Tag: Medicaid

Biden-Harris Admin on Track to Oversee Massive $1 Trillion in Improper Payments, Watchdog Group Finds

Daily Caller News Foundation
Congress Spending

If current trends persist, the Biden-Harris administration will have made over $1 trillion in improper payments by the time President Joe Biden leaves office, according to a report released by the watchdog organization Open The Books on Thursday.

An improper payment is a disbursement “made by the government to the wrong person, in the wrong amount or for the wrong reason,” per federal guidelines. The Biden-Harris administration, between 2021 and 2023, oversaw $801.4 billion in such payments after adjusting for inflation, according to the report.

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Tennessee TennCare and CoverKids Members to Begin Receiving Free Diapers for Children Under Two

Kaitlin Housler
Diapers

Tennessee Governor Bill Lee announced that TennCare and CoverKids members under age two will be eligible to receive up to 100 diapers per month as part of the TennCare Diaper Benefit beginning Wednesday.

TennCare is Tennessee’s Medicaid program, while CoverKids offers free health coverage for pregnant women and children who do not have insurance and do not qualify for TennCare.

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Texas, Montana Sue Biden over Rule Requiring States to Pay for ‘Gender Transition’

The Center Square
Montana Attorney General Austin Knudsen with Texas Attorney General Ken Paxton (composite image)

Texas and Montana have sued the Biden administration over another federal rule change it implemented, this time over one that requires states to pay for “gender transition” procedures through their Medicaid programs.

It also requires health-care providers to perform such procedures in states where the practice has been banned, including in Montana and Texas. Their state legislatures passed bills their governors signed into law prohibiting “gender transition” procedures from being performed on minors in their states, among other restrictions.

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Florida Nonprofit Begins Quest for 1 Million Signatures, Getting Medicaid on 2026 Ballot

The Center Square
Medicaid Expansion

A nonprofit group is gathering signatures to put Medicaid expansion in Florida on the ballot in 2026.

“Our mission is to let voters decide whether Florida should expand Medicaid, bring billions of our tax dollars home, increase jobs, grow our economy, and provide access to care to over one million people,” said the group, Florida Decides Healthcare. “Together, we can make health care a reality for all Floridians.”

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Georgia Sues Biden Administration over Objections to Gov. Kemp’s ‘Pathways to Coverage’ Medicaid Expansion

Tom Pappert

The State of Georgia and Georgia Department of Community Health (GDCH) launched a lawsuit on Friday against the Biden administration over its objections to Governor Brian Kemp’s limited Medicaid expansion, the Georgia Pathways to Coverage.

Georgia, the lawsuit explains, entered into a five-year agreement with the Centers for Medicare and Medicaid Services (CMS) to implement Pathways, but in January 2021, CMS told Georgia it “preliminarily determined” the program was “unlawful and should be suspended.”

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Utah Gives Taxpayer-Funded Health Care to Illegal Immigrant Children

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Utah Bill

Utah is giving taxpayer-funded health insurance to illegal immigrant children, according to a law that went into effect Jan. 1.

Roughly 6,500 illegal immigrant children in Utah will qualify for care under the program, Thaiss Del Rio, a health policy analyst at Voices for Utah Children, told Axios of the new law. Utah’s move follows a decision by the state of California to provide health care for illegal immigrants up to the age of 49.

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Commentary: As Planned Parenthood’s Abortion Market Share Goes Up, So Does Its Taxpayer Funding

Admin

To borrow from an old saying, nothing can be certain except for death and taxpayer funding for the abortion industry. At the request of pro-life members of Congress, the Government Accountability Office released the latest round of data detailing how much taxpayer funding goes to Planned Parenthood and other international abortion organizations. From 2019 through 2021, Planned Parenthood in the U.S. received $1.7 billion in taxpayer subsidies.

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Nevada Spent Millions on Sex Changes and Trans Hormones, Including for Those Under 18

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The state of Nevada paid $12.5 million for transgender medical services and procedures over the past eight years, according to documents obtained exclusively by the Daily Caller News Foundation.

The Nevada Department of Health and Human Services provided data to the Daily Caller News Foundation showing that from January 2015 to May 2023, the state paid $12,572,974 for transgender medical procedures, therapy and treatments through Medicaid and Nevada Check Up (NCU). The payments were for insurance claims tagged with “Gender Identity” and national drug codes, as well as for claims tagged with procedure codes related to transgender care, including surgeries, infertility, counseling and speech therapy, according to the documents.

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Pennsylvania Ambulance Reimbursement Rates Made Whole

The Center Square

Emergency service agencies across Pennsylvania have warned of funding shortfalls and labor shortages, but a recently passed bill will help ease a fraction of the pain.

House Bill 1351, signed into law this week as Act 15, will require Medicaid to reimburse EMS agencies for every mile an ambulance travels with a patient. Previously, no payment would be made for the first 20 miles of travel.

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Michigan to Begin Testing Children for Lead Poisoning

The Center Square

Starting January 1, Michigan minors will be screened for lead poisoning unless a parent or guardian objects.

Gov. Gretchen Whitmer signed Senate Bill 31, which requires children be tested for lead poisoning at certain ages, the testing be recorded on their certificate of immunization and the Department of Health and Human Services (DHHS) develop rules to implement the bill’s requirements.

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Florida Enrollment in Medicaid Continues Recent Decline

The Center Square
doc nurse senior patient

Florida’s Medicaid enrollment continue to decline, according to recent data from the Kaiser Family Foundation, a nonprofit organization focused on health policy, research and polling.

According to data from the Medicaid Enrollment and Unwinding Tracker, the number of people on Medicaid in the Sunshine State declined 7% from April to July, shrinking from 5.78 million to 5.36 million.

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Almost 30,000 People Lost TennCare Coverage in May But Near-Record Enrollment Has Remained

The Center Square

Tennessee saw 27,000 lose Medicaid coverage in May as the state continues its process of redetermining TennCare eligibility following the end of federal COVID-19 pandemic rules.

Those rules blocked states from the mandated process of determining eligibility between March 2020 to March 31. TennCare began the eligibility determination process in April.

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Georgia Removes 95,000 Patients as Medicaid Eligibility Returns to Pre-COVID Standards

The Center Square

State officials have removed more than 95,000 from Georgia’s Medicaid rolls, but one Georgia group says the move merely returns the program to how it was administered for its first 50 years.

State officials said that of the 95,578 who lost coverage, 89,168 were removed because of “a lack of information received … to make an eligibility determination.” The state indicated it has information that more than 20,000 of those “procedurally terminated” would not have been eligible for an extension.

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Medicaid Emergency Spending for Illegal Migrants Doubles in One Year to $7 Billion: GOP House

Just the News

Medicaid emergency spending for illegal immigrants more than doubled from fiscal year 2020 to fiscal year 2021, according to House Homeland Security Committee Chairman Mark Green.

During a congressional hearing Wednesday on Homeland Security Secretary Alejandro Mayorkas’ job performance, Green said more people have entered the U.S. illegally under his roughly two-year tenure “than in the 12 years of the Obama and Trump administrations combined.”

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Virginia Employees of Federally-Contracted Call Center Go on Strike

The Center Square

Hundreds of employees of the country’s largest federally-contracted call center went on strike in Virginia last week to protest claims of “unfair layoffs,” poor pay, lack of career advancement opportunities and racial inequality in the workplace.

Maximus is contracted with the Department of Health and Human Services to supply call center services for the federally-mandated health care marketplace, Medicaid and Medicare enrollees, and the CDC-INFO line. Maximus employees handle millions of calls on behalf of HHS every year.

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Bipartisan Measure Would Create a Pennsylvania Earned Income Tax Credit

Bradley Vasoli

Two Pennsylvania state Senators from opposite sides of the aisle are asking colleagues to support legislation they are drafting to create a state earned income tax credit (EITC). 

For nearly a half-century, lower-wage workers have benefitted from a federal EITC which ranges from $560 to $6,935 for a household earning up to $59,187, depending on the number of that filer’s qualifying children. In 2021, this program bestowed $1,874 on the average Pennsylvania family.

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Republicans Take a Page from Democrats, Offer Novel Idea on Medicaid

Just the News

Democrats are trying to paint Republicans as enemies of Medicaid, but Florida GOP Rep. Daniel Webster is gaining support for a bill that would provide a tax deduction to healthcare providers in exchange for pro bono health services for people who rely on Medicaid or CHIP, the Children’s Health Insurance Program.

Webster’s Helping Everyone Access Long Term Healthcare Act, or HEALTH Act, would amend the IRS code to allow medical professionals to take a tax deduction for the value of service performed, which he says will reduce the amount of paperwork associated with the low-income healthcare systems.

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Wisconsin’s Largest Business Advocate Applauds Republicans’ Removal of Hundreds of Governor Tony Evers’ Proposals from Budget

M.D. Kittle

The Legislature’s Joint Finance Committee this week jettisoned 545 of liberal Governor Tony Evers’ budget proposals, packed with higher taxes on businesses and individuals and growing government initiatives.

Wisconsin Manufacturers & Commerce, the state’s largest business advocate, is applauding the Republican-controlled budget-writing committee for trimming Evers’ bigger government budget plan. 

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Commentary: The ‘Limit, Save, Grow’ Plan’s Discretionary Spending Caps that Save More than $3 Trillion Might Not Be Enough

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House Speaker Kevin McCarthy (R-Calif.) and the House Republican majority have unveiled their spending plan for the next decade, the Limit, Save, Grow Act, that will be tied to a $1.5 trillion increase in the $31.4 trillion national debt ceiling, the centerpiece of which imposes discretionary budget caps beginning in 2024, but which will be set at 2022 levels, which could save more than $3.2 trillion over the next decade, according to an estimate by the Committee for a Responsible Federal Budget.

While an official score still has not come in from the Congressional Budget Office, the proposal stands out as a promise kept on McCarthy’s part to use the must-pass debt ceiling to restore some semblance of fiscal sanity to the out-of-control federal budget and national debt, the latter of which the White House Office of Management and Budget projects will rise to a gargantuan $50.7 trillion by 2033.

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Tennessee Among the States Supporting Florida’s Lawsuit to Enforce Prohibiting Medicaid Payments for Gender Transition procedures

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Seventeen attorneys general have filed an amicus brief supporting Florida’s healthcare regulation that denies Medicaid coverage for gender transitioning procedures.

They’re supporting Florida’s motion for summary judgment in the lawsuit August Dekker v. Jason Weida in the U.S. District Court Northern District of Florida Tallahassee Division.

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17 State Attorneys General Declare Support for Florida Trans Guidance

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by Eric Lendrum   On April 7th, an amicus brief was filed in favor of Florida’s current ban on using state funds to support “transgender” treatments, with 17 state attorneys general voicing their support for the law. According to the Daily Caller, the brief’s filing was part of an ongoing legal battle in the state of Florida, where far-left, pro-transgender activists have teamed up with several pseudo-medical organizations to file a lawsuit against the law. The groups involved include the World Professional Association for Transgender Health (WPATH), the Endocrine Society, and the American Academy of Pediatrics (AAP). The law in question states that Medicaid funds cannot be used to cover any transgender operations, including sex change surgery, cross-sex hormones, and puberty blockers. The 17 states that have filed in support of Florida are: Alabama, Arkansas, Georgia, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, South Carolina, Tennessee, Texas, Utah and Virginia. In their filing, the AGs argue that the organizations involved in the lawsuit have “prioritized politics over science.” “The amici States submit this brief in support of Florida’s right to regulate medicine and determine appropriate treatments for Medicaid coverage,” the brief states. “Moreover, there is particular reason to…

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Pennsylvania Cabinet Officer Says New Medicaid Fraud Prevention System Coming in June

Bradley Vasoli

Pennsylvania’s acting human services secretary on Tuesday told lawmakers an improved state system to detect Medicaid fraud will be in place this summer. 

The comments from anesthesiologist and former Montgomery County commissioner Val Arkoosh came as policymakers expressed concern about erroneous payments made by the government health-insurance program for the poor. In 2020, Governor Josh Shapiro (D) said in his previous capacity as state attorney general that his investigations indicated improper payments could total as much as $3 billion annually in Pennsylvania. That amounts to about one-tenth of all state Medicaid funds. 

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Detransitioners Back Florida Medicaid Rule amid LGBT Legal Challenge

Admin

Three “detransitioners”—men who underwent surgeries in pursuit of a female gender identity but later rejected that identity—filed a legal brief supporting a Florida health agency’s rule preventing Medicaid from reimbursing for transgender medical interventions.

Florida’s Agency for Health Care Administration finalized the rule in August 2022, declaring that Medicaid would not cover “puberty blockers,” hormones, “sex reassignment” surgeries, or other procedures that alter primary or secondary sex characteristics.

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Virginia Gov. Youngkin Proposes Amendment to ‘Stopgap’ Budget to Include Medicaid Renewal

The Center Square

As Virginia resumes the Medicaid renewal process that was paused during the COVID-19 pandemic, Gov. Glenn Youngkin is asking the General Assembly to amend the “skinny” budget passed during the legislative session to include millions in funding from the American Rescue Plan Act to support the process.  

The General Assembly adjourned at the end of February without a finalized budget. Instead, lawmakers approved a “stopgap” budget bill that included just a few items, including funding to address a calculation error that overstated the amount of state aid Virginia schools could expect to receive. 

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Commentary: Governor Shapiro’s First Budget Falls Short

RealClearWire

Gov. Josh Shapiro’s first state budget proposal perpetuates unsustainable spending and fails to address the most promising ideas he put forward during his campaign. For starters, his budget calls for $45.9 billion in ongoing General Fund spending – but the state has only $43 billion in net revenues, so the governor is positioning us for a nearly $3 billion annual deficit.

Spending that exceeds revenue is unsustainable and fiscally irresponsible for individuals, businesses, and certainly for government.

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‘That’s a Lie’: GOP Senator Presses Janet Yellen on Plan to Pay for Social Security

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Republican Sen. Bill Cassidy of Louisiana accused the Biden administration of lying about its commitment to working with Congress to protect seniors’ social security benefits at a hearing of the Senate Finance Committee Thursday.

Cassidy asked Treasury Secretary Janet Yellen, who was testifying about President Joe Biden’s proposed budget for the fiscal year 2024, if the president was aware that “when [Social Security] goes broke in nine years” there would be a 24% cut in benefits for current recipients.

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Commentary: Medicaid Expansion Fails to Deliver on Promises

RealClearWire

Medicaid expansion is failing states across the nation according to a recent Foundation for Government Accountability (FGA) report. The report found states that have expanded Medicaid have faced more hospital closures than states that haven’t expanded the program. Of course, for years, advocates have claimed that expansion would be a necessary provision for financial health and job security for hospitals. Though, as suspected, data reveals the opposite. More accurately, non-expansion states have seen improved profitability, a larger bed capacity, and increased job growth. 

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Think Tank Unveils Market-Oriented Recommendations for Wisconsin Healthcare System

Bradley Vasoli

The Institute for Reforming Government (IRG), a Delafield-based free-market think tank, this week released a report detailing several reforms to improve Wisconsin’s healthcare system. 

A major problem the document tackles is the state’s anticipated shortage of 2,263 physicians by 2035. Areas expected to be especially underserved are those west of Milwaukee, northwest of Madison, east of Lake Winnebago and in various locales along the state’s northern border. 

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Evers Unveils Record $104 Billion Budget Plan, Republicans Get Ready to Rewrite

M.D. Kittle

Billing it a “breakthrough budget,” Governor Tony Evers rolled out a massive two-year spending plan on Wednesday that would dump billions more taxpayer dollars into a host of new programs, raise taxes by $1 billion-plus on businesses, deliver a sweetheart deal to the Milwaukee Brewers, and gobble up much of the state’s historic $7.1 billion surplus. 

At approximately $104 billion, Evers’ budget proposal is the first to break the $100 billion mark and comes in at about $13 billion more than his 2021-23 plan and more than $16 billion higher than the current budget he signed into law in June 2021. 

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Dozens of Hospitals Have Closed in States That Expanded Medicaid, Research Shows

Admin

Medicaid expansion has failed to prevent hospital closure, with almost 50 shutting down in expansion states since 2014, according to research given exclusively to the Daily Caller News Foundation.

The research from the Foundation for Government Accountability (FGA) indicates that while Medicaid expansion was intended to solve hospitals’ finances and job shortage, its “empty promises” have done the opposite, report author Hayden Dublois wrote. Hospitals instead have had to shut their doors, lost thousands of jobs and racked up substantial losses, amounting to a loss of almost 5,400 beds.

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Tennessee Gov. Lee Pitches Plan to Expand Support for Pregnancy Care Centers to $100 Million

Susan Berry, PhD

Governor Bill Lee (R-TN) announced Monday during his State of the State address he would propose boosting support for women in unplanned pregnancies through various programs, including an expansion in funding for crisis pregnancy care centers to $100 million, widening Medicaid eligibility for pregnant women and parents, and granting additional paid family leave time for state employees.

Tennessee’s “trigger” law that bans abortion, titled the Human Life Protection Act, took effect August 25, two months after the U.S. Supreme Court overturned Roe v. Wade.

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TennCare to Spend $500M Because of Enrollment from COVID-19 Pandemic

The Center Square

TennCare currently has $1.1 billion in its reserves and expects it to cost $500 million of those reserves over the next year as it redetermines Medicaid eligibility for those additional 500,000 members who joined the plan over the past three years.

During the COVID-19 pandemic, states were not allowed to remove those who are no longer eligible for the program as previous. Starting on April 1, states must start that redetermination process and will have a year to complete it.

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Michigan Doctor Sentenced to More Than 16 Years for His Role in Healthcare Fraud, ‘Shots-for-Pills’ Scheme

The Center Square

A Michigan doctor was sentenced to 16.5 years in prison for his part in a health care fraud scheme that billed more than $250 million in fraudulent claims to Medicare, Medicaid, and health insurance programs and illegally distributed over 6.6 million doses of opioids.

In September 2021, Francisco Patino, M.D., 68, of Wayne County, was convicted at trial in the Eastern District of Michigan of conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to defraud the United States, and pay and receive health care kickbacks, conspiracy to commit money laundering, and money laundering.

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Ohio Awards Multi-Million Dollar Grant to Ensure Kindergarten Readiness

Hannah Poling

Ohio will soon receive an influx of federal funding intended to improve kindergarten readiness.

According to a statement from Governor Mike DeWine’s Office, the Ohio Department of Job and Family Services will receive a total of $48 million over three years to support and increase access to quality early childhood care and education as part of the Preschool Development Grant Birth to Five from the U.S. Department of Health and Human Services Administration for Children and Families.

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Newly Signed Ohio Bill Expands Afterschool Enrichment Accounts

Bradley Vasoli

A $6 billion spending bill that Ohio Governor Mike DeWine (R) signed on Friday expands a program assisting parents and guardians with supplemental education purchases.

The ACE Educational Savings Account program previously bestowed a $500 credit on families seeking to purchase enrichment materials or services to help their children get past the learning setbacks caused by the COVID-19 school shutdowns. The new legislation raises the credit to $1,000. 

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The Number of Medicaid Recipients Will Soon Top 100 Million U.S Residents: Report

The Center Square

The United States will have 100 million residents on Medicaid in the next 72 days, according to the Foundation for Government Accountability, meaning that nearly one-third of all Americans will be on the program for health care.

Over the past three years, states have been prevented from removing recipients from the program through a federal COVID-19 emergency. Now, the date when states can begin to re-registering recipients when that emergency ends on April 1.

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Ohio Congresswoman Brown Pushing Bill to Expand Government Role in Healthcare

Bradley Vasoli

U.S. Representative Shontel Brown (D-OH-11) is leading a charge among members of Congress in favor of a measure to expand the federal government’s role in healthcare, particularly regarding mental-health-related comorbidities. 

The Cleveland-area Democrat is cosponsoring her Mental and Physical Health Care Comorbidities Act with House colleague Brendan Boyle (D-PA-2). Senator Michael Bennet (D-CO) has introduced a version of the legislation in his chamber. 

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Ohio Lawmakers Prepare for the First Week of Lame-Duck Session

Hannah Poling

After taking a break over the summer and part of the fall for the general election, lawmakers are returning to the Ohio Statehouse to consider many different bills before the two-year session of this general assembly ends in December.

The committees and floor votes which occur after an election, known as a lame duck session, work to conclude urgent or unfinished bills that lawmakers have introduced. Once the session ends, lawmakers will either overlook or reject the bills and legislators, returning incumbents, and newly-elected officials will have to reintroduce the pieces of legislation and restart the committee process.

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Taxpayers Have Tab for Estimated $2 Billion After ‘Reckless Policy Changes’ in Pennsylvania Medicaid

The Center Square

In Pennsylvania, Medicaid eligibility has expanded at the same time that officials have suspended verification. The result is that costs have gone up — along with the number of people getting benefits while not legally qualifying for them.

So explains a new report from the Commonwealth Foundation on Pennsylvania’s “Wayward Welfare State.”

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DeWine Calls for Expansion of Medicaid, Other Services for Ohio Families

Bradley Vasoli

Governor Mike DeWine (R) on Friday announced a plan to expand a number of social services in Ohio, including an increase in eligibility for Medicaid for pregnant women and children whose families make up to three times the federal poverty level.

The policy enlarges upon his Bold Beginning Initiative, which has already spent about $1 billion on services to expectant families. The broadening of Medicaid would make the program available to single expectant mothers earning up to $54,930 annually and to families of three earning as much as $69,090 per year. Legislative approval would need to occur for this measure to take effect.

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Qualifying Families Need to Apply for Free School Meals After End of Pandemic-Era Student Meals Provided to All

Eric Burk

The Virginia Department of Education is reminding families qualifying for free meals for students to apply for the program after pandemic-era federal provisions for free meals for all students expired at the end of the 2021-2022 school year, meaning that otherwise qualifying families could face charges for meals starting on the first day of school.

“School meals are important sources of nutrition for students and help reduce food insecurity in the Commonwealth,” Superintendent of Public Education Jillian Balow said in a Monday VDOE newsletter. “I urge all families to apply to determine if they qualify. Filling out an application is simple and takes less than 15 minutes.”

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Federal Court Decision Clears Way for Medicaid Waiver for Georgia

The Center Square

Georgia could soon implement a program that proponents say will lead to more coverage for Georgians who are otherwise ineligible for Medicaid.

The Centers for Medicare and Medicaid Services made an “arbitrary and capricious” decision when it rescinded a Medicaid waiver for Georgia Pathways to Coverage program, U.S. District Judge Lisa Godbey Wood ruled last week.

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Tennessee Arrests ‘Most Wanted’ Person for TennCare Fraud

Kaitlin Housler

Lindsey Horner, considered the “most wanted” person for TennCare fraud, was arrested Friday, according to a press release by the Tennessee Department of Finance and Administration (F&A).

The Tennessee Office of Inspector General (OIG), in a joint effort with the Benton County Sheriff’s Office, announced that the 39-year-old  Big Sandy, Tennessee, was charged with TennCare fraud and theft of services. The TennCare fraud charge is a class D felony, and the theft of services charge is a class C felony, the press release notes.

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Judge Orders Macon Health Clinic to Pay $9.6 Million in Fraud Damages

Addison Basurto

U.S. District Judge Tilman E. “Tripp” Self III has ordered Middle George Family Rehab (MGFR) healthcare clinic in Macon, Georgia to pay $9,617,679.22 in damages after the District Court for the Middle District of Georgia found the business to be involved in fraudulent TRICARE and Medicaid claims on Thursday.

“The ‘reckless disregard’ displayed by Middle Georgia Family Rehab (MGFR) in its billing should serve as a warning to other health facilities across Georgia—and the nation—that filing improper and false claims will come with hefty consequences,” said U.S. Attorney Peter D. Leary.

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Arizona Enacts Biomarker Testing Expansion

Admin

Arizona Gov. Doug Ducey has signed legislation to ensure that more insurance plans, including Medicaid, cover biomarker testing.

Ducey signed House Bill 2144 into law. The bill’s goal is to increase the chances of cancer patients surviving, improve their quality of life, and provide lower healthcare costs to them, according to a press release from Ducey’s office.

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