New York’s Medicaid program wasted $874M due to errors
From January 2011 through February 2015, New York’s Medicaid program lost $513 million in improper payments or potential revenue, and an additional $361 million in questionable transactions might be...
View ArticleNo fun before 21: smoking age may be raised in Hawaii
Hawaii state Senate bill SB1030 HD2 has been passed by both chambers and sent on to Governor David Ige (D) for consideration. The bill includes electronic cigarette devices in its definition of tobacco...
View ArticleLingering recession impact slowing health spending growth rate
Although health care spending is continuing to grow, the rate of growth has slowed dramatically. U.S. News & World Report has created a new interactive Health Care Index highlighting spending...
View ArticleManaged care expansion gets a green light in Missouri
Missouri’s option to expand Medicaid managed care became etched in stone when Governor Jay Nixon (D) signed 13 budget bills on May 8, 2015. Missouri currently has some managed care in place, but this...
View ArticleWheels of justice turning quickly: DOJ puts on the HEAT
The Department of Justice (DOJ) has made progress in several health care fraud cases in the past few days. Additionally, the DOJ announced the appointment of a new acting administrator of the Drug...
View ArticleDespite expanded health coverage, expensive ER visits are on the rise
Despite the implementation of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), 75 percent of emergency physicians indicate that emergency room (ER) visits are on the rise. When the...
View ArticleWe’ve heard enough: court draws the line at accommodation, denies rehearing
Priests for Life, a nonprofit organization, was denied a rehearing en banc regarding its objections to the accommodation allowing religious non-profits to pass the burden of providing contraceptives to...
View ArticlePreventable hospital admissions down among seniors, other challenges persist
Improvements in the rate of preventable hospitalizations for seniors are encouraging, according to United Health Foundation’s America’s Health Rankings® Senior Report: A Call to Action for Individuals...
View ArticleHighlight on New Mexico: Behavioral health care improved following extensive...
Increased accountability has made a significant impact on the quality and amount of care that New Mexico Medicaid beneficiaries receive. The oversight stemmed from the results of a long behavioral...
View ArticleHospitals strongly oppose House bill allowing more physician self-referrals
The American Hospital Association (AHA), representing several other industry associations and groups, wrote to the Committee on Ways and Means for the U.S. House of Representatives opposing H.R. 2513,...
View ArticleHighlight on New Hampshire: Expanded Medicaid effective, but in jeopardy
According to the numbers, New Hampshire’s decision to expand Medicaid coverage was a successful one, but it is also in danger. In 2014, when the expansion took effect, projections hovered around 50,000...
View ArticleAddressing mental health needs requires collaboration, creativity, and funding
Keeping up with the demand for mental health care is yet another challenge for the industry. As competition for funding grows ever more intense, communities are finding creative new ways to meet...
View ArticleMedical tourism might affect post-surgical complications
Medicare beneficiaries that need to return to the hospital following a serious surgery typically fare better if they return to the hospital where the original procedure was performed, known as the...
View ArticleCalifornia becomes third state to remove religious and personal vaccine...
California’s generous vaccination exemptions are no more after Governor Jerry Brown (D) signed SB-277 on June 30, 2015, eliminating religious and personal exemptions to vaccinations required for...
View ArticleMost states still failing at price transparency
Not only has there been little improvement in state health care price transparency laws since last year, the Health Care Incentives Improvement Institute’s latest report notes that there has also been...
View ArticleHospitals to HHS: ‘Impossible’ is not an excuse for backlog
The American Hospital Association (AHA) is not buying HHS’ reasons for the large backlog of Medicare claims appeals. According to the AHA’s reply brief in its appeal to the U.S. Court of Appeals for...
View ArticleHighlight on Minnesota: Funding and coverage for many in jeopardy
Minnesota has a large backlog of renewals for Medical Assistance and MinnesotaCare, and 60,000 people stand to lose subsidized coverage if they do not submit more information. According to the state...
View ArticlePopulation health is here to stay
As health care continues to trend towards provider-driven, value-based reimbursement instead of fee-for-service arrangements, insurers are pushing population health data management services. Although...
View ArticlePart D could save billions if CMS had negotiating power
Medicare Part D pays more for name-brand drugs than many other countries and even other U.S. government programs, such as Medicaid and the Veterans Health Administration (VHA). The Carlton University...
View ArticleLittle Sisters gear up for round two before the Supreme Court
The Little Sisters of the Poor Home for the Aged (Little Sisters), a group of Catholic nuns, is going before the Supreme Court yet again in its challenge of the contraception mandate found in the...
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