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 The leading web portal for pharmacy resources, news, education and careers January 22, 2019
Pharmacy Choice - News - Medicare & Medicaid - January 22, 2019

Pharmacy News

 Medicare & Medicaid
Current Articles | 7 - 30 Days Old | 30 - 90 Days Old | Over 90 Days
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12/23/18 - Group backing private Medicare is funded by insurance giants
The multimillion-dollar budget for the alliance isn't supplied by seniors, but by UnitedHealthcare, Aetna and Humana, according to the group's president and its federal tax returns. It lobbies Congress and the administration and sponsors research. It has reported spending $370,000 so far this year on lobbying Congress primarily, according to disclo
12/23/18 - Medicaid advocates worry lawmakers will obstruct, change coverage
On Saturday Luke Mayville addressed a small group at the Flying M Coffeegarage in Nampa about the concerns. The initiative requires Idaho to submit its state plan amendment to expand Medicaid to federal authorities within 90 days of the proclamation-signing, the Idaho Press previously reported. Over the past month, Mayville and staff of Reclaim Ida
12/23/18 - Seacoast-area nursing homes penalized by Medicare Payments reduced to nine facilities due to hospital readmission rates
Known as the Skilled Nursing Facility Value-Based Purchasing Program it was created in 2014 and administered by the Center for Medicare and Medicaid services. The facilities cited in the Seacoast region are Clipper Harbor, Portsmouth -1.98; Webster at Rye -1.98; Colonial Hill Center and Rochester Manor -1.98; Dover Center for Health and Rehabilitat
12/23/18 - Thinking About Health: Medicare Advantage directories are full of outdated, incorrect information
The other day came a lengthy report from the Centers for Medicare& Medicaid Services announcing worrisome findings for anyone with a Medicare Advantage plan and anyone thinking about buying one in the future. The findings are also relevant to anyone buying any kind of health insurance this year. The information given to consumers in the provider di
12/23/18 - Work requirement ends coverage for 4,600
The work rule says that Medicaid beneficiaries who don't report 80 hours of monthly "work activities" to DHS for any three months out of a given calendar year are locked out of the Arkansas Works program for the rest of that year. That means anyone may reapply for coverage in the new year, a DHS spokesperson confirmed by email on Monday, as long as
12/22/18 - ACA enrollment figures hold steady
That was a slight jump from last December's 24,889. Dennis Delpizzo, a spokesman for the Centers for Medicare and Medicaid Services, said a final enrollment snapshot will be released next week but that those numbers should "closely reflect" the Dec. 15 figures. Premium rates had spiked dramatically in 2017 for exchange plans offered by Blue Cross B
12/22/18 - DHS set to impose Medicaid spending caps for at-home services under ARChoices
A new set of state Department of Human Services rules governing several Medicaid-funded programs for elderly and disabled beneficiaries will go into effect on Jan. 1 after clearing a final Arkansas legislative panel on Friday. He read aloud on Thursday from the U.S. Supreme Court's "Olmstead" decision, a 1999 ruling that declared people with disabi
12/22/18 - Feds approve LePage's push for stricter Medicaid rules, but Mills could end it [Bangor Daily News, Maine]
Dec. 22 By Michael Shepherd, BDN Staff December 21, 2018 6:15 pm. Maine is the sixth state to win approval for work requirements in Medicaid since the Republican president took office in 2017. The changes would allow Maine to require Medicaid recipients to work 80 hours per month or meet other community engagement requirements and pay up to $40
12/22/18 - Feds approve Michigan's Medicaid work requirement, beginning in 2020 [Detroit Free Press]
Dec. 21 WASHINGTON The Trump administration on Friday approved Michigan's request to require some low-income individuals receiving Medicaid to prove they are working, trying to find work or undergoing training or risk losing their health care coverage. Michigan joins seven states to have a work requirement for Medicaid coverage approved by th
12/22/18 - GAO Issues Report on Medicare Fee-For-Service
Steve Womack, R- Arkansas, chairman of the House Budget Committee, Rep. Greg Walden, R- Oregon, chairman of the House Energy and Commerce Committee, Rep. Kevin Brady, R- Texas, chairman of the House Ways and Means Committee, and Rep.
12/22/18 - Group backing private Medicare is funded by insurance giants
The multimillion-dollar budget for the alliance isn t supplied by seniors, but by UnitedHealthcare, Aetna and Humana, according to the group s president and its federal tax returns. It lobbies Congress and the administration and sponsors research. It has reported spending $370,000 so far this year on lobbying Congress primarily, according to
12/22/18 - Medicare price controls would harm patients, workers (edit)
Health and Human Services Secretary Alex Azar just released a sweeping proposal that would drastically change how Medicare pays for advanced cancer therapies and other potent medicines. The government pays doctors the average U.S. price of the drug, plus a markup to cover administrative costs. Administration officials correctly note these drugs cos
12/22/18 - More Mississippians sign up for Obamacare, bucking national trends [Northeast Mississippi Daily Journal, Tupelo]
Dec. 21 TUPELO Even though national enrollment numbers are down, Mississippi saw a significant increase in people signing up for health insurance through healthcare.gov. Based on preliminary figures from the Centers for Medicare and Medicaid, 88,000 Mississippians sought health insurance for 2019 through the federal exchange. Mississippi curren
12/22/18 - More on governor's bureaucratic trainwreck in Medicaid: Kaiser study finds confusion among beneficiaries on work requirements
Governor Hutchinson's so-called "work requirements" demand that certain Medicaid beneficiaries fill out paperwork on a monthly basis or have their health insurance taken away. A new report out this week from the Kaiser Family Foundation examined the issue in a series of focus groups with beneficiaries and interviews with safety net health care and
12/22/18 - Operator of medical equipment company sentenced on fraud charges [Governance, Risk & Compliance Monitor Worldwide]
George Louis Moreno, operator of Mars DME Inc., stood before U.S. Moreno, who pleaded guilty in January to one count of healthcare fraud, will serve a three-year sentence in connection with a federal investigation that revealed he defrauded the Texas Medical Assistance Program, also known as the Texas Medicaid program, of more than $1.5 million.
12/22/18 - Operator of medical equipment company sentenced on fraud charges [Trends (Middle East)]
George Louis Moreno, operator of Mars DME Inc., stood before U.S. Moreno, who pleaded guilty in January to one count of healthcare fraud, will serve a three-year sentence in connection with a federal investigation that revealed he defrauded the Texas Medical Assistance Program, also known as the Texas Medicaid program, of more than $1.5 million.
12/22/18 - RGC man, owner of medical equipment company indicted on fraud charges [Governance, Risk & Compliance Monitor Worldwide]
The Southern District of Texas U.S. Attorneys office said in a release that Omar Cuate Canales is scheduled for his initial hearing Friday in connection with a scheme that purportedly ran for more than six years. Between January 2010 to about October 2016, Canales allegedly billed Texas Medicaid in excess of $1 million for claims that were supporte
12/22/18 - River's Edge receives final Medicare Advantage plan rejection
Blue Cross Blue Shield's decision to exclude River's Edge Hospital from its Medicare Advantage network for 2019 is final. "Despite attempts by River's Edge Hospital administrators to reach out to Blue Cross Blue Shield of Minnesota, the insurer has denied a request to allow River's Edge Hospital to be an in-network facility," the hospital said in
12/22/18 - Satisfy A Need For System Integrator ("si") And Data Hub ("dh") (collectively, "si/dh") Services In Support Of The Medicaid Management Information System ("mmis") 2020 Platform Project. Includes Provi [TendersInfo (India)]
Bid Date& Time: 12/18/18 12:00 PM Major organization: PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES, DIVISION OF PROCUREMENT Address: 625 Forster Street Room 402, Health And Welfare Bldg. Harrisburg, PA, 17120 Attn: Michelle Herring Country: United States Url: http://www.dhs.pa.gov Tender notice number: 25-16 Notice type: Tender Notice Open date: 2019-
12/22/18 - Settlement Agreement Announced in Medicare and Medicaid Investigation
The U.S. Attorney for the District of Rhode Island, Stephen G. Dambruch, issued the following news release:. An investigation by the United States Attorney's Office, the U.S. Department of Health and Human Services- Office of Inspector General, and the FBI determined that between 2012 and 2015, Professional Ambulance billed the Medicare and Medicai
12/22/18 - Study Shows Dementia Care Program Delays Nursing Home Admissions, Cuts Medicare Costs
The University of California Los Angeles campus issued the following news release:. David Reuben, Archstone Professor of Medicine and chief of the UCLA Division of Geriatrics at the David Geffen School of Medicine at UCLA. The study was published Dec. 21 in JAMA Internal Medicine.
12/22/18 - TRICARE Medicare Eligible Program (TMEP)
Location: Other Defense Agencies, Defense Health Agency, Contracting Office- Aurora. Classification Code: Q- Medical services. Subject: TRICARE Medicare Eligible Program.
12/22/18 - With late surge, Affordable Care Act enrollment in NC closes in on last year's total [The News & Observer (Raleigh, N.C.)]
Dec. 22 More than half-a-million people in North Carolina have signed up for Affordable Care Act health insurance in a year that was supposed to mark the beginning of the collapse of the federal health insurance law. National ACA enrollment was 8.45 million people, just 3.3 percent lower than a year ago, the Centers for Medicare& Medicaid Service
12/21/18 - Apollo Medical Holdings Announces That APA ACO Generated $12.96 Million In Gross Savings In 2017 And Achieved $5.90 Million In Shared Savings From The Centers For Medicare And Medicaid Services As A Result
ALHAMBRA, Calif. and GLENDALE, Calif., Dec. 21, 2018/ PRNewswire/ Apollo Medical Holdings, Inc., an integrated population health management company, announced today that its wholly-owned subsidiary, APA ACO, Inc. generated $12.96 million in gross savings in its first performance year and that, as a result, it achieved $5.90 million in shared savi
12/21/18 - Group backing private Medicare is funded by insurance giants
A group gaining influence in Washington as a champion for Medicare beneficiaries is bankrolled by major health insurance companies that are trying to cash in on private coverage offered through the federal health insurance program. The Better Medicare Alliance operates on a multi-million dollar budget supplied by UnitedHealthcare, Aetna and Humana.
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