California Medicaid cuts spark anger; N.Y. Medicaid fraud detection

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In California, doctors are blasting a decision to cut payments for caring for poor patients.

The Hill: Supreme Court To Decide If Suits Can Be Filed Over Medicaid Cuts
The Obama administration's decision to approve Medicaid cuts in California isn't expected to affect a Supreme Court case involving those cuts. The Supreme Court heard oral arguments earlier this month in Douglas v. Independent Living, which asks whether patients and healthcare providers have the right to sue states over proposed Medicaid cuts (Baker, 10/29).

CQ HealthBeat: California Docs 'Extremely Angry' With CMS Over Medicaid Cuts
The California Medical Association blasted a decision by federal officials this week to approve $623 million in Medicaid cuts that state officials asked for. The group says the cuts will deny poor people access to doctors, drive many sick Californians into costly emergency room care and badly weaken the state's Medicaid system just as millions of uninsured residents get access to coverage under the federal health care overhaul law (Reichard, 10/28).

Medscape: California Physicians Decry 10% Medicaid Pay Cut
The association contends that the 10% reduction in provider reimbursement will drive more physicians out of the program and make it harder for the poor to receive medical care, violating federal requirements that govern the Medicaid program (Lowes, 10/28). 

Meanwhile, in New York, auditors found a massive mistake.

The Associated Press/USA Today: NY Medicaid Auditors Save Millions On A Hunch
On a hunch, state auditors Mike Ernst and Joe Gagnon decided to go beyond their usual work of searching out intricate fraud schemes and double check some of the most basic data in the massive Medicaid bureaucracy: The patient's address. They found a nearly $60 million mistake. The auditors in the Medicaid Inspector General's Office discovered that managed care companies often inaccurately billed the government health program based on where patients got care, not where they lived (Gormley, 10/29).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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