- Maine debate hints at rift on Medicaid after ruling, By Abby Goognough and Robert Pear, July 18, 2012, New York Times: “As some Republican governors declare that they will not expand Medicaid under the national health care law, Gov. Paul R. LePage is going a step further. In what could lead to a direct confrontation with the Obama administration, he is planning to cut thousands of people from Maine’s Medicaid rolls, arguing that the recent Supreme Court ruling on the law gives him license to do so. Mr. LePage, a Republican, says the ruling gave states leeway to tighten eligibility for Medicaid, the joint state-federal program that provides health care to low-income and disabled people. Federal officials insist that while the ruling allowed states to opt out of a planned expansion of Medicaid, it left intact all other aspects of the law affecting the program…”
- The big push on Medicaid fraud, By Emily Ramshaw, July 19, 2012, New York Times: “When it comes to finding cost savings in the state’s unwieldy Medicaid program, the Office of Inspector General at the Health and Human Services Commission gets high marks. The division, charged with investigating fraud among health care providers paid to treat impoverished children and the disabled, has drastically increased both its caseload and the potential monetary returns associated with it over the last fiscal year. The spike has won glowing reviews from budget-weary state lawmakers and has cast Texas’ innovative enforcement team into the national spotlight. But O.I.G.’s dollar-recovery strategy – which includes an increased reliance on a rule that allows investigators to freeze financing for any health care provider accused of overbilling – has enraged doctors, dentists and other providers who treat Medicaid patients. They say an anonymous call to a fraud hot line or a computer-generated analysis of a handful of billing codes is enough to halt their financing without even a hearing, jeopardizing their practices and employees and leaving thousands of needy patients in a lurch while the state works to prove – or rule out – abuse…”
Poverty-related issues in the news, from the Institute for Research on Poverty