Tag: Medicaid

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.

Read More

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.”

Read More

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.

Read More

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.”

Read More

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.

Read More

Crom’s Crommentary: The Ever-Expanding Medicaid Budget

Julie Carr

Wednesday morning on The Tennessee Star Report, host Leahy welcomed the original all-star panelist Crom Carmichael to the studio for another edition of Crom’s Crommentary.

Read More

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.

Read More

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.

Read More

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.

Read More

Progressives Ask Connecticut Lawmakers to Expand Medicaid to Illegal Immigrant Minors

Bradley Vasoli

Progressives this week are pushing for Connecticut lawmakers to extend HUSKY Health, the state’s Medicaid program, to illegal-immigrant minors at an estimated cost of $1.9 million.

Last year, reacting to the COVID-19 pandemic, the Constitution State enacted a measure to make illegal-alien children under the age of eight eligible for HUSKY, a policy that will take effect at the beginning of next year. But some say those between the ages of nine and 18 should not be left out of the program.

Read More

Arizona Attorney General Brnovich Argues at Supreme Court Defending Public Charge Rule Regarding Green Cards and Welfare

Rachel Alexander

Arizona Attorney General Mark Brnovich led a lawsuit with 12 other attorneys general against the Biden administration for dropping the Public Charge rule implemented in 2018 underneath the Trump administration, which ended up at the Supreme Court on Wednesday for oral arguments. The Public Charge rule made noncitizens ineligible for green cards if they are receiving public assistance, which was U.S. policy for over 100 years. 

“The United States is indeed the land of the free and of industrious immigrants, but it is not a welfare state,” said Brnovich in a statement about Arizona v. City and County of San Francisco. “The Biden Administration has once again caved to far-left groups attempting to erase a common-sense law that we’ve had in various forms for more than 100 years.”

Read More

Sixteen States File New Lawsuit Against Federal COVID Vaccination Mandate

The Center Square

Sixteen states again are challenging a federal COVID-19 vaccination mandate for health care workers who work at facilities that receive Medicare and Medicaid funding.

Friday’s filing in U.S. District Court for the Western District of Louisiana comes after the issuance of final guidance on the mandate from the U.S. Centers for Medicare & Medicaid (CMS), arguing the guidance is an action that is reviewable.

The U.S. Supreme Court ruled by 5-4 vote Jan. 13 against the original Louisiana challenge to the mandate and a similar Missouri filing.

Read More

Measure Directs $225 Million to Recruit, Retain Pennsylvania Health Care Workers

The Center Square

Pennsylvania Republicans highlighted legislation Wednesday that is moving through the General Assembly to direct $225 million to recruit and retain health care workers for hospitals and behavioral service providers.

Leaders of the House and Senate gathered on the lieutenant governor’s balcony between the two chambers for a news conference on House Bill 253, sponsored by Rep. Clint Owlett, R-Tioga.

The legislation allocates $225 million to hospitals and behavioral and psychiatric service providers for retention and recruitment programs for staff. The bill is targeted specifically at nurses and other hospital employees, and it excludes hospital executives, administration, contracted staff and physicians.

Read More

Iowa Governor Requests DHS Staff Salary Increases, ‘Status Quo’ on Medicaid Funding

The Center Square

For the first time in at least 15 years, an Iowa governor has not recommended funding changes for Medicaid.

The announcement was made by Legislative Service Agency Analyst Jess Benson as he presented Gov. Kim Reynolds’ fiscal year 2023 Department of Health and Human Services budget recommendations Tuesday.

Read More

Georgia Sues Biden Administration over Rejecting Medicaid Work Requirement

The Center Square

Georgia has filed a lawsuit against the Biden administration for rejecting the work requirement and premium proposal in Gov. Brian Kemp’s partial Medicaid expansion plan.

The plan, called Georgia Pathways, was approved by the U.S. Centers for Medicare & Medicaid Services (CMS) in October 2020 under former President Donald Trump.

President Joe Biden’s CMS sent a letter to Georgia officials in December, rescinding the selected parts of the plan because they counteract with the objectives of the program.

Read More

Liberal Supreme Court Justices Show Weak Grasp of Basic COVID-19 Facts

Admin

The liberal justices on the Supreme Court demonstrated a stunningly weak grasp of basic facts concerning the COVID-19 pandemic Friday, as they defended the Biden regime’s policies during oral arguments over vaccine mandates in the workplace.

The court heard separate oral arguments over federal vaccine mandates for employers with more than 100 employees, and for health care workers at facilities receiving Medicaid and Medicare funding.

Justice Stephen Breyer at one point seemed to suggest outrageously that the OSHA mandate would prevent 100 percent of daily US COVID cases. It is common knowledge now that the vaccinated people can still spread the disease.

Read More

Biden Administration Labels Georgia’s Medicaid Work Requirements ‘Harmful,’ Abolishes Them

Chris Butler

Centers for Medicare & Medicaid Services (CMS) officials this week described Georgia’s Medicaid work requirements as “harmful” and announced that Peach State officials may no longer impose them as a condition of Medicaid eligibility. CMS officials also announced that Georgia officials no longer have the authority to charge premiums beyond those allowed under the Medicaid statute in its Georgia “Pathways to Coverage” demonstration.

Read More

Circuit Court Not Taking Up ‘Medically Fragile’ Children Ruling

Grant Holcomb

The 11th U.S. Circuit Court of Appeals decided on Wednesday to not hear a case relating to “medically fragile” children being placed in nursing homes. A three-panel judge in 2019 ruled in favor of a U.S. Department of Justice’s (DOJ) authority to pursue a lawsuit against the State of Florida.

The issue originally began after the DOJ found Florida was institutionalizing children with severe medical conditions in nursing homes in 2012 and that Florida’s Medicaid program put more children at risk of being put into a home.

Read More

Shelbyville Doctor Who Allegedly Overcharged TennCare Blasts State’s ‘Intricate Reporting Requirements’

Chris Butler

TennCare reportedly overpaid nearly $300,000 of taxpayer money to a Shelbyville physician, according to a report that Tennessee Comptrollers released Thursday. The reported cited Joseph Howard Rupard for failing to accurately report TennCare visits and payments submitted to the state of Tennessee.

Read More

Facing Labor Shortages, Several Large Hospital Systems Drop Vaccine Mandates

Admin

Several large U.S. hospital systems have dropped their COVID-19 vaccine requirements for employees in the wake of a U.S. district court’s temporary halt of the Biden regime’s vaccine mandate for healthcare workers.

After months of protests, the mandate forced thousands of hospital employees to either resign, or be terminated because of their refusal to get vaccinated.

Louisiana-based federal Judge Terry Doughty issued a preliminary injunction on November 30, blocking the federal government from mandating the experimental injections for workers at Medicare or Medicaid-funded healthcare facilities in 40 states.

Read More

Florida Lawmakers Looking to Expand Health Insurance for Children

Grant Holcomb

Florida’s lawmakers are considering expanding state-funded health insurance for children. The idea has gained traction among Republicans and Democrats, and two competing proposals would increase the amount of money beneficiaries can make.

Currently, families making less than 200 percent of the federal poverty level are eligible for the state’s program, KidCare. However, the same families do not qualify for Medicaid.

Read More

Lawsuits Challenging Biden’s Vaccine Mandates Mount, Likely Heading to U.S. Supreme Court

The Center Square

Multiple lawsuits have been filed against the Biden administration over three different vaccine mandates targeting private employees, federal employees and healthcare workers serving Medicare and Medicaid patients.

But lawsuits filed by 27 states over the private sector mandate is setting the stage for the U.S. Supreme Court to weigh in because they were filed directly in five federal courts of appeals.

Read More

Minnesota Rep. Tom Emmer Introduces Bipartisan Legislation to Reduce Opioid-Related Deaths

Hayley Feland
Ann McLane Kuster and Tim Emmer

Minnesota Representative Tom Emmer (R-MN-06) introduced legislation to try and reduce opioid related deaths. Emmer, along with Representative Annie Kuster (R-NH-02), wrote the Inpatient Opioid Safety Act of 2021, which is “legislation to improve patient safety, simplify care, and reduce preventable opioid-induced injury and death under the Medicare and Medicaid programs.”

Read More

Gov. Whitmer Asks Michigan Catastrophic Claims Association to Refund $5 Billion to Ratepayers

The Center Square

Gov. Gretchen Whitmer is calling for the Michigan Catastrophic Claims Association to refund $5 billion in surplus funds to Michigan automotive insurance customers.

“My office recently reviewed the Annual Report of the Michigan Catastrophic Claims Association (MCCA) to the Legislature issued in September 2021,” the governor wrote in a Nov. 1 letter addressed to R. Kevin Clinton, MCCA executive director. “The report stated that the MCCA had a surplus of $2.4 billion at the end of 2020. In your annual statement issued on June 30, 2021, the surplus is now $5 billion. I am calling on you today to refund money to Michiganders.”

The governor attributes the surplus to the bipartisan Senate Bill 1 insurance reform bill she signed in May 2019. Provisions of the bill include:

Guaranteeing lower rates for drivers for eight years;    
Giving people the choice to pick their own Personal Injury Protection (PIP) options with coinciding PIP rate reductions, offering unlimited coverage (at least 10% PIP reduction), $500,000 coverage (at least 20% PIP reduction), $250K coverage (at least 35% PIP reduction), $50,000 coverage for Medicaid eligible recipients (at least 45% PIP reduction), or a complete opt out for seniors or anyone with sufficient private insurance (100% PIP reduction).  
Increasing consumer protections by banning companies from using the following non-driving factors to set rates: ZIP code, credit score, gender, marital status, occupation, educational attainment, and homeownership.  
Setting fee schedules for hospitals and providers to prevent overcharging for auto-related injuries.   

Read More

Florida Will Lose Millions over 2020 Census Undercount

Grant Holcomb

As a result of an undercount in the 2020 census, Florida is projected to lose millions of dollars, and as much as $88 million in Medicaid payments alone. Florida is set to gain a seat in Congress as the population count indicates a substantial enough growth, but the undercounting will not affect congressional seats, just funding.

Read More

Tennessee Clinic Overcharged TennCare Nearly $5 Million, New Audit Reveals

Chris Butler

A west Tennessee primary care clinic overcharged TennCare — and, by extension, taxpayers — more than $4.7 million, according to an audit that Tennessee Comptrollers published late last week.

Officials who oversaw that company, the Grove Primary Care Clinic, closed all three of their facilities in 2019. They did this one day after state auditors announced they would examine the company’s finances.

Read More

Commentary: After Disastrous September and 2022 Midterms Looming, Biden May Have Lost His Mandate to Govern

Admin

Following a catastrophic U.S. military withdrawal from Afghanistan, the highest inflation since 2008,pushing unpopular COVID vaccine mandates, rationing COVID treatments to red states and finally, watching his domestic legislative agenda falter in Congress, President Joe Biden is already upside down on his job approval ratings, according to the latest average of polls compiled by RealClearPolitics.com.

Reuters/Ipsos on Sept. 29-30 had Biden’s approval at 46 percent and disapproval at 50 percent.

Read More

More Than 180 Minnesota Health Care Workers Sue over Vaccine Mandate

The Center Square

More than 180 Minnesota health care workers spanning statewide hospital systems filed a federal lawsuit over the COVID-19 vaccine mandate, seeking an injunction to block the upcoming rule.

The lawsuit follows weeks after President Joe Biden announced a vaccine mandate for employers with more than 100 employees and facilities that receive Medicaid or Medicare. Defendants named include St. Mary’s Duluth, University Of Minnesota Physicians; Mayo Clinic; North Memorial Health Care; Park Nicollet Methodist Hospital; St. Luke’s Hospital Of Duluth; and Minneapolis Radiation Oncology.

Read More

Two Tennessee Women Convicted of TennCare Fraud Ordered by the Office of Inspector General to Repay State

Kaitlin Housler

According to the Tennessee Department of Finance & Administration, two convicted Tennessee women have been ordered by the Office of Inspector General (OIG) to repay the State of Tennessee on charges involving TennCare fraud.

Read More

Commentary: House Abortion Bill Would Repeal Existing Laws, Prohibit Future Pro-Life Laws

Admin

In response to pro-life policy victories like the Texas Heartbeat Act and an upcoming Supreme Court case asking the justices to provide a constitutional course correction to America’s arbitrary and unworkable abortion jurisprudence, pro-abortion legislators in Congress are advancing a deceptively named piece of legislation called the Women’s Health Protection Act. The radical, far-reaching proposal would entrench unfettered access to abortion in federal law.

House Speaker Nancy Pelosi and her congressional allies—as well as the media —have characterized the Women’s Health Protection Act as simply “codifying Roe v. Wade.”

Read More

Georgia Psychologist Indicted for Medicaid Fraud

The Center Square
Doctor with arms folded, holding stethescope

A Georgia man is facing a fraud charge after law enforcement officials said he stole more than $99,000 from the state’s Medicaid program.

The Georgia attorney general’s office said Gainesville psychologist Dr. Guy Jordan filed claims for therapy sessions that never happened. Jordan was indicted on Medicaid fraud and false statements charges by a Hall County Grand Jury.

“We will not stop protecting taxpayer dollars, and we thank the Hall County Grand Jury for their work on this case,” Attorney General Chris Carr said in a statement. “We hope this indictment sends a clear message that tax dollars will not be abused.”

Read More

President Biden Announces Vaccine Requirement for Nursing Home Employees

Casey Owens

The Biden Administration announced Wednesday its plan to require nursing home employees across the country to receive the vaccination for COVID-19 in order to receive federal Medicaid and Medicare funding.

Given the fact that Florida is a common retirement destination for people across the country, it is responsible for almost 700 nursing homes out of more than 15,000 nursing homes in the U.S. that will be affected by the mandate.

Read More

Florida Medicaid Enrollment Tops 4.8 Million, Surpassing Forecasted Growth

The Center Square
Florida State Capitol

Florida’s Medicaid enrollment increased by 1% in June with 48,468 low-income residents qualifying for subsidized health care, according to the state’s Agency for Health Care Administration (AHCA).

As of June 30, there were 4,846,412 low-income, elderly and disabled Floridians enrolled in Medicaid, an increase of more than 730,000 since June 2020, AHCA documents in its June enrollment report.

Read More

SCOTUS to Take Up Florida Medicaid Case

Grant Holcomb
United States Supreme Court

The Supreme Court of the United States has announced they will be taking up a legal battle over a decade in the making regarding how much money a state can recoup after a legal settlement.
The issue revolves around Gianinna Gallardo, who was struck by a bus in 2008 and suffered drastic injuries. Gallardo’s parents reached an $800,000 legal settlement, and the accident left Gallardo in a vegetative state.

Read More

DeSantis Seeks Approval of Importation of Canadian Prescription Drugs

Peter D'Abrosca

Gov. Ron DeSantis (R) is asking the Biden administration to approve a plan that would allow for the importation of FDA-approved Canadian drugs to the Sunshine State, which would lower costs, according to the governor. 

“Today, Governor Ron DeSantis called on the Biden Administration and leadership at the U.S. Department of Health and Human Services (HHS) to approve Florida’s Section 804 Importation Proposal (SIP) for Florida’s Canadian Prescription Drug Importation Program,” a Friday press release said

Read More

Commentary: Don’t Expect Any State Flexibility Under Obama 2.0

RealClearWire

The “circle back” meme in the Biden White House isn’t limited to Jen Psaki’s avoidance of tough questions at press briefings. The Biden administration demonstrated that it also intends to circle back to the way things were under the Obama years when it comes to managing Medicaid. Rather than taking a cooperative approach to the state and federal partnership, Obama 2.0 is committed to running the program by decree and eliminating flexibilities that improve the program. Unfortunately, states hoping for true flexibility will be disappointed, as Medicaid flexibility has departed for Mar-a-Lago.

Read More

Lieutenant Governor Entertains Possibility of Expanding Medicaid

Corinne Murdock

Lieutenant Governor Randy McNally (R-Oak Ridge) appears to have a change of heart on the possibility of expanding Medicaid in Tennessee. According to reports, the White House’s latest plan to expand subsidized coverage caught McNally’s fancy.

Via the American Rescue Plan, President Joe Biden promised that if states expanded their Medicaid programs they’d receive more federal dollars to cover the program. McNally’s spokespersons have indicated that he is open to this option.

Read More

Feds Threaten to Remove Work Requirement from Georgia’s Partial Medicaid Expansion

The Center Square

The federal Centers for Medicare & Medicaid Services (CMS) could decide in a matter of weeks whether it will remove the work or activity requirement in Georgia’s partial Medicaid expansion plan.

The CMS said the plan, which was approved by former President Donald Trump’s administration in October, does not “promote the objectives of the Medicaid program” and would be impossible to accomplish because of the COVID-19 pandemic.

Read More

Tennessee Legislature Approves Modified Block Grant for State’s Medicaid Program

Corinne Murdock

Tennessee’s General Assembly approved the Medicaid waiver, granting the state to apply federal healthcare funding to an aggregate gap model of spending. The legislature filed the bill when it first convened on Tuesday. Just three days after the bill’s introduction, legislators took their final votes on Thursday and Friday. The six subcommittees who reviewed the waiver all recommended its passage over the course of a few days.

The waiver allows the state to establish a self-imposed, fixed budget to last over a ten-year period, known as TennCareIII. It also allows the state to reserve a portion of the unused funds and apply them to other government programs, with potential for those savings to be matched with additional federal funds for healthcare programs.

Read More

Representative Cooper Submits Letter to Biden Requesting Revocation of Modified Medicaid Block Grant

Corinne Murdock

Representative Jim Cooper (D-TN-05) submitted a letter to President-elect Joe Biden requesting the revocation of the recently-approved TennCareIII. In his concluding remarks, Cooper claimed that the agreement was unethical and accompanied by potentially criminal affairs.

“There is still information surfacing about this unprecedented waiver, including secret side agreements that are unprecedented and probably illegal,” wrote Cooper. “As we learn more, enabling us to further evaluate our state’s cruelty to its deserving poor and its vulnerable hospitals, I will be back in touch with you.”

Read More

Federal Government Approves Tennessee’s Medicaid Proposal, Swapping a Block Grant for an Aggregate Cap

Corinne Murdock

The federal government approved Tennessee’s proposed Medicaid aggregate cap, granting a lump sum for a self-imposed, fixed budget. The ten-year agreement, referred to as “TennCare III,” is the first of its kind nationwide. It also allows for the state to reserve any unused funds and apply them to other government programs, with up to 55 percent of those savings potentially matched by additional federal funds for state health programs.

The Centers for Medicare and Medicaid Services (CMS) described the measure as an “innovative financing approach.” Unlike what various reports claimed, federal officials explicitly stated that this agreement wasn’t a block grant. This agreement allows the state government to be flexible with its spending cap under certain circumstances – like last year’s pandemic and related unemployment crisis. 

Read More

Trump Administration to Announce Medicare, Medicaid Will Cover Eventual COVID-19 Vaccine According to Report

Admin

The Trump administration is expected to announce that the eventual coronavirus vaccine will be covered by Medicare and Medicaid, Politico reported late Monday.

The administration is expected to change a rule that previously prevented Medicare and Medicaid from covering vaccines that received emergency use authorization from the FDA. The official announcement is expected from the Center for Medicare and Medicaid Services (CMS) Tuesday or Wednesday, according to Politico.

Read More

Congressional Debate: Candidates Scott Taylor and Incumbent Elaine Luria Spar Over Stimulus Packages and Gun Control

Corinne Murdock

Republican challenger Scott Taylor and incumbent Representative Elaine Luria (D-Virginia Beach) faced off Tuesday night in their first televised debate. The 2nd Congressional District race is currently a toss-up.
Political reporter Joe St. George served as the moderator. Questions featured were presented in three segments: from the moderator first, then viewers, and lastly from Taylor and Luria.

Read More

Obamacare Loophole Allows Medicaid Fraud, Costs Taxpayers, Report Says

Admin

The Affordable Care Act mandated that states accept a hospitals’ decision on the eligibility of all able-bodied adults who verbally report their income to be below the Medicaid level, which has led to many fraudulent eligibility claims, according to a report published Monday.

The Foundation for Government Accountability (FGA) report examined recently released data from state Medicaid agencies. It specifically looked at the government Medicaid funds that were wasted through false hospitals’ presumptive eligibility (HPE) determinations.

Read More

Commentary: Lowering the Cost of Prescription Medicines for Seniors Is Not Impossible

Admin

Earlier this year James Payne, a 73-year-old retired attorney in Utah, was so fed up with the high cost of a blood thinner medication he takes, he researched prices in Canada, where he found it was cheaper.

“Under Medicare, I am now paying $225 for a three-month supply,” Payne explained. “That’s $25 more than I was paying last year. Under my employer’s insurance I was only paying $20.” Payne says he is not sure why the costs are so much higher and continue to climb under Medicare, but he thinks there must be ways to make life-saving medications more affordable.

Read More