Medicaid and CHIP
The Connecticut Attorney General has reached a settlement with the owner of six dental management and consulting firms accused of Medicaid fraud.
A federal court has struck down a California "carve in" law requiring Medicaid safety net providers to only dispense drugs purchased at a discount, although the ruling also implied that type of mandate would be permissible with federal approval.
Adding more mixed evidence to the Medicaid expansion debate, health researchers found that extending coverage to low-income, childless adults in Wisconsin corresponded with a decrease in preventable hospitalizations but also increases in outpatient and emergency department visits.
The New Hampshire Governor's Commission on Medicaid Care Management is recommending expanding Medicaid eligibility under the Affordable Care Act, "due to its necessity" in transitioning the state's Medicaid program from fee-for-service to managed care.
The managed care programs of several states profiled in a new Urban Institute report show a range of policy options available as new Medicaid rules and eligibility expansion (in 21 states for now) takes effect next year.
It took six months and a letter to the governor with a picture of their newborn for two Philadelphia graduate students to successfully enroll their son in CHIP — and even then their premiums were miscalculated, based on a system reporting error that tripled their actual income.
The Nebraska state auditor has found what he calls "gross mismanagement" in the state's Medicaid Health Insurance Premium Payment Program (HIPP), with the state Department of Health and Human Services "flagrantly disregard(ing) its own regulations."
Last week, Parkland Memorial Hospital in Dallas announced an agreement to pay a $1.4 million settlement to the United States Department of Justice over Medicare and Medicaid fraud allegations.
Price transparency is a touchy subject in healthcare. It's one of the last market strongholds desperately clutching to its principles of price secrecy, and it won't go down without a fight. 
Healthcare providers will be paid less for their for services under the federal Pre-Existing Condition Insurance Plan (PCIP) starting next month to stretch its funding because it is fast running out of money. Many of the patients enrolled in the transitional program need expensive and ongoing treatment for cancer and other critical conditions.
A study containing mixed results of the effects of increased Medicaid enrollment in Oregon offers some caution about expectations for dramatic improvements in the health of millions of individuals from just expanding coverage across the nation in 2014, according to one of the authors of a recent study.
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