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Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states.

Commercial disease management models do not reduce Medicare costs in America

At a time when everyone is looking for ways to reduce health care costs in America, using commercial disease management programs to reduce the fee-for-service Medicare costs associated with chronic conditions among senior citizens seems like a practical approach.

4 Nov 2011

Cain offers up his views on health policy

In a short policy speech delivered on Capitol Hill, GOP presidential hopeful Herman Cain expressed his support for repealing the 2010 health law and replacing it with market-based reforms.

4 Nov 2011

Glaxo pays $3 billion to settle investigations involving alleged marketing missteps and Medicaid fraud

GlaxoSmithKline PLC said it will pay the U.S. government $3 billion to settle several long-running criminal and civil investigations into the company, including allegations that Glaxo marketed some drugs illegally and defrauded the Medicaid program. The settlement will also cover a Department of Justice probe into Glaxo's development and marketing of the diabetes drug Avandia, which has been linked to heart attack risks.

4 Nov 2011

ACP tells 112th Congress to 'go big' by reforming Medicare payments

The American College of Physicians (ACP) today told the 112th Congress to "go big" by reforming Medicare payments, including enacting a permanent end to scheduled Medicare sustainable growth rate (SGR) physician payment cuts.

4 Nov 2011

CMS issues J-code for Savient's KRYSTEXXA

Savient Pharmaceuticals, Inc. announced that the Centers for Medicare and Medicaid Services has assigned a product-specific billing code, or J-code, for KRYSTEXXA (pegloticase), which is used for the treatment of chronic gout in adult patients refractory to conventional therapy.

3 Nov 2011

First Edition: November 3, 2011

Today's headlines include reports about a bipartisan group of lawmakers who are urging the super committee to consider "all options."

3 Nov 2011

SXC third quarter revenue increases 163% to $1.3 billion

SXC Health Solutions Corp., a leading provider of technology and pharmacy benefit management (PBM) services, announces its financial results for the three-month and nine-month periods ended September 30, 2011.

3 Nov 2011

Budget experts focus on health costs

Four well-known budget gurus testified Tuesday in a public super committee hearing, telling the panel they should raise revenues and overhaul expensive federal health programs in order to develop a budget compromise that will meet the $1.2 trillion, 10-year mandate.

3 Nov 2011

Roundup: N.Y. autism coverage mandate; Miss. 'personhood' referendum; Wis. MLR controversy

The dazzling new hospital that will open here in Hopewell on Sunday looks more like a five-star resort than a medical center. It may also be the best hope for survival of its corporate parent, Capital Health, a nonprofit company that operates three health care facilities in New Jersey.

3 Nov 2011

Doctors face deep Medicare pay reductions — but slightly less than original estimates suggest

Without congressional intervention, physicians will face a 27.4 percent Medicare pay cut on Jan. 1. This reduction is slightly smaller than the earlier estimate of 29.5 percent.

3 Nov 2011

Medicare fee payments for outpatient care to go up 1.9 percent; payments for home health will drop

Hospital operators such as Tenet Healthcare Corp. (THC) will get higher federal payments for emergency room visits, diagnostic imaging and other outpatient services in 2012 under U.S. rules. Medicare payments for outpatient services will rise 1.9 percent to $41 billion and dialysis clinics, cancer centers and ambulatory surgery facilities also are scheduled to receive modest fee increases from the U.S. health program for the elderly and disabled under regulations issued yesterday.

3 Nov 2011

State Medicaid Directors seek to sway feds on eligibility rules

In a letter to the Centers for Medicare and Medicaid Services, the state officials made recommendations about new regulations and asked for coordination between federal and state leaders. Meanwhile, in other Medicaid news, a New York doctor gets a big payout from his whistleblower lawsuit, and the Lousiania program reports a shortfall.

3 Nov 2011

Allergy shots are cost-effective and deliver relief in weeks

Allergy shots, an age-old treatment for allergy sufferers, are getting a shot in the arm from new research. This proven therapy saves money; accelerated schedules deliver relief in weeks, rather than months; and alternative methods are on the horizon, according to allergists at the annual scientific meeting of the American College of Allergy, Asthma and Immunology in Boston, Nov 3-8.

3 Nov 2011

Edwards Lifescience receives FDA approval for Sapien Transcatheter Heart Valve

The U.S. Food and Drug Administration today approved the first artificial heart valve that can replace an aortic heart valve damaged by senile aortic valve stenosis without open-heart surgery.

3 Nov 2011

Viewpoints: GOP intransigence on super committee; taxing health benefits would backfire; the need for care in defining essential benefits

There may be logic to Speaker John Boehner's insidious intransigence. Republicans keep saying no and Democrats keep offering more concessions. Super committee Republicans suggested instead a package based largely on cuts in Medicare, Medicaid and Social Security, combined with magical hundreds of billions they say would be produced by slashing assistance to the elderly and the vulnerable, by selling off government assets, and by the growth sparked by tax cuts.

3 Nov 2011

First Edition: November 2, 2011

In today's headlines, reports about Tuesday's super committee hearing and the message communicated by bipartisan budget hawks to the panel -- raise revenue and revamp health programs.

2 Nov 2011

Alliances form among super committee members

Reuters reports that three Republicans and three Democrats are joining together in an effort to develop the framework of a deal themselves. Meanwhile, an outside organization - the AFL-CIO - is launching a campaign to defeat any Medicare, Medicaid or Social Security cuts the panel may ultimately propose. And, according to Politico, Social Security is in play as the panel's deliberations continue.

2 Nov 2011

State roundup: Ga., Minn. move slowly on exchanges

The entire Massachusetts congressional delegation is asking CMS to preserve the level of safety net funding and provider payments as the state tries to renew its Medicaid waiver. "We are concerned that changes proposed by CMS could significantly threaten payments to Massachusetts health care providers providing care for the most vulnerable populations," Sens. John Kerry and Scott Brown and the 10 House members in the state's delegation wrote.

2 Nov 2011

Home health payments will fall 2.3% in 2012

The pay cut for home health agencies was announced in a regulation that was issued Monday. Although this reduction is less than initially proposed and will be phased in over two years, industry voices described it as "severe."

2 Nov 2011

Early retirees' health insurance fund running out

A federal report predicts this $5 billion account created as part of the health law will be drained by 2012. In related news, one senator criticizes the program's handling. Also drawing criticism are exchange regulations, which advocates say could undermine the law's goal of expanding health insurance. Meanwhile, the Department of Health and Human Services finalized standards - part of the administration's efforts to reduce health disparities - to track factors that affect people's health.

2 Nov 2011