Supreme Court Rules Florida Can Claw Medicaid Costs From Legal Damages
A legal case the Miami Herald says "drew attention" from officials across the U.S. has concluded with a ruling that Florida's Medicaid program is entitled to some of the cash from a settlement payout made after a young girl was injured by a truck. Separately, Medicaid doula services increase.
Miami Herald:
U.S. Supreme Court Rules In Florida Medicaid Expense Case
Nearly 14 years after a Lee County girl was catastrophically injured when she was hit by a truck, the U.S. Supreme Court on Monday said Florida’s Medicaid program can recoup a chunk of the money it paid for her initial care. Justices, in a 7-2 opinion, sided with the Florida Agency for Health Care Administration in a case that drew attention from officials across the country. (Saunders, 6/6)
In other news about Medicaid and Medicare —
Stateline:
More States Adding Medicaid Benefit For Doula Services
Faced with a crisis in maternal mortality, particularly among women of color, more states are extending Medicaid coverage to doula services. Doulas are trained professionals who provide emotional, physical and educational support to women before, during and after childbirth. According to an analysis by the Georgetown Center for Children and Families, at least 17 states are considering, planning or implementing policies to provide Medicaid reimbursement for the services of doulas. (Ollove, 6/6)
Modern Healthcare:
Medicaid Enrollees Must Share Lawsuit Awards With States, Supreme Court Rules
States can seek reimbursement for future medical expenses from Medicaid beneficiaries' injury settlements, the Supreme Court decided in a 7-2 opinion issued Monday. Justice Clarence Thomas penned the majority opinion, which asserts that federal Medicaid law allows states to collect private settlement funds for medical expenses and doesn't expressly limit that to previously paid bills. Chief Justice John Roberts and Justices Samuel Alito, Elena Kagan, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett joined Thomas. Justices Stephen Breyer and Sonia Sotomayor dissented. (Goldman, 6/6)
Modern Healthcare:
Legal Experts Expect 'More Scrutiny' Of Medicare Prior Authorization From Feds
As the federal government's attention to improper Medicare Advantage prior authorization denials intensifies, insurers should consider examining their policies if they want to avoid trouble. Hospitals have called on the Justice Department to use the False Claims Act against Medicare Advantage carriers that improperly deny coverage. Health insurance companies ought to take a closer look at their policies and how employees are trained to implement them, said Scott Stein, a partner at Sidley Austin and editor of the law firm's False Claims Act blog. (Goldman, 6/6)
And more on the health care industry —
Fox News:
Telehealth Could Get More Expensive With Public Health Emergency Set To End This Year
Telehealth visits could soon get pricier for a lot of Americans. The COVID-19 pandemic showed how much can be done from the comfort of home -- doctor's visits included. But now, more doctors will have to see patients in-person, because the federal public health emergency started during the pandemic is set to end soon. The pandemic has sparked "significant" labor shortages and workforce changes, according to nurse executive Nanne Finis, who oversees and assesses how hospitals are run. (Addison, 6/6)
Modern Healthcare:
Teladoc Hit With Investor Lawsuit After Share Price Sinks
Teladoc Health has been hit with a lawsuit accusing the company of violating federal securities laws and downplaying challenges it faced in its mental health and chronic care businesses. Shareholder Jeremy Schneider sued Teladoc, company CEO Jason Gorevic and chief financial officer Mala Murthy in a federal court in the Southern District of New York Monday, alleging he and others purchased company shares at "artificially inflated prices." The share price has dropped drastically in recent months after "alleged corrective disclosures," the lawsuit alleges. (Kim Cohen, 6/6)
Modern Healthcare:
HCA Healthcare Hit With More Price Inflation Allegations
The city of Brevard, North Carolina, sued HCA Healthcare for allegedly inflating healthcare costs after it acquired Mission Health. Nashville, Tennessee-based hospital giant HCA controls more than an 85% of the acute care market in the Asheville, North Carolina area, and at least 70% of that market in the surrounding region, city officials claim in a complaint filed Friday in a North Carolina federal court. That leverage allegedly allowed HCA to force insurers and employers into anticompetitive contracts that included all-or-nothing provisions that required them to include all of their facilities in the health plan networks and steered patients away from competitors. (Kacik, 6/6)
KHN:
They Thought They Were Buying Obamacare Plans. What They Got Wasn’t Insurance.
Tina Passione needed health insurance in a hurry in December. The newly retired 63-year-old was relocating to suburban Atlanta with her husband to be closer to grandchildren. Their house in Pittsburgh flew off the market, and they had six weeks to move out 40 years of memories. Passione said she went online to search for the federal health insurance marketplace, clicked on a link, and entered her information. She promptly got multiple calls from insurance brokers and bought a plan for $384 a month. Later, though, when she went to a pharmacy and doctor offices in Georgia, she was told she did not have insurance. In fact, it said it right on her card: “THIS IS NOT INSURANCE.” (Sable-Smith, 6/7)
