Centers for Medicare and Medicaid Services
Federal authorities move to close mammoth drug-pricing loophole
Years after the potential for abuse was flagged in Ohio, the federal agency that oversees Medicaid is moving to close a loophole that likely is worth billions to prescription drug middlemen. The Centers for Medicare and Medicaid Services on Friday proposed a new rule that it said would help ensure compliance with a requirement under […]
Former CVS exec accuses it of ripping off seniors, taxpayers
The top leadership of CVS Health directed an illegal scheme to work across the corporation’s sprawling subsidiaries to drive up drug prices in the Medicare program, says a whistleblower suit that was recently unsealed in the Eastern District of Pennsylvania. It accuses CVS of breaching firewalls between its SilverScript prescription drug plan, CVS Caremark, its […]
Government watchdog: Health care giants improperly denied Medicare benefits
The health care companies offering Medicare Advantage plans improperly denied services and payments at what might seem an alarming rate during a one-week test period in 2019, according to a government report released last week. The companies — many of which are also major players in the Ohio Medicaid system — improperly denied payment 18% […]
Report: Medicare drug reforms would save seniors billions
A report published Monday says that another, less-sweeping (Medicare) change would save American seniors $18 billion a year, an annual average of about $281 for each senior getting drugs through Medicare Part D.
Despite governor’s claims, Medicaid work requirement adds big burden, expert says
It would be a new regulation on 700,000 of Ohio’s poor, but Gov. Mike DeWine says it wouldn’t impose any additional regulatory burden on them. However, asked to describe the new requirements, the Ohio Department of Medicaid provided a lengthy document that’s full of regulations. DeWine is urging Attorney General Dave Yost, a fellow Republican, […]
Lavishly paid and unapologetic. Company at center of Medicaid scandal focuses on profits.
Coordinating government health care for poor people has been very, very good to Michael F. Neidorff. By one measure, he’s the country’s top-paid health care executive, making $25 million a year. That means the Centene chief makes as much in a year as 1,409 of the best paid of the 25 million Americans for whom his company […]
Ohio’s suing a huge Medicaid contractor. Mississippi’s investigating whether to follow suit
Ohio might have started a trend last month when it filed suit against the largest Medicaid contractor in the United States. Now Mississippi is considering litigation of its own. A spokeswoman for Mississippi Attorney General Lynn Fitch didn’t respond to requests for comment last week, but that office told the Daily Journal in Mississippi that […]
Their roommates had COVID-19. A nursing home kept them there anyway
It started Oct. 5 with a nurse feeling ill on her day off. By the time the COVID-19 outbreak at Crestview Rehabilitation and Skilled Nursing Services subsided late last year, 173 cases traced back to the Lancaster facility’s staff and occupants. State inspectors determined Crestview’s poor infection control practices allowed the virus to glide through […]
Covid crowds some out of Ohio hospitals, federal release shows
Hospital beds in Ohio and elsewhere are filling with coronavirus patients, prompting the federal government to ease rules and allow more people to be treated at home. But for some reason, top Ohio health officials don’t seem to want to say that. Among other experts, Ashish K. Jha has reported that nationally the portion of […]
More Medicaid funding needed to survive the recession, advocates say
After cuts to the state’s health care assistance program, Medicaid advocates are hoping a temporary federal funding increase will continue. In May, Ohio Gov. Mike DeWine announced cuts to many state agencies, but the biggest cuts hit Medicaid and education. The budget for Medicaid was chopped by $210 million. Much of that original cut represented […]
Planned Medicaid cuts seem reasonable, says policy analyst
Cutting funding from Medicaid might not seem like the best idea in the midst of a global pandemic. But an analyst of state Medicaid policy on Wednesday said cuts planned for the Ohio program seem reasonable, based on what’s known about them so far. State tax revenue has plummeted with the state economy choked down […]
New federal Medicaid waiver is not healthy for Ohio
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) announced the deceptively named Healthy Adult Opportunity waiver to allow states to receive Medicaid funding as either an annual aggregate cap (block grant) or per capita cap program instead of continuing to pay states the federal share of Medicaid expenses. The waiver applies to parts […]