9 Recent Medicare, Medicaid Issues

Here are nine issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.

1. In a 5-4 vote, the Supreme Court upheld the Patient Protection and Affordable Care Act as constitutional, although the Medicaid expansion provision was narrowly read. This means that major Medicare reforms will more than likely continue to progress, but the Medicaid expansion will be left up to states, as the states can lose only new Medicaid funding from the federal government if they don't comply with the new requirements. States would not lose all of their federal money for Medicaid, which the PPACA originally proposed.

2. The Kentucky Cabinet for Health and Family Services announced Lawrence Kissner as the new commissioner of the Kentucky Department for Medicaid Services. Previously, Mr. Kissner served as president and CEO of one of the two managed care companies that Kentucky's Medicaid program contracts with — Magnolia Health Plan, which is a subsidiary of Centene.

3. Kansas is now one step closer to transitioning to Medicaid managed care, as state Medicaid officials awarded contracts to three Medicaid managed care companies — UnitedHealthcare, Amerigroup and Sunflower State Health Plan, which is a subsidiary of Centene.

4. Vanguard Health Systems, based in Nashville, Tenn., sought approval from the state of Michigan to acquire ProCare Health Plan, a Medicaid HMO.

5. The American Hospital Association sent a letter to the Senate Finance Committee suggesting how to prevent and combat Medicare and Medicaid waste, fraud and abuse.

6. An Ohio county judge put a one-month hold on the state's new Medicaid managed care contracts after Aetna issued a complaint about how Molina Healthcare and Centene won back contracts.

7. In a letter to the Government Accountability Office, a bipartisan group of Senators and Representatives asked for a study on the effectiveness and coordination among the different Medicare contractors — including MACs, RACs, ZPICs, PSCs and CERTs — within CMS.

8. The Alaska Department of Health and Social Services and the state Medicaid agency agreed to pay HHS $1.7 million to settle possible HIPAA violations.

9. The federal government spends a substantial and increasing amount of potentially duplicative funds for people enrolled in both the Medicare Advantage program and the Veterans Healthcare System, according to a study published in the Journal of the American Medical Association.

More Articles on Medicare and Medicaid:

PPACA Ruled Okay: 8 Issues Hospitals Should Keep in Mind Moving Forward

Building the Right Financial Squad: Q&A With Former Mayo Clinic CFO David Ebel

20 Recent Medicare, Medicaid Issues

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