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…”
Court’s decision could widen Medicaid gap, By Noam N. Levey, June 29, 2012, L.A. Times: ” President Obama, in his drive for a national healthcare overhaul, strove to provide a new guarantee that all Americans, no matter where they live, would have basic protection against sickness and disease, ending decades of variation among states. The Supreme Court did not dismantle that guarantee Thursday. But while upholding the Affordable Care Act, the court opened the door to something the president and other champions of the law sought to avoid — widening disparities between red and blue states in who gets healthcare. Under the court’s ruling, states will be free to elect not to cover all of their poor residents through their Medicaid programs. That may mean liberal states that have embraced the healthcare law such as California, Illinois and Maryland will effectively offer all of their residents health coverage. . .”
Health Care ruling clears path for Colo. exchanges, By Ivan Morenokristen Wyatt, June 29, 2012, Businessweek: “Colorado Republicans who decried Thursday’s health care ruling said the state did the right thing by beginning to create insurance exchanges required under the law, rather than waiting for the federal government to create one. Democrats said that the decision clears the path for Colorado’s health plans and that Colorado more than other states would have been tripped up if the health law had been axed. State lawmakers last year created the Colorado Health Benefit Exchange, which forms a virtual marketplace to allow individuals and groups the ability to purchase health insurance at discounts like those in larger risk pools. About 13 percent of the state, or 656,000 state residents, had no health insurance as of 2011. . .”
U.S. Supreme Court health care ruling leaves Medicaid expansion up to individual states, By Bill Barrow, June 28, 2012, New Orleans Times-Picayune: “In a defining moment in U.S. Supreme Court history, Chief Justice John Roberts joined the court’s liberal bloc Thursday to announce a 5-4 decision upholding the most hotly debated provision of President Barack Obama’s 2010 health care overhaul. To do so, the Roberts majority framed the requirement for all Americans to purchase health insurance, along with an IRS penalty for not complying, as a tax, not the argument the administration preferred but enough to leave in place the linchpin of the insurance market changes. . .”
