May 19, 2016 |
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...
April 29, 2016 |
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.
April 24, 2016 |
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.
November 29, 2015 |
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.
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.