Latest Headlines

Latest Headlines

Michigan-Illinois partnership moves Medicaid provider screening to the cloud

A multi-million dollar project between Michigan and Illinois has moved each state's Medicaid system to the cloud, which could offer better fraud detection mechanisms.

OIG: Medicaid is losing money on rebate program for generic drugs

In another signal that the prices of even traditionally low-cost drugs may be spiraling out of control, a new report by the U.S. Department of Health and Human Services' Office of Inspector General has concluded that many generics have seen price increases far outpacing inflation.

Supreme Court to hear FCA case on 'implied certification'

The U.S. Supreme Court has agreed to hear a case that will determine whether Medicaid claims can be considered false if a provider does not adhere to "implied" program requirements, according to  Courthouse News Services.  

If Kentucky shuts down Kynect, consumers will still have options

Even if Kentucky's Republican governor-elect Matt Bevin closes down the state's health insurance exchange, consumers there wouldn't necessarily feel negative effects right away, according to a  National Public Radio  report.

Plenty of blame to go around for Medicaid's growing improper payment rate

Last month, the Department of Health and Human Services released its Fiscal Year 2015 Agency Financial Report, and one often-criticized program stuck out like a sore thumb: Medicaid. The program's improper payment rate now sits at 9.8 percent, a significant leap from 6.7 percent in 2014, and nearly double the 5.8 percent rate in 2013. Although CMS continues to deflect blame onto the five-year-old regulation and the states, the agency is conveniently ignoring its own critical role in the transition. 

HHS report: CHIP coverage better than ACA plans for children

A new report by the Department of Health and Human Services compared the second lowest cost silver plan in the largest rating area in each state to CHIP in that state, and determined that CHIP and ACA marketplace coverage offer beneficiaries different levels of financial protection and benefits.

Few hospitals sign up for privatized Medicaid in Iowa

The state of Iowa has been transitioning its Medicaid to a privatized managed care program, but to date there have been few takers among hospitals.

CMS okays Medicaid money for housing

The Obama administration has signed off on the use of Medicaid funds to house enrollees, possibly creating a path that would not only bring down the homeless population but also cut down on hospital costs.

Medicaid hepatitis C patients more likely to be denied drug coverage

Almost half of hepatitis C patients whose doctors had prescribed antiviral drugs were denied coverage to the therapies by Medicaid because they weren't considered "a medical necessity" or because the patients tested positive for alcohol/drugs, according to a study by University of Pennsylvania researchers.

HHS to end provider agreement with Seattle hospital over 'multi-systemwide failures'

In the wake of an inspection that found "multi-systemwide failures" that created a major risk of patient harm, Seattle's Western State Hospital may lose millions in Medicare and Medicaid funding, according to the Associated Press.