Tennessee Provides A Lens For Viewing Medicaid Managed Care’s Access Issues, Challenges
As Tennessee and many other states move increasingly to managed care in their Medicaid programs, federal officials weigh new protections for enrollees. Elsewhere, about 40 percent of Connecticut babies are covered by Medicaid, the Office of the Inspector General finds shortcomings, fraud vulnerabilities in Colorado low income health insurance program, and N.J. Gov. Chris Christie's comments about the program's cost increases are examined.
Kaiser Health News:
Medicaid’s Tension: Getting Corporate Giants To Do Right By The Needy
Lynda Douglas thought she had a deal with Tennessee. She would adopt and love a tiny, unwanted, profoundly disabled girl named Charla. The private insurance companies that run Tennessee’s Medicaid program would cover Charla’s health care. Douglas doesn’t think the state and its contractors have held up their end. In recent years she says she has fought battle after battle to secure essential care to control Charla’s seizures, protect her from choking and tube-feed and medicate her multiple times a day. (Hancock, 4/28)
CT Mirror/Trend:
40% Of Connecticut Babies Are Born On Medicaid
Four out of 10 babies born in Connecticut are covered by HUSKY, the state’s Medicaid program for low-income residents. But in some cities, that number is as high as three-quarters. Statewide, 458,674 people were covered by HUSKY A, the portion of the Medicaid program that covers children and their parents. Gov. Dannel P. Malloy’s budget proposal calls for lowering the income limit for parents in the program, a move that is estimated to cause 34,200 parents to lose HUSKY coverage. (Levin Becker and Chang, 4/28)
The Denver Post:
OIG: Colorado's Flawed Medicaid System Open To Provider Fraud
Colorado paid more than 800,000 Medicaid claims that were missing required provider identifying numbers or had invalid numbers during 2011 and, until the system is updated in November 2016, the state is vulnerable to fraudulent provider claims, a federal investigation reports. The U.S. Department of Health and Human Services' Office of Inspector General found that the state agency administering Medicaid lacks sufficient internal controls to ensure claims it paid during fiscal year 2011 included required documentation — the national provider identifiers, or NPIs. It's a unique 10-digit number identifying health care providers and health plans. State officials countered that there is no evidence that fraud occurred. (Draper, 4/27)
The Washington Post's Fact Checker:
Christie’s Claim That Medicaid Spending Has Grown ‘Over 800 Percent’ In 25 Years
Overhauling long-term entitlement programs has become a major talking point for [N.J. Gov. Chris] Christie, and it is expected to his centerpiece of his potential presidential campaign. Christie recently unveiled his plan to make sweeping changes to government spending and structure of entitlement programs, especially long-term programs such as Social Security, Medicare and Medicaid. Such programs have grown out of proportion and taken up too much of the federal budget and debt, according to Christie. ... While it is correct that Medicaid spending has grown disproportionately to the size of the economy, Christie’s numbers give a misleading impression of the magnitude. (Lee, 4/27)
Meanwhile, one outlet takes a look at news related to another government health care program: Medicare -
The New York Times:
Obama Proposes That Medicare Be Given The Right To Negotiate The Cost Of Drugs
Embedded in President Obama’s budget request to Congress is a paradox. He proposes a major new initiative to develop drugs tailored to the genetic characteristics of individual patients, but he expresses deep concern about the costs of such specialty medicines for consumers and for the Medicare program. He has asked Congress to let Medicare officials negotiate prices with drug manufacturers — a practice explicitly forbidden by current law. (Pear, 4/27)
