KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Judge Halts Implementation Of La. Medicaid Managed Care Plan

The Times-Picayune: State Judge Temporarily Blocks State From Proceeding With Medicaid Reform Plan
A state judge, granting the request of Aetna Inc., has issued a temporary restraining order blocking the Louisiana Department of Health and Hospitals from implementing its plan to shift more than 800,000 Medicaid recipients and their $2.2 billion in claims to private insurers. Aetna is protesting the state's selection of three-firms -- Louisiana Healthcare Connections Inc., a subsidiary of Centene; Amerihealth Mercy of Louisiana Inc.; and AmeriGROUP Louisiana Inc. -- to run "pre-paid coordinated care networks." Aetna went to a Baton Rouge district court after Health Secretary Bruce Greenstein rejected its administrative appeal of his initial decision (Barrow, 9/6).

Meanwhile, in other Medicaid news --

Chicago Tribune: Illinois Limits Psychiatric Drugs For Medicaid Patients
In a money-saving move that reflects the dire condition of the state budget, the Illinois Department of Healthcare and Family Services no longer automatically provides 17 brand-name psychiatric drugs to people on Medicaid, the state's insurance program for the poor. Officials say doctors must first explain why the pricey medicines are preferable to alternatives that can be far cheaper. The changes, which began in May, are meant to trim $90 million annually from Illinois' $14 billion Medicaid budget, which consumes nearly a quarter of state spending. Department officials say they consulted with experts before deciding that the less expensive drugs would be acceptable for most patients (Keilman, 9/7).

The Associated Press/Houston Chronicle: Mass. AG: RI Man Defrauded Medicaid From Jail
Rhode Island man has been sentenced to up to three years in prison after pleading guilty to defrauding the Massachusetts Medicaid program of more than $100,000 from jail. Investigators from Massachusetts Attorney General Martha Coakley's office said 34-year-old Bruce Fields, of Johnston, R.I., falsely claimed to have provided personal care attendant services to an associate between 2004 and 2008 (9/6).

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