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Cancer community joins coalition seeking Medicare coverage for CT lung cancer screening

More than 60 patient advocacy and medical organizations have joined a coalition headed by the Lung Cancer Alliance, the American College of Radiology and The Society of Thoracic Surgeons, in urging Medicare to cover low dose computed tomography (LDCT) screening for beneficiaries at high risk for lung cancer.

30 Sep 2014

State highlights: Calif. health insurers and contraception coverage; Alaska sues Xerox over Medicaid payment systems

Health insurance policies in California will have to cover all federally approved contraceptives for women by 2016 without charging co-payments under legislation signed this week by Gov. Jerry Brown, countering trends in other states and the U.S. Supreme Court. The bill, SB1053 by Sen. Holly Mitchell, D-Los Angeles, expands state laws that required coverage for most birth-control drugs and devices approved by the U.S. Food and Drug Administration. The new law mandates coverage for all FDA-approved contraception, prohibits co-payments and includes managed-care Medi-Cal plans, which are not expressly covered by current laws (Egelko, 9/27).

30 Sep 2014

Drugmakers boost generic drug prices

A big increase in generic drug prices is forcing some patients to go without, reports CBS Boston. Meanwhile, U.S. News & World Report teases out some of the reasons for the slowdown in health care costs.

29 Sep 2014

CVS to pay $6M to settle Medicaid reimbursement case

Caremark LLC, a unit of CVS, will make the payments to settle allegations that it knowingly failed to reimburse Medicaid for prescription drug costs paid on behalf of patients who were also covered by private plans it administered. The company denied wrongdoing.

29 Sep 2014

Texas Rep. Brady ready to brawl for ways & means top spot

Rep. Kevin Brady, R-Texas, announced he will seek the chairmanship of this powerful House panel. Rep. Paul Ryan, R-Wis., was expected to have a smooth path to that position.

27 Sep 2014

Medicaid expansion concept gains momentum in some initially reluctant states

Reuters reports that this development has to do with financial pragmatism -- especially in GOP-led states that were at the forefront of opposition to the health law. The Associated Press provides a status check on Indiana's expansion request.

27 Sep 2014

Four more hospital systems quit ACO program

Three years after the Centers For Medicare & Medicaid Services selected 32 groups to participate in the Pioneer Accountable Care Organization Model program, they are down to 19 players.

26 Sep 2014

State highlights: N.C. lawmakers still talking about Medicaid revamp; changes to La. health plan for state workers stir controversy

Legislators who couldn't agree this year on how to overhaul North Carolina's Medicaid program plan to spend more time talking about the issue before the General Assembly reconvenes early next year. A legislative oversight panel subcommittee charged with examining Medicaid reform and reorganization scheduled its first meeting Wednesday. Another oversight panel also examining Medicaid governance held its first meeting this month. The House and Senate approved differing versions of legislation to change how Medicaid pays for medical expenses by shifting risk from the state to either medical provider networks or private managed-care companies (9/24).

26 Sep 2014

Longer looks: ACOs and job shifts; abortion's racial gap; having a stroke at 33

It is now nearly a year since the roll-out of Obamacare. The launch was a shambles, and Obamacare is a totem for every American who hates big government. Republicans will deride it, yet again, in the mid-term elections. Obamacare is indeed costly and overcomplicated. Yet it is not to blame for America's health mess, and it could just contain the beginnings of a partial solution to it. But that will only happen if politicians treat health care like a patient: first, diagnose the disease, then examine whether Barack Obama's treatment helped, and then ask what will make the patient better (9/20).

26 Sep 2014

Drug firms shift sales calls from doctors to administrators controlling hospital formularies

Since many hospitals now work to help keep costs down by watching what drugs are used, pharmaceutical representatives must include administrators in their sales pitches. Also in the news, new concerns about the government's plan to open a database next week on drug makers' payments to doctors.

26 Sep 2014

GuideWell, OSI partner to provide affordable, quality health care to growing Hispanic market

GuideWell Mutual Holding Corporation and Organizacion Sanitas Internacional have established a strategic alliance to create a new company with the purpose of offering a culturally relevant health delivery model that provides affordable and quality health care to the important and growing Hispanic market.

25 Sep 2014

State highlights: Calif. gov. signs rural telehealth bill; Louisiana's ex-health secretary indicted

States around the country are taking advantage of a once little-used policy that allows them to bill Medicaid for the healthcare expenses of prisoners who leave a correctional institution for treatment. Since 1997, states have been allowed to bill Medicaid for the care of inmates who required treatment at a hospital or nursing facility for longer than 24 hours. The provision has drawn new attention this year as millions of Americans, including those serving time in correctional institutions, have become newly eligible for Medicaid under the Patient Protection and Affordable Care Act (Dickson, 9/23).

25 Sep 2014

HCA faces class-action lawsuit for allegedly concealing revenue declines

A Nashville district court judge allowed the shareholders' case to move forward by rejecting the hospital chain's arguments that the plaintiffs had missed 'multiple opportunities' to learn more about the company before buying shares.

25 Sep 2014

West Virginia home health community takes part in Save Home Health rally

Representatives of the West Virginia home health community – including Parkersburg area clinicians, family members and advocates as well as national leaders – today took part in a Save Home Health rally to commend special guest Congressman David McKinley (WV-1) and speak out against unprecedented Medicare cuts of 14 percent to home health services that went into effect on January 1 as part of the Affordable Care Act (ACA).

24 Sep 2014

Medicare News and Research

Cancer community joins coalition seeking Medicare coverage for CT lung cancer screening

State highlights: Calif. health insurers and contraception coverage; Alaska sues Xerox over Medicaid payment systems

Drugmakers boost generic drug prices

CVS to pay $6M to settle Medicaid reimbursement case

Texas Rep. Brady ready to brawl for ways & means top spot

Medicaid expansion concept gains momentum in some initially reluctant states

Four more hospital systems quit ACO program

State highlights: N.C. lawmakers still talking about Medicaid revamp; changes to La. health plan for state workers stir controversy

Longer looks: ACOs and job shifts; abortion's racial gap; having a stroke at 33

Drug firms shift sales calls from doctors to administrators controlling hospital formularies

GuideWell, OSI partner to provide affordable, quality health care to growing Hispanic market

State highlights: Calif. gov. signs rural telehealth bill; Louisiana's ex-health secretary indicted

HCA faces class-action lawsuit for allegedly concealing revenue declines

West Virginia home health community takes part in Save Home Health rally

Physicians wage campaign to urge Congress not to allow Medicaid Pay Parity to expire

Viewpoints: Surgery surprise: Out-of-network doctors' bills; consequences of making Medicaid enrollees pay premiums

Drugmakers warned against giving coupons to Medicare beneficiaries

State highlights: Medicaid bankruptcy ruling could save some nursing homes; high HIV rates in Southern states

Court dumps Obamacare lawsuit brought by doctors

New study reveals differences in payment and income between physicians

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