transition to Medicaid managed care. Elsewhere, after securing Medicaid for some children in California illegally, advocates mull coverage for the rest of the family, and Illinois and Maryland deal with their own issues in the safety-net program for the poor.
Political Uncertainty Of Expanded Medicaid Has Drug Treatment Expansion Plans On Hold
The state’s Medicaid expansion program offers an opportunity for substance abuse treatment centers to add more services, but it’s also proving an administrative headache for others. Since the program began last July, many publicly funded treatment centers have been billing insurance for the first time, as opposed to getting state grants. It’s a huge shift because the insurance reimbursements offer a steady revenue stream that typically pays at a higher rate than the state – and as a result it is considering hiring new staff and adding new programs. (Morris, 7/6)
The Associated Press:
Sessions Scheduled On Transition Into Medicaid Plan
New Hampshire’s Department of Health and Human Services has scheduled three more public meetings to help Medicaid recipients and providers about the transition into Medicaid care management from a fee-for-service program. The sessions are being held to address the move of additional Medicaid-eligible people into the care management system for medical services. Medicaid recipients who could initially opt out of Medicaid care management will now be required to choose one of the two health plans for medical coverage. (7/7)
Kaiser Health News:
Covering Poor Children Without Legal Status Is First Step, Say California Advocates
When Fabiola Ortiz heard California had granted health coverage to poor children lacking legal immigration status, she felt grateful. Since arriving in the U.S. illegally 12 years ago, she has taken her two youngest children to the doctor only for required school physicals and relied on home remedies for everything else. ... The coverage under Medi-Cal, the state’s version of Medicaid, is expected to result in more preventive care and better long-term health for an estimated 170,000 children who have long relied on safety-net clinics and emergency rooms. But while many policymakers, advocates and researchers celebrated the budget deal announced by Gov. Jerry Brown last month, they also said the new coverage is limited because it doesn’t guarantee access to doctors and doesn’t include adults. (Gorman, 7/7)
The Baltimore Sun:
Audit Finds Maryland Owes $34M For Medicaid Claims
A federal inspector general has found that Maryland incorrectly billed Medicaid for services for the developmentally disabled in hundreds of thousands of cases and that the state owes the U.S. government more than $34 million, according to an audit to be released Tuesday. The probe, by the inspector general of the U.S. Department of Health and Human Services, found the state did not ensure beneficiaries met requirements for "add-on" services — such as physical therapy or overnight, in-home help — and allowed many who did not qualify to receive the assistance. (Fritze, 7/7)
Budget problems in Illinois are threatening state funding for some groups that also help low-income residents.
The Chicago Tribune:
Illinois' Safety Net Snagged On Budget Mess
Every year, they sign petitions, call their lawmakers and head to Springfield to fend off spending cuts. And every year, they somehow manage to squeeze the belt a little tighter, step up fundraising and eke out another 12 months of pinched survival. But when state government began its new financial year last Wednesday with no budget in place, the stakes got even higher for the private, largely nonprofit organizations that operate much of Illinois' network of social services. (Rubin and Geiger, 7/7)
And AstraZeneca and Cephalon agree to pay to settle claims the companies underpaid on rebates they owed Medicaid programs --
The Wall Street Journal:
AstraZeneca And Teva Settle Allegations Of Underpaying Medicaid Rebates
Two big drug makers have settled allegations they underpaid rebates owed under the Medicaid prescription drug programs. In one case, AstraZeneca agreed to pay $46.5 million to the U.S. government and two dozen states, while Cephalon, which is now owned by Teva Pharmaceutical, agreed to pay $7.5 million to the federal and state governments to resolve similar allegations. (Silverman, 7/6)
AstraZeneca, Cephalon To Pay To Resolve Medicaid Allegations: U.S.
AstraZeneca LP has agreed to pay $46.5 million and Cephalon Inc $7.5 million to resolve allegations that the two drug companies underpaid rebates owed under the Medicaid program, the U.S. Justice Department said on Monday. (Beech, 7/6)