More states are seeking to fundamentally change their Medicaid programs through waivers, and their requests involve more than just work requirements for enrollees. Among the ideas are lifetime limits, temporary lockouts if beneficiaries fail to report income changes or renew enrollment on time, charges for missed appointments, cost-sharing requirements and moving more recipients to private coverage.
More than 160 health care organizations sent a letter to HHS Secretary Alex Azar urging him to revoke CMS guidance for states requesting work requirements for Medicaid recipients and to withdraw related waiver approvals, saying the policy could inhibit health care access for people with chronic conditions, particularly those dealing with substance abuse and mental health disorders. The groups said the policy interferes with the government's efforts to curb opioid abuse and improve re-entry from the criminal justice system.
Apple and 12 health care provider organizations will collaborate on an initiative to improve patient care coordination by sharing EHR data. The initiative, which will rely on Health Level 7's Fast Healthcare Interoperability Resources standard, will enable patients to use the Apple Health app to download some of their medical records and store the data on their iPhones.
Pharos Systems has a wellness committee that works to come up with initiatives that are comprehensive and inclusive. Executive administrator Susy Bordin said the programs cover everything from emotional and spiritual wellness to financial education and fun events, such as bringing in a tea master and olive oil expert.
The rate of US babies younger than age 1 year who died from unintentional suffocation rose from 12.4 per 100,000 persons in 1999 to 28.3 per 100,000 in 2015, according to a study in JAMA Pediatrics. Researchers also found that the increase was primarily driven by the growing prevalence of infant suffocations and strangulations in bed but said some of the increase may be due to improved diagnosis.
More than 50% of parents didn't receive guidance from health care providers on when their children should begin receiving dental care, according to a national poll by the University of Michigan's C.S. Mott Children's Hospital of 790 parents of youths ages 5 and younger. The findings also showed that children's young age was the most common reason cited by parents for delaying a first pediatric dentist visit.
Medicare Part B drug coverage does nothing to encourage competition and "really is a dinosaur," said Pharmaceutical Care Management Association President and CEO Mark Merritt. "There's no encouragement to use less expensive options when there are several equally effective drugs to choose from," Merritt said.
Yury and Rimma Baumblit, operators of flophouses that targeted poor and mentally ill individuals in New York, were ordered to forfeit up to $2.5 million in assets after entering a guilty plea in a Medicaid fraud case. The couple were accused of receiving over $1.5 million in illegal kickbacks from Medicaid-funded providers NRI Group, Canarsie Aware, and Narco Freedom in exchange for forcing their tenants to attend the providers' outpatient drug treatment programs, prosecutors say.
John Cornachio, a resident of Oyster Bay, N.Y., is facing a maximum 15-year prison term after being convicted of grand larceny for having a "no-show" job that allowed him to collect money from Narco Freedom, a New York City-based Medicaid-funded nonprofit that provides substance abuse treatment services. Prosecutors say Cornachio conspired with Narco Freedom's corrupt officials to fraudulently collect over $500,000 in salary and benefits for more than five years, among other offenses.
- Page 1