November 8, 2015 |
Universal Health Services Inc., of King of Prussia, said Friday that Pennsylvania officials had demanded that seven of its mental hospitals return $4 million to the state in fiscal 2011 payments made to the hospitals to compensate for losses on Medicaid and uninsured patients. The demand was made in a late September letter from the Pennsylvania Department of Human Services, UHS said in its quarterly filing with the Securities and Exchange Commisssion. State officials on Friday said the letters went to about 40 of roughly 200 hospitals eligible for the payments, but did not say how much money was demanded back overall.
October 1, 2015 |
A groundbreaking - but very expensive - new drug that cures many people with hepatitis C caused rapid and widespread increases in Medicaid spending in 2014, but with substantial variation across states, two doctors reported in a recent article in the New England Journal of Medicine. Sofosbuvir, which has the brand-name Sovaldi and is made by Gilead Sciences, changed the standard of care for hepatitis C, which can destroy the liver and cause death if not properly treated. The 12-week course of treatment had a list price of $84,000.
September 18, 2015 |
The Pennsylvania Department of Human Services on Wednesday took steps to put $17 billion worth of Medicaid business out for bid to private companies. At a time when the insurance industry considers goverment programs a growth sector, the moves are expected to attract new national competitors to Pennsylvania, where home-grown firms, such as AmeriHealth Caritas, have dominated for years. "When fully implemented, these new changes will mark the most significant changes to Medicaid in Pennsylvania since the department first moved to mandatory managed care 18 years ago," DHS Secretary Ted Dallas said.
September 2, 2015 |
The Pennsylvania Office of Attorney General accused three Southeastern Pennsylvania residents of fraudulently billing Medicaid a total of $26,558 for personal-care services. Jeanne Schafle, 60, of Ambler, allegedly billed Medicaid $9,444 for attendant-care services to her daughter when her daughter was in the hospital on 13 separate occasions from March 2012 through March of this year. William Swinson III, 40, of Philadelphia, was accused of billing Medicaid $11,503 for services to a Medicaid beneficiary for more than two months after the beneficiary died.
September 1, 2015 |
Yvette R. Long, 50, of Philadelphia, who pushed to obtain quality health-care services for Pennsylvania's low-income residents, died Saturday, Aug. 22, of a pulmonary embolism while visiting her family in Delaware. Ms. Long was a leader of Pennsylvania's Medical Assistance Advisory Committee (MAAC), which counseled the state on Medicaid policy development and program administration. Since 2005, she had chaired the MAAC's Consumer Subcommittee, one of the most active consumer-advisory committees in the nation.
August 20, 2015 |
A subsidiary of Philadelphia-based AmeriHealth Caritas was one of four companies selected by Iowa officials to participate in the management of the state's $4.2 billion Medicaid program, which serves about 560,000, officials announced Tuesday. AmeriHealth and the other winners - units of Anthem Inc., UnitedHealth Group Inc., and WellCare Health Plans Inc. - will compete statewide for Medicaid beneficiaries under the program, which starts Jan. 1, 2016. Iowa officials picked four of 10 health insurer applicants that completed the process.
April 22, 2015 |
New Jersey lawmakers on Monday scrutinized the state's handling of thousands of low-income residents' Medicaid applications, as the Christie administration asserted it had made progress in reducing the backlog. Gov. Christie expanded Medicaid under the Affordable Care Act, and 400,000 residents have gained health insurance through the government program since 2014. However, thousands of applications have languished at understaffed county welfare agencies, in part because of the state's antiquated computer systems.
March 6, 2015 |
The switch from former Gov. Tom Corbett's "Healthy Pennsylvania" program to Gov. Wolf's Medicaid expansion is expected to be completed by the end of September, Ted Dallas, acting secretary of the state Department of Human Services, said Wednesday. Dallas said the transition is a "couple-of-phase process" that will blend the three parts of Corbett's program - an expansion for those newly eligible, plus high- and low-risk categories for current participants - into a single plan like that adopted in New Jersey and more than 20 other states.
February 11, 2015 |
HARRISBURG - Fulfilling a campaign pledge, Gov. Wolf on Monday moved to dismantle his predecessor's alternative to Medicaid expansion and implement a traditional plan to extend health insurance to hundreds of thousands of low-income Pennsylvanians. Wolf said the "Healthy PA" alternative plan instituted by Gov. Tom Corbett was flawed, confusing some patients and leading others to lose treatment. He called his action a step "toward simplifying a complicated process and ensuring hundreds of thousands of Pennsylvanians have greater access to the health insurance they need.
February 6, 2015 |
A Philadelphia company and two employees were charged Wednesday by state prosecutors with more than $1 million in Medicaid fraud. Infinite Care Inc., 6423 Rising Sun Ave., has been billing for services not provided or for inflated services since January 2010, according to a statewide grand jury presentment. Also charged were a sister company, Infinite Care Special Needs Inc.; Julio Miranda, vice president of both companies; and Wanda De Martinez, treasurer of both companies. Infinite Care paid family members to monitor home-care patients and then billed Medicaid for professional medical services that were not rendered, prosecutors said.