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NEWS
August 10, 1995 | BY LESTER THOMAS
Three jobs, three layoffs and three mouths to feed. Losing my job made me realize the importance of health insurance and how devastating it is to lose it. I thank God that Medicaid was there to protect my family from utter devastation. I hope Congress does not destroy that protection for other working families who may need it. When, after 17 years on the job, Enclosure Corp. of Bristol closed down in 1990, I felt the world closing in on me. My wife already had been sick and I had just been diagnosed with diabetes.
NEWS
April 3, 2012
SINCE LAST summer, when Gov. Corbett's administration started a massive effort to review whether Medicaid recipients were still eligible for their benefits, thousands of Philadelphia children have vanished from the rolls. Here's a look at the change in child Medicaid enrollments in Philadelphia County from August 2011 through January 2012. August 2011: 273,484. September 2011: 270,648. October 2011: 264,341. November 2011: 261,850. December 2011: 247,968.
BUSINESS
May 7, 1991 | By Gilbert M. Gaul, Inquirer Staff Writer
The state budget crisis is about to hit home for hospitals, doctors and pharmacists. A spokeswoman for the state Department of Public Welfare yesterday said the agency was short nearly $29 million, because of lagging tax revenues, and, as a result, would be able to pay hospitals, doctors and pharmacies only part of what they are owed in the next Medicaid payment cycle. The department is scheduled to mail checks Friday to health-care providers for services they performed in recent weeks for Medicaid recipients.
NEWS
July 13, 2006
ACOUPLE OF questions for Ed Rendell. (You remember him, don't you? He's the guy you see in Philadelphia during football season.): Ed, do you have any idea how hard it is for middle-class Pennsylvania residents to obtain Medicaid to cover a hospital bill? The leaders of our great state just decided, starting July 1, that U.S. citizens must prove they are such by providing an original birth certificate or passport. That seems fair, right? Don't answer just yet. An illegal alien can get Medicaid to cover a hospital bill with a notarized letter, a letter from the doctor and a copy of the bill.
NEWS
April 29, 2009
RE YOUR editorial "Watchdog Bites Guv": I couldn't agree more that an in-your-face, my-way-or-the-highway approach to auditing isn't helpful or productive. But your reference to the auditor general finding $3.3 million in improper Medicaid health insurance benefits in this multibillion-dollar program is akin to the discovery that a dog recently bit a man. While any degree of error in a public program is regrettable, it is a minuscule part of the total spending. Moreover, the auditors failed to take into account the complexities of the program and the fact that many of the alleged errors are inadvertent bookkeeping errors that have nothing to do with the integrity of the program and may not even have caused any mistaken payment for health care.
NEWS
July 26, 1989 | By Russell E. Eshleman Jr., Inquirer Harrisburg Bureau
Commonwealth Court yesterday upheld a ruling by the state Department of Public Welfare denying additional medical-assistance reimbursement to Hahnemann University and Frankford Hospitals in Philadelphia. Senior Judge Jacob Kalish said a new reimbursement system put into place by the department was proper, even though the reimbursements might be "inadequate" or less than actual costs. Jennifer Stiller, a lawyer representing the two hospitals, said the decision would cost Hahnemann and Frankford "in excess of a million dollars.
NEWS
June 22, 2011 | By Ricardo Alonso-Zaldivar, Associated Press
WASHINGTON - President Obama's health-care law would let several million middle-class people get nearly free insurance meant for the poor, a twist that government number crunchers say they discovered only after the complex bill was signed. The change would affect early retirees: A married couple could have an annual income of $64,000 and still get Medicaid, said officials who make long-range cost estimates for the Health and Human Services Department. After initially downplaying any concern, the Obama administration said late Tuesday that it would look for a fix. Up to three million more people could qualify for Medicaid in 2014 as a result of the anomaly.
NEWS
April 30, 1997 | by Jim Smith, Daily News Staff Writer
A psychiatrist who operated eight inner-city mental health clinics for more than a decade was placed on three years' probation yesterday with three months under house arrest for an admitted $122,000 Medicaid fraud. "I am very sorry for what I have done," Dr. Howard H. Wurtzel, 60, of Lower Merion, told U.S. District Judge Herbert J. Hutton. The lenient sentence came as a relief for the defendant, his family and friends who had praised Wurtzel for being a compassionate, dedicated physician who has helped thousands of patients over the past 34 years.
NEWS
January 19, 1989 | By Bernice Z. Heron, Special to The Inquirer
When the state legislature passed a measure last year to include hospice care in Medicaid benefits starting Jan. 1, it in effect created a new benefit for AIDS patients. Typically, patients with acquired immune deficiency syndrome are too young for hospice benefits provided under Medicare, are unemployed and do not have private health insurance. But most do qualify for Medicaid, which is available to people who cannot afford medical care. Prior to Jan. 1, Medicaid did not cover hospice care, which is provided for people who are terminally ill. Hospice program administrators say they are hurrying to incorporate the new state provisions into the package of services they already provide for AIDS patients.
NEWS
May 28, 2013
By Barbara W. Gold and Stephen F. Gold Despite an unemployment rate of 7.6 percent in April, Pennsylvania still hasn't decided to accept $3.8 billion a year from the federal government to expand Medicaid. The money, promised for each of the next three years, would not only increase health care and services to nearly 650,000 low-income people, but would also provide much-needed jobs. Gov. Corbett has written that the expansion would be "fiscally unsustainable without significant reforms to the program itself.
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NEWS
August 16, 2016
By Brian Blase Washington experts have been frequently wrong about the Affordable Care Act. They projected far more enrollees in ACA exchanges than materialized. They also projected that the individual insurance market would stabilize in 2016 with robust competition. Instead, the country is grappling with enormous premium hikes and fewer choices. A new government report reveals perhaps the largest mistake yet: Medicaid enrollees who gained coverage through the ACA cost almost 50 percent more, on average, than the government projected just one year ago. ACA supporters often point to Medicaid expansion as the law's greatest success since it reduced the overall uninsurance rate.
BUSINESS
August 3, 2016 | By Harold Brubaker, STAFF WRITER
The Pennsylvania Department of Human Services delayed the start of new managed Medicaid contracts to April 1 from Jan. 1, after Aetna won a preliminary injunction that blocked the state from continuing the process of implementing new contracts. Aetna, which had 201,196 Pennsylvanians in its Medicaid managed care plans in March, objected to the state's use of undisclosed factors in its its decision-making. After the preliminary injunction was issued on July 19 by a Commonwealth Court judge, the human services department restarted the procurement process, setting an August 22 deadline for proposals.
NEWS
July 9, 2016
By Daniel Sutter Since it was founded alongside Medicare in 1965, Medicaid's costs have exploded from $5.3 billion to $449 billion (adjusted for inflation). It now comprises about 3 percent of our gross domestic product. The uncertainties associated with Medicaid, along with Medicare and Social Security, pose a serious threat to America's long-term fiscal health. How can we control Medicaid spending growth? We must first understand what's driving it. If medical need - the number of low-income Americans needing coverage and the cost of providing their medical care - explains all of the growth, then reform might involve a divisive and painful approach, like slashing the health care of children and pregnant women.
BUSINESS
July 9, 2016 | By Harold Brubaker, Staff Writer
The insurer Health Partners Plans had 32 percent of the Medicaid market in Southeastern Pennsylvania last year, but accounted for 70 percent of regional spending on hepatitis C drugs. That meant the Philadelphia company spent $32 million on expensive new drugs to treat the disease that damages the liver - and had to absorb 60 percent of that outlay as a loss because its contract did not include enough money to cover a surge in hepatitis C treatments. But this year, Pennsylvania regulators launched a risk-sharing plan to help its Medicaid contractors withstand the crippling costs of hepatitis C drugs, which cure the disease but are so expensive that states and Medicaid plans have struggled with how to pay for them.
NEWS
June 9, 2016
The state of Delaware said Tuesday that it would phase in a new policy to treat all hepatitis C patients in its Medicaid program. States have been under pressure from the Obama Administration and lawsuits - in Delaware's case, Harvard Law School's Center for Health Law & Policy Innovation had threatened litigation - to abandon money-saving policies that limited treatment with effective but costly new medications to the sickest patients. More than three million Americans are estimated to be infected with hepatitis C, a bloodborne virus that may cause no symptoms for decades but is the leading cause of liver cancer and transplants.
NEWS
May 19, 2016 | By Don Sapatkin, Staff Writer
MECHANICSBURG, Pa. - A state advisory committee, wading into one of the most fraught issues facing health-care policymakers, recommended Tuesday that Pennsylvania's Medicaid program pay to treat all patients infected with hepatitis C. The recommendation led to cheers - instead of the planned chants - from a dozen advocates who had been standing by quietly, not expecting the vote to go their way. The first new treatments that can effectively cure...
BUSINESS
April 29, 2016 | By Harold Brubaker, STAFF WRITER
Southeastern Pennsylvania will have two new companies offering managed Medicaid benefits in 2017, the Pennsylvania Department of Human Services said Wednesday. Entering the market are publicly-traded Centene Corp., of St. Louis, and UPMC For You, part of the giant University of Pittsburgh Medical Center, which dominates the managed Medicaid market in western Pennsylvania. Not selected to continue with the program in the Philadelphia region was Aetna Better Health, which had 73,852 members in March, or 9 percent of the market, according to state data.
NEWS
April 24, 2016 | By Phil Galewitz, KAISER HEALTH NEWS
In states that expanded Medicaid under the Affordable Care Act, low-income adults were more likely to see a doctor, stay overnight in a hospital, and receive their first diagnoses of diabetes and high cholesterol, according to a study published Monday. Yet researchers found no improvement in adults' own assessments of their health, a conclusion echoed by similar studies, the authors wrote in the Annals of Internal Medicine. Two factors might explain the lack of perceived improvement.
BUSINESS
November 29, 2015 | By Harold Brubaker, Inquirer Staff Writer
Nine companies have submitted bids to enter Pennsylvania's Medicaid market, which has grown substantially this year since Gov. Wolf expanded access to coverage. But only one of the new applicants seeking to offer managed care to lower-income Pennsylvanians beginning in 2017 is a national player. "Pennsylvania should be more attractive, in theory, to Medicaid-focused insurers, since it has an established statewide mandatory managed Medicaid program coupled with the recent eligibility expansion," said Mark Cherry, principal analyst for Florida and Pennsylvania at Decision Resources Group, a health-care data firm.
BUSINESS
November 8, 2015 | By Harold Brubaker, Inquirer Staff Writer
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.
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