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 The leading web portal for pharmacy resources, news, education and careers April 18, 2014
Pharmacy Choice - News - Medicare & Medicaid - April 18, 2014

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 Medicare & Medicaid
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4/18/14 - AJMC Studies: Barriers to Newer Antipsychotic Drugs Can Drive Up Other Medical Costs, Reduce Adherence
Two recent studies published in The American Journal of Managed Care have found that state Medicaid policies restricting access to newer antipsychotic medications can drive up healthcare costs down the line, in part because psychiatric patients are more likely to go off medication. The studies found that in states where doctors face hurdles in...
4/18/14 - American Academy of Ophthalmology Issues Statement of Opposition to Congress' Short-Term Reprieve from Medicare Pay Cut
By a News Reporter-Staff News Editor at Insurance Weekly News Ophthalmologists are voicing their anger with Congress' recent passage of H.R. 4302, the Protecting Access to Medicare Act of 2014, legislation that only temporarily halts the impending 24 percent cut to Medicare physician pay until April 1, 2015. The American Academy of Ophthalmology,
4/18/14 - Cardiologist who improperly referred patients to hospitals must pay $1M [Pittsburgh Post-Gazette :: ]
April 17 A cardiologist in Ohio must pay a $1 million penalty for submitting false claims to Medicare and improperly referring patients to two hospitals following an investigation by federal authorities in Wheeling. Devender Batra, president of Belmont Cardiology, will pay that amount for causing Ohio Valley Medical Center and East Ohio Regional
4/18/14 - Findings from Marquette University Provides New Data about Dentistry
According to news reporting from Milwaukee, Wisconsin, by VerticalNews journalists, research stated, "To examine patterns of dental service utilization for adult Medicaid enrollees in Wisconsin following nontraumatic dental condition visits to the emergency department. For more information on this research see: Patterns of dental service utilizatio
4/18/14 - House speaker makes final push for Medicaid expansion with plan based on New Hampshire [Bangor Daily News, Maine :: ]
April 17 AUGUSTA, Maine The debate over Medicaid expansion has dominated the 126th Legislature, and it will continue to do so as the session winds down and lawmakers prepare to head back to their districts. Rather than simply expanding Medicaid permanently to 70,000 low-income Mainers as originally envisioned by the 2010 federal Affordable Care
4/18/14 - Medicare Advantage costs [Deseret News (UT)]
When I initially signed up for Medicare Advantage, it did not cost me anything beyond what the government charges for Medicare Part B. I was able to get a lot of extra services that Medicare didn't cover, like hearing aids and contact lenses. Others are in worse shape and may not be able to get care at all if Medicare Advantage is scaled back. Our
4/18/14 - Obama tells Democrats to defend health-care law [St. Louis Post-Dispatch :: ]
The president also took another swipe at states that, like Missouri, have refused to accept federal aid to expand Medicaid, one part of the reforms. The Kaiser Family Foundation's Web site Thursday said that 27 states had expanded Medicaid, with the rest refusing or still debating expansion. Roy Blunt, R- Mo., a member of his party's Senate leaders
4/18/14 - Oregon providers make less from Medicare, and health, medical culture explain why [The Oregonian, Portland, Ore. :: ]
April 17 The federal government recently released data on Medicare provider reimbursements, and one of the numbers jumps out: The median Oregon reimbursement per provider in 2012 was $18,890, compared to a national median of $30,265, according to The Oregonian's analysis. Enter an Oregon health care provider's last name to see how much Medicare r
4/18/14 - Studies from National Heart Lung and Blood Institute Further Understanding of Medicare and Medicaid
By a News Reporter-Staff News Editor at Insurance Weekly News Data detailed on Medicare and Medicaid have been presented. The news correspondents obtained a quote from the research from National Heart Lung and Blood Institute, "Herein, we assess whether Medicare data can reliably assess stroke events in the WHI. Subjects were WHI participants wit
4/17/14 - 'Progress indeed' in the unusually high Medicare charges cases [Deseret News (UT)]
Last week, the Centers for Medicare& Medicaid Services, in a historic move, applied the transparency disinfectant to the ailing Medicare program by publishing comprehensive physician payment data for the first time in nearly 35 years. Release of this information is a boon for taxpayers, a treasure trove for researchers, and a nightmare for physicia
4/17/14 - Anchorage physician charged with Medicaid fraud of more than $300,000 [Anchorage Daily News :: ]
April 17 Authorities arrested an Anchorage physician Tuesday evening, alleging he billed Medicaid more than $300,000 for services he never provided. The state's Medicaid Fraud Control Unit was first alerted to Ghosh Psychiatric Services, 9138 Arlon St., by an employee who said there was a "large fraudulent Medicaid billing issue," charges said.
4/17/14 - Anchorage physician charged with Medicaid fraud of over $300,000 [Anchorage Daily News :: ]
April 17 Authorities arrested an Anchorage physician Tuesday evening, alleging he billed Medicaid more than $300,00 for services he never provided. Since October 2012, the Alaska Medicaid Fraud Control Unit has charged 77 individuals with Medicaid fraud, abuse or neglect, compared to about 30 people the decade before, said Andrew Peterson, assist
4/17/14 - ApolloMed ACO Increases Patient Enrollment to 30,000 Medicare Beneficiaries and Number of Physicians to More Than 700 [Global Data Point]
ApolloMed ACO now has physicians and patients in Los Angeles County and Orange County in Southern California, Alameda County in the San Francisco Bay Area and Tulare County in Central California, as well as in Mississippi and Ohio.&# x0D;. "The goal of ApolloMed ACO is to improve the quality of care for Medicare fee-for-service patients," stated W
4/17/14 - Attorney General's Office Announces Arrest of Hillsborough County Woman for Medicaid Fraud
The office of the Florida Attorney General issued the following news release:. Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Hillsborough County Sheriff's Office today arrested Hillsborough County resident Esther Stirewalt for Medicaid fraud. The case will be prosecuted by the Attorney General's Office of Statewide Prosecution.
4/17/14 - Centers for Medicare & Medicaid Services Announces Extension of Submission Deadlines for Letters of Intent and Applications
WASHINGTON, April 17 The U.S. Department of Health and Human Services published the following notice in the Federal Register from the Centers for Medicare& Medicaid Services:. A Notice by the Centers for Medicare& Medicaid Services on 04/17/2014. Dates: Letter of Intent Submission Deadline: Interested large dialysis organizations must submit a no
4/17/14 - Comptroller DiNapoli Releases State Audits
State Department of Health: Medicaid Payments for Medicare Part A Beneficiaries. An initial audit report issued in September 2010 identified $14 million in potential Medicaid overpayments for claims pertaining to 2,564 individuals enrolled in both Medicaid and Medicare. Auditors recommended the Department of Health improve its detection of Medicare
4/17/14 - EDITORIAL: Look around, governor There are many examples of states expanding Medicaid in their own way [The Anniston Star, Ala. :: ]
Robert Bentley's ironclad refusal to expand Medicaid in Alabama have tried logic, reasoning, emotional requests and biblical pleas, and nothing has worked. Bentley should look at the states that have won federal approval to use funds from an expanded Medicaid for alternative programs. Bentley should look at Arkansas, one of the Southern states you'
4/17/14 - Eves' Eleventh Hour Medicaid Expansion Ploy is as Political as it Gets
Governor Paul R. LePage today responded to the introduction by House Speaker Mark Eves of a fourth bill to expand Medicaid. Eves calls the bill "dramatically different" from other Medicaid expansion-related bills. New Hampshire lawmakers crafted the legislation after Medicaid expansion model in Arkansas, which uses federal money to pay for subsidie
4/17/14 - ExamWorks Schedules First Quarter 2014 Earnings Release and Conference Call
ATLANTA, GA. April 17, 2014- ExamWorks Group, Inc. announced today that the Company will release first quarter 2014 earnings on Tuesday, May 6 after the market close. About ExamWorks Group ExamWorks Group, Inc. is a leading provider of independent medical examinations, peer reviews, bill reviews, Medicare compliance, and related services. Forward L
4/17/14 - Fact Sheet: Affordable Care Act by the Numbers
It is giving millions of middle class Americans the health care security they deserve, it is slowing the growth of health care costs and it has brought transparency and competition to the Health Insurance Marketplace. *3 million more people were enrolled in Medicaid and CHIP as of February, compared to before the Marketplaces opened. Medicaid and C
4/17/14 - Guv still optimistic about Medicaid expansion plan [Deseret News (UT)]
Gary Herbert continued to be optimistic Wednesday that the federal government will sign off soon on his proposed alternative to Medicaid expansion following meetings in Washington, D.C., earlier this week. Herbert told reporters that federal approval should come in time for him to call a special session of the Utah Legislature this summer to accept
4/17/14 - House Republican Leader's Statement on Medicaid Expansion Bill
House Republican Leader Ken Fredette of Newport issued the following statement regarding the upcoming vote on LD 1578, the Medicaid expansion bill sponsored by House Speaker Mark Eves. I believe just as strongly that Medicaid expansion would be bad for our state's economy and budget, and yesterday's public poll indicates that an increasing number o
4/17/14 - House Speaker makes final push for Medicaid expansion with plan based on New Hampshire [Bangor Daily News, Maine :: ]
April 17 AUGUSTA, Maine The debate over Medicaid expansion has dominated the 126th Legislature, and will continue to do so as the session winds down and lawmakers prepare to head back to their districts. The plan would accept millions of federal dollars to expand Medicaid for one year to newly eligible poor Mainers as a "bridge" to a new system
4/17/14 - Kaiser Permanente's Medicare Website Recognized as Top-Notch, User-Friendly Site
Kaiser Permanente's Medicare health plan website,, received top marks again from HealthMetrix Research Inc. for offering Medicare consumers an easy, positive and high-value experience. The independent research firm announced its list of "Outstanding Medicare Advantage Plan Websites" for 2014 MedicareWebWatch certification, and...
4/17/14 - Medicaid petition given to Howell [The Free Lance-Star, Fredericksburg, Va. :: ]
April 17 Lee Russell stood outside Virginia House Speaker Bill Howell's Falmouth office Wednesday with a petition asking the General Assembly to expand Medicaid. The petition was signed by 451 small-business leaders from across Virginia, and Russell was picked to deliver it to Howell. The General Assembly is currently at a stalemate to pass a bud
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