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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.

SynerMed announces achievement of Elite status on 2010 SOE assessment

SynerMed, Inc., the largest Medicaid managed service organization in the country, today announced the achievement of "Elite" status on the 2010 Standards of Excellence assessment administered by the California Association of Physician Groups, the nation's largest professional association representing physicians practicing in the managed care model.

15 May 2010

Miami-area resident charged in $23M HIV infusion Medicare fraud scheme

A Miami-area resident who owned and operated an HIV infusion clinic was arrested today and charged for her alleged participation in a $23 million HIV infusion Medicare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced.

15 May 2010

Research roundup: Whistleblowers, spreading best practices, Medicare's growth-limiting strategy

The Impact Of Removing Financial Incentives From Clinical Quality Indicators: Longitudinal Analysis Of Four Kaiser Permanente Indicators - The researchers found the removal of pay-for-performance incentives "was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening" (Lester et al., 5/11). More details about the study and related news coverage are in the May 12 Morning Report.

15 May 2010

LifeCare Holdings reports $95.0 million net patient service revenue for first-quarter 2010

LifeCare Holdings, Inc. today announced its operating results for the first quarter ended March 31, 2010.

15 May 2010

Two community dental clinics to receive $10,000 grant from Delta Dental of Pennsylvania

Two community dental clinics that provide much-needed services to low-income people who lack access to care will receive a $10,000 grant from Delta Dental of Pennsylvania.

15 May 2010

States consider joining Medicaid expansion early to take advantage of federal money

Despite budget squeezes, some states are considering expanding Medicaid , due to the new health law.

15 May 2010

CeltiCare to provide high-quality health insurance for Commonwealth Care Bridge Program members

CeltiCare Health Plan of Massachusetts, a Centene Corporation subsidiary, today announced that the state of Massachusetts has renewed its contract to serve Commonwealth Care Bridge Program members, effective July 1, 2010.

15 May 2010

Sen. Kerry, White House push back on Berwick criticism

After Republicans levied attacks on Donald Berwick, the physician and professor President Barack Obama has nominated to lead the Medicare agency, Sen. John Kerry, D-Mass., came to the aide of his fellow Bay Stater, The Boston Globe reports. He said, "It's no secret that the national Republican Party has tried to crank up the attack machine and make his nomination a distorted referendum on reform.

15 May 2010

GOP launches new challenge to health law with coordinated messaging

Republicans are starting a new bid to undermine Democratic attempts at touting a new health law. The GOP effort includes attacks on both President Barack Obama's pick to run Medicare and on claims that implementation is going smoothly.

15 May 2010

FDA grants tentative approval for Teva's Cinacalcet HCl Tablets ANDA

Teva Pharmaceutical Industries Ltd. announced today that the U.S. Food and Drug Administration (FDA) has granted tentative approval for the Company's Abbreviated New Drug Application (ANDA) for Cinacalcet HCl Tablets 30, 60 & 90 mg.

15 May 2010

Democrats weary of health changes, mull new health bills, 'doc fix'

Democrats are feeling health care "fatigue" and are doubting that Congress will consider any more health-related legislation this year. "Measures in jeopardy include bills that would require more information on healthcare prices, empower federal regulators to sign off on premium increases and strip insurers of their exemption from anti-trust laws."

15 May 2010

Obama administration cracks down on health care fraud

Modern Healthcare: "The government's efforts to rein in Medicare fraud and abuse recovered $2.5 billion for the program in fiscal 2009, up 29% from $1.9 billion the previous year, according to a new annual report. ... The $2.5 billion collected in fiscal 2009 is attributed to judgments and settlements in previous years as well as 2009, according to the report of the Health Care Fraud and Abuse Control Program.

14 May 2010

First Edition: May 14, 2010

Today's headlines suggest that, even as congressional Democrats appear to be suffering from "health reform fatigue" and shying away from other health-related legislation, the G.O.P. is applying newfound vigor and skepticism to the White House's pick to head the agency that runs Medicare and to the administration's claims that the implementation phase of reform is going smoothly.

14 May 2010

Increase in use of imaging scans underscores need for evidence-based protocols in cancer care

New research showing a more than 30 percent annual increase in the use of high-tech imaging scans in older cancer patients underscores the need for evidence-based protocols in cancer care, said MedSolutions, a leading provider of medical management services.

14 May 2010

Health reform implementation issues: Emergency room costs, consumer websites and small business questions

Kaiser Health News: The new health reform law guarantees insurance companies must cover emergency care for their beneficiaries at hospitals in- or out-of-network at the same rate. "The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the 'prudent layperson' rule.

14 May 2010

New England Journal offers perspectives on health law

The New England Journal of Medicine dedicates a significant amount of its current issue to research and perspectives on the new health reform law, the Patient Protection and Affordable Care Act, which is abbreviated as ACA (5/12).

14 May 2010

States take different actions in plans for implementing health overhaul law

WPRI: Rhode Island Governor, Donald Carcieri, continues to ask Attorney General Patrick Lynch to file a lawsuit against the federal health reform law. "But Lynch says he will not do it. In a statement, Lynch says he believes quality health care is a right for all citizens. He also says the law does not infringe on the rights of states" (Gouthro, 5/10).

14 May 2010

Insight Imaging third-quarter revenues decrease 12.9% to $46.4 million

InSight Health Services Holdings Corp. today announced its financial results for the third quarter ended March 31, 2010.

14 May 2010

Minnesota lawmakers debate budget, Medicaid expansion

More budget talks were expected Thursday as Minnesota's legislative session hurtled toward a midnight Sunday deadline with no deal on a $3 billion deficit. The Democratic-controlled Legislature defied another veto threat from Republican Gov. Tim Pawlenty late Wednesday and sent him a health and welfare package he opposes.

14 May 2010

GOP launches attacks on CMS nominee Berwick

Republicans have begun attacking Donald Berwick, a doctor and Harvard professor nominated to head the Obama administration's Medicare and Medicaid agency, The Boston Globe reports. If confirmed, Berwick would run the Centers for Medicare and Medicaid Services, an agency with 4,500 employees and an annual budget of $780 billion.

14 May 2010

Medicaid News and Research

SynerMed announces achievement of Elite status on 2010 SOE assessment

Miami-area resident charged in $23M HIV infusion Medicare fraud scheme

Research roundup: Whistleblowers, spreading best practices, Medicare's growth-limiting strategy

LifeCare Holdings reports $95.0 million net patient service revenue for first-quarter 2010

Two community dental clinics to receive $10,000 grant from Delta Dental of Pennsylvania

States consider joining Medicaid expansion early to take advantage of federal money

CeltiCare to provide high-quality health insurance for Commonwealth Care Bridge Program members

Sen. Kerry, White House push back on Berwick criticism

GOP launches new challenge to health law with coordinated messaging

FDA grants tentative approval for Teva's Cinacalcet HCl Tablets ANDA

Democrats weary of health changes, mull new health bills, 'doc fix'

Obama administration cracks down on health care fraud

First Edition: May 14, 2010

Increase in use of imaging scans underscores need for evidence-based protocols in cancer care

Health reform implementation issues: Emergency room costs, consumer websites and small business questions

New England Journal offers perspectives on health law

States take different actions in plans for implementing health overhaul law

Insight Imaging third-quarter revenues decrease 12.9% to $46.4 million

Minnesota lawmakers debate budget, Medicaid expansion

GOP launches attacks on CMS nominee Berwick

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