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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.

Medicare false claims: Los Angeles DME company owner pleads guilty

The owner and operator of a Los Angeles durable medical equipment (DME) company pleaded guilty today to submitting nearly $1 million in false claims to Medicare, announced Assistant Attorney General Lanny A. Breuer of the Criminal Division and Acting U.S. Attorney George S. Cardona for the Central District of California.

28 Jan 2010

Access Scientific's PICC WAND receives FDA clearance

Access Scientific has received FDA clearance for The PICC WANDTM, which enables clinicians to insert a peelable sheath for PICC or Midline catheter placement using the new Accelerated Seldinger Technique (AST). The PICC WAND is an all-in-one safety introducer that addresses the over-wire vascular access market, valued at more than $1 billion, by providing faster, safer and simpler vascular access.

27 Jan 2010

Two former LA Medical Center owners to pay $10 million in Medicare fraud case

"The two former owners of City of Angels Medical Center will pay $10 million as part of a consent judgment over allegations that they performed unnecessary medical work on homeless people recruited from skid row shelters as part of a Medicare fraud scheme." Authorities alleged that the center would charge the government for the treatments (Grad, 1/26).

27 Jan 2010

CBO: Stimulus more expensive than expected, Medicare costs to double by 2020

A new Congressional Budget Office report "provides more ammunition for Republicans who say the stimulus has been long on spending and short on creating promised jobs," The Associated Press/ABC News reports. The report says the stimulus will cost $75 billion more than expected, because of increased unemployment, requirements for the food stamp program and the high popularity of an infrastructure bonds program. The report comes as Democrats consider a second stimulus bill that could include another extension of unemployment benefits, job creation tax credits and further help for jobless people to buy health coverage (Taylor, 1/26).

27 Jan 2010

Home health care fraud: Detroit-area physical therapist pleads guilty

Detroit-area resident Jessica Vigil pleaded guilty today for her role in a Detroit-area home health care fraud scheme, announced Assistant Attorney General Lanny Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI's Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services, Office of the Inspector General's (HHS-OIG) Chicago Region.

27 Jan 2010

MAXIMUS recognized as 'Certified Center of Excellence' by BenchmarkPortal

MAXIMUS (NYSE: MMS), a leading provider of government services, announced today that its New York Medicaid CHOICE project call center has once again been recognized as a “Certified Center of Excellence” by BenchmarkPortal in collaboration with the Center for Customer-Driven Quality (CCDQ) at Purdue Research Park.

27 Jan 2010

WellPoint announces net income of $2.7 billion for fourth-quarter fiscal 2009

WellPoint, Inc. today announced that fourth quarter 2009 net income was $2.7 billion, or $5.95 per share. The results included net after-tax income of approximately $2.2 billion, or $4.79 per share, resulting from a gain on the sale of the NextRx pharmacy benefit management subsidiaries ("NextRx"), partially offset by costs for restructuring activities and intangible asset impairments.

27 Jan 2010

Montana DPHHS approves Rethink Autism to provide services as part of Children's Autism Waiver

The Montana Department of Public Health and Human Services (DPHHS) has approved the use of Rethink Autism (http://www.rethinkautism.com), a web-based autism treatment platform, to provide services as part of the State's Children's Autism Waiver.

27 Jan 2010

23M people in the U.S without health insurance: Bishops call for changes in proposed reform bills

The U.S. bishops called on Congress to continue to work on health care reform to provide access for everyone, protection of life at all stages and conscience rights.

27 Jan 2010

Budget realities are rippling through states' health institutions

The (Raleigh, N.C.) News-Observer: "The state's drug assistance program for HIV patients has been capped at its current enrollment, with budget cuts hitting at the same time more people need help, state officials said Monday." Because patients with HIV are more likely to spread the virus when not on medications, public health officials are worried about denying medications (Avery, 1/26).

27 Jan 2010

Health companies adapt to diminished likelihood of health reform

Some health executives are still calling for reform in the wake of Scott Brown's upset in the Massachusetts Senate race last week that undermined Democratic efforts to advance health reform, The (Richmond) Virginian-Pilot reports.

27 Jan 2010

Obama acknowledges mistakes in health overhaul politics and processes

President Barack Obama acknowledged Monday in an interview with ABC News' Diane Sawyer that mistakes were made in the health reform debate, among the biggest "was the confusing way in which the health bill was shaped." Obama said: "'I think the healthcare debate as it unfolded legitimately raised concerns not just among my opponents, but also amongst reporters that we just don't know what's going on,' and that some 'stray cats' got in the bill." Obama also said he "didn't make a bunch of deals" and "I am happy to own up to the fact that I have not changed Congress and how it operates the way I would have liked" (Mooney, 1/25).

27 Jan 2010

Florida, California, Kansas eyeing cuts in Medicaid funding

The Daytona Beach News-Journal reports that as the recession continues to increase the number of people without jobs, many more are seeking health care through the state's Medicaid program, "driving up costs and playing a major role in a potential $3 billion state budget shortfall next year.

27 Jan 2010

Care to Care granted license to manage outpatient diagnostic imaging services in Virginia

Care to Care, a radiology benefits management company, has been granted a license by the Virginia Department of Health to manage outpatient diagnostic imaging services in the State of Virginia as a Private Review Agent (PRA).

27 Jan 2010

Democratic leaders still pondering reconciliation pros and cons for health bill

Congressional Democrats are facing a critical decision about whether to use the procedural maneuver known as budget reconciliation to pass a health care reform bill, The New York Times reports.

27 Jan 2010

Commissions to examine paring costs from Medicaid, Medicare

Medicaid payments are coming under review by a new commission, American Medical News reports. "MACPAC was created by a provision of the Children's Health Insurance Program Reauthorization Act, signed by President Obama in February 2009. The act instructs the panel to examine the effect of Medicaid pay and other factors on the access and quality of care received by Medicaid and CHIP enrollees." Kaiser Family Foundation executive Diane Rowland will chair the panel. The panel has not yet gained federal funding (Trapp, 1/25).

27 Jan 2010

Doctors delay talking about end-of-life care

A study published this month finds doctors delay talking about end-of-life care, which often proves very costly. The Los Angeles Times reports: "Most doctors don't talk about end-of-life issues with their cancer patients when those patients are feeling well, a new survey has found." Physicians also tended to delay these conversations "until treatments have been exhausted. Those delays mean patients might not be able to make truly informed choices early in their treatment.

27 Jan 2010

As state legislatures gear up, federal health overhaul is on their agenda

The New York Times Prescriptions Blog: "The question of equality, or inequality, among states is a major reason President Obama's overhaul of the health care system, and the legislation in Congress to make it happen, seemed to reach the brink of collapse last week." The issue also reflects "one of the biggest challenges" the President and Congressional leaders face in their efforts to overhaul the health care system. The key question: "how to devise a national solution for a problem that varies sharply from state to state."

27 Jan 2010

First Edition: January 25, 2010

Today's news begins to set the scene for the President's upcoming State of the Union address, and provides continuing coverage of Democrats' efforts to regroup on health reform.

25 Jan 2010

Detroit jury convicts physician for healthcare fraud conspiracy

Troy, Mich., physician Toe Myint was convicted today by a Detroit jury of conspiracy to commit health care fraud in a $4.2 million Medicare Fraud scheme, announced Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan; Special-Agent-in-Charge Andrew G. Arena of the FBI's Detroit Field Office; and Daniel R. Levinson, Inspector General of the Department of Health and Human Services (HHS).

23 Jan 2010