12 Recent Medicare, Medicaid Issues

Here are 12 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.


1. Illinois Gov. Pat Quinn released a plan that would cut $2.7 billion out of the Medicaid program, and 75 percent of the plan focuses on increasing cuts and reducing Medicaid rates to hospitals and healthcare providers.

2. Approximately 228,435 Medicare and Medicaid beneficiaries where victim to a data breach when former South Carolina HHS employee, Christopher Lykes Jr., allegedly transferred personal information to his email account.

3. In a 12-month moving average, the Standard & Poor's Healthcare Economic Hospital Medicare Index was 1.94 percent in February 2012, up from the 1.56 recorded in January.

4. For the first time, physicians received more cash in Medicare meaningful use bonuses than hospitals in a single month.

5. McLaren Health Plan, owned by McLaren Health Care in Flint, Mich., announced an agreement to purchase CareSource Michigan, a 34,500-member Medicaid health maintenance organization in Lansing, Mich.

6. The Office of Inspector General conducted an audit on the Medicare-Medicaid Data Match Program, finding the initiative to collaboratively fight fraud resulted in limited returns.

7. Two New York hospitals have agreed to a settlement of more than $2.3 million after an Attorney General investigation found the facilities allegedly overbilled Medicaid for physician-administered drugs.

8. There are roughly 9 million people who are beneficiaries of both Medicare and Medicaid — also known as dual eligibles — and although it is a costly population, less than 1 percent of dual eligibles are considered to be in "high-cost" categories.

9. Research published in the journal Circulation: Cardiovascular Quality and Outcomes found that Medicare Part D beneficiaries with cardiovascular conditions who had no financial assistance during the "doughnut hole" coverage gap were 57 percent more likely to discontinue their cardiovascular medications than those beneficiaries who had consistent drug coverage.

10. In the final $70 billion budget plan, Florida Gov. Rick Scott laid out $142.7 million in vetoed appropriations, many of which involved healthcare funding and healthcare projects throughout the state. Overall, $21 billion of the budget is going toward the state's Medicaid program, and Medicaid represents roughly 71 percent of the entire state Health and Human Services budget.

11. Five of the six managed care health insurers that lost a contract with Ohio's Medicaid program filed appeals, arguing the state erred during the application process.

12. HHS Secretary Kathleen Sebelius submitted a plan to Congress that would reform Medicare's hospital wage index by establishing a labor market area and wage index for each hospital.

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