NYC settles Medicaid suit; Wis. officials face deadline for new plan for health care for poor

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A roundup of state news about health care programs for low-income residents.

The New York Times: City To Pay $70 Million In Medicaid Suit
New York City will pay the federal government $70 million to settle a lawsuit that accused the city of overbilling Medicaid by improperly approving home care for frail and elderly clients, both parties said on Monday (Hartocollis, 10/31).

The Wall Street Journal: $70 Million Medicaid Settlement
New York City agreed to pay $70 million to settle a Justice Department lawsuit that accused the city's personal-care services program of overbilling Medicaid for millions of dollars in reimbursements (FitzGerald, 11/1).

Milwaukee Journal Sentinel: Walker Adjusts Plan To Close $554 Million Gap In Medicaid Programs
Gov. Scott Walker's administration tweaked its proposals Monday to close a half billion-dollar budget hole in the state's health plans for the poor as a deadline approaches for deciding whether the state will drop the health coverage of tens of thousands of state residents. The state Department of Health Services made the changes in a 238-page plan being sent for review to the Legislature's budget committee, which is expected to take up the proposal next week. But a Democratic lawmaker said Monday he was concerned that there still wouldn't be enough time for lawmakers and President Barack Obama's administration to review the plan -- action that is required to keep more than 50,000 state residents from losing their state coverage altogether at the end of the year (Stein, 10/31).

Kaiser Health News: Capsules: Health Expert Urges States To Slow The Move To Medicaid Managed Care
As more states turn to managed care to reduce Medicaid costs, Judy Feder is urging caution. Feder, a  professor at and former dean of the Georgetown University's Public Policy Institute , is worried that officials' enthusiasm for managed care in Medicaid "might get out of hand," and she is urging them to move slowly when it comes to caring for the nearly 9 million "dual eligibles,"  Medicaid enrollees who also qualify for Medicare (Carey, 10/31). 

California Healthline: Effort For Settlement Of ADHC Lawsuit
State officials and advocates for seniors and the disabled are meeting today trying to work out a settlement of a lawsuit over adult day health care. ... The court is asked to determine whether the state's transition plan is adequate to handle the needs of roughly 35,000 frail, elderly and disabled patients. The state's ADHC program ceases to be a Medi-Cal benefit on Dec. 1 (Gorn, 11/1). 

The Miami Herald: Jackson Health System's Plan To Sell Insurance Business Falls Through
Jackson Health System's deal to sell its troubled Medicaid insurance business has collapsed, its governing board was told Monday. Carlos Migoya said the arrangement to sell the Medicaid plan with its 12,000 members to Simply Healthcare fell through because "state regulators required a longer transition period than was possible." He said an alternative potential buyer has stepped forward with a non-binding letter of intent, but he offered no details because discussions are continuing. He said the new buyer would not offer any cash up front (Dorschner, 10/31).


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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