Roundup: Feds say Ariz. overbilled them $12M on Medicaid; Insurer v. co-op coverage fight in Md.

Published on January 29, 2013 at 2:42 AM · No Comments

A selection of health policy stories from Arizona, Maryland, North Dakota, California, Massachusetts, Minnesota, North Carolina and Texas.

Arizona Republic: Feds: Ariz. Overbilled Medicaid Program
Arizona failed to properly document efforts to enroll children in its Medicaid program for years and overcharged the federal government nearly $12 million, auditors found in a report expected to be released today. In addition to recommending that Arizona repay the federal government $11.7 million, the report by the inspector general for the U.S. Department of Health and Human Services suggests the review of an additional $18.8 million as questionable billing. In a written response to the findings, state officials with the Arizona Health Care Cost Containment System acknowledged that they need to update the way work is documented, but they challenged the recommendation to have the state repay millions (Hansen, 1/27).

Bloomberg: Obama Law Pits Insurance Giants Against Maryland Co-Op
UnitedHealth Group Inc. and other U.S. health insurers will soon have company in Maryland: a nonprofit started by a county government that plans to sell coverage at rates as much as 30 percent lower than competitors. Backed by $65 million in federal loans, Howard County, a suburban area south of Baltimore, Maryland, will become the first municipality to establish a nonprofit, member-run health co-op to compete with commercial insurers under a provision in the 2010 Affordable Care Act. The Howard County co-op will sell individual and small group plans through the insurance marketplaces, or exchanges, created by the law to help extend medical coverage to 30 million uninsured Americans. It is among two dozen nonprofits to roll out coverage in 23 states starting in October, though the only one run by a local government (Wayne, 1/27).

The New York Times: North Dakota Oil Boom Takes A Toll On Health Care
The patients come with burns from hot water, with hands and fingers crushed by steel tongs, with injuries from chains that have whipsawed them off their feet. Ambulances carry mangled, bloodied bodies from accidents on roads packed with trucks and heavy-footed drivers. The furious pace of oil exploration that has made North Dakota one of the healthiest economies in the country has had the opposite effect on the region's health care providers.  (Eligon, 1/27).

Los Angeles Times: St. John's In Court Fight Over Failed Nurse Recruitment Effort
Now the hospital is pursuing a court fight over this costly failure, saying it was the victim of fraud, bribery and unfair business practices. But the legal battle may also yield unflattering details about the inner workings of one of the area's best-known hospitals, which recently saw a high-profile management shake-up (Terhune, 1/25).

Boston Globe: Program Brings Dental Care To Children Without Dentists
Kyara Fortes hadn't been to a dentist for about a year. So, when the 3-year-old and her mother stopped in to the offices of Brockton Area Multi-Services Inc. recently, she visited a tiny back office just big enough for a desk, a filing cabinet, and a collapsible dental chair. "Do all your teeth feel good? Can you eat all the foods that you like?" dental hygienist Carol Gilmore of Halifax asked, and the bright-eyed girl in pink nodded. "Go, 'Ahhhh.'" … Gilmore is a public health hygienist, one of the first licensed under a program created in 2010 to improve access to dental care among low-income children and adults by giving experienced hygienists more authority to deliver preventive care without direct supervision from a dentist. The state Medicaid program covers dental care for children. Yet, each year, about 200,000 children enrolled in the program do not receive any care from a dentist, said Dr. Brent Martin, dental director for MassHealth (Conaboy, 1/28).

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