Medicaid

The White House is conducting a final review of a proposal from the healthcare reform law that would cut federal grants for hospitals that serve poor patients.

The facilities, known as Medicaid Disproportionate Share Hospitals (DSH), are eligible for state and federal funding to balance out the amount they spend caring for patients who are unable to pay their bills.

The Department of Health and Human Services (HHS) spent more than $17 billion on payments to DSHs in 2011, according to a Government Accountability Office study. The Affordable Care Act aimed to slash those grants exponentially from 2014-2020, starting with a $500 million cut next year.

Lawmakers in Arkansas on Monday rejected a controversial approach to the Medicaid expansion in President Obama's healthcare law. 

Arkansas Gov. Mike Beebe, a Democrat, has proposed a version of the Medicaid expansion that GOP-led states might follow. Rather than directly expanding Medicaid, Beebe wants to move the newly eligible Medicaid population into his state's insurance exchange, where they could shop for private coverage.

But the Arkansas House voted down the proposal on Monday. The bill needed 75 votes to pass; it failed 69-28. The House is expected to try again tomorrow, as party leaders try to wrangle a few more votes for a proposal that could catch on in other states — if it can pass in the state that thought of it.

Read more...

Medicaid is quickly abandoning the traditional fee-for-service model when it comes to handling patient prescriptions, according to a new study.

The IMS Institute for Healthcare Informatics reported Thursday that Medicaid managed care plans handled 19 percent of the program's prescriptions in September 2011.

That share more than doubled by June 2012, less than one year later, the researchers found. 

Expanding Medicaid is the healthcare law's single best tool for reducing out-of-pocket healthcare costs, the Robert Wood Johnson Foundation said in a research paper Wednesday.

The study said other provisions of the Affordable Care Act will have an "uneven impact" on healthcare costs for low-income families, because of state-by-state variations in cost.

But the Medicaid expansion would apply uniformly in every state that decides to accept it, and therefore is more likely to make a dent in out-of-pocket spending, the report said.

Sen. Chuck Grassley (R-Iowa) is probing whether U.S. hospitals are profiting from a discount drug program meant to offset the cost of treating low-income patients.

Grassley asked three North Carolina hospitals to report on their use of the 340B drug program, which requires pharmaceutical companies to cut prices for hospitals that serve large uninsured populations.

Duke University Hospital reportedly made $69.7 million last year by selling the discounted drugs to patients. Those profits would have been closer to $20 million without 340B, according to the Charlotte Observer.

The Texas governor says the Medicare expansion in the healthcare law would make his state "hostage" to Washington.

House Republicans said Monday they have successfully pushed the federal Medicaid agency to cut more than $1 billion in Medicaid overpayments to New York state.

House Oversight and Government Reform Committee Chairman Darrell Issa (R-Calif.) has been pressing the Health and Human Services Department (HHS) to reduce payments to certain state-run facilities in New York.

Issa said Monday that HHS has set a new payment rate, which will save the federal government roughly $1.2 billion over the next 18 months.

Freshman Rep. Joaquin Castro (D-Texas) warned Texas Gov. Rick Perry (R) on Sunday that his refusal to expand Medicaid to low-income people in Texas will hurt his presidential chances in 2016.

"Governor, being tough on people with no health insurance won't win you the Republican presidential primary in 2016," Castro wrote in a Dallas Morning News op-ed. "It definitely won't win you the presidency."

States that want to privatize the healthcare law's Medicaid expansion will need a waiver from the federal government, the Health and Human Services Department said Friday.

The option of a private expansion has gained traction since Arkansas Gov. Mike Beebe (D) first proposed it last month.

Under Beebe's plan, the state would not expand its Medicaid program, but people normally eligible for the expanded Medicaid program would receive private coverage — and subsidies from the federal government.

Tennessee will not expand its Medicaid program under President Obama's healthcare law, at least not yet, the governor announced Wednesday.

Gov. Bill Haslam (R) was petitioning to use the expansion's federal dollars to subsidize private insurance for low-income Tennesseans, but no agreement was reached before a fiscal deadline forced his hand, according to reports.

"I cannot recommend to you that we move forward on this plan," Haslam told legislators Wednesday. "Our budget amendment will not include language to accept the federal funds."