Medicaid

U.S. Also Files Complaint Against Two Atlanta-Based Nursing Home Chains and Their Principals

November 3, 2009 -- WASHINGTON — The nation’s largest nursing home pharmacy, Omnicare Inc. of Covington, Kentucky, will pay $98 million, and drug manufacturer, IVAX Pharmaceuticals of Weston, Florida, will pay $14 million to resolve allegations that Omnicare engaged in kickback schemes with several parties, including IVAX, the Justice Department announced today. Approximately $68.5 million of the settlement proceeds will go to the United States, while $43.5 million has been allocated to cover Medicaid program claims by participating states.    » read more »

October 19, 2009 -- WASHINGTON – Mylan Pharmaceuticals, UDL Laboratories, AstraZeneca Pharmaceuticals and Ortho McNeil Pharmaceutical have entered into settlement agreements for a total of $124 million to resolve claims that they violated the False Claims Act by failing to pay appropriate rebates to state Medicaid programs for drugs paid for by those programs, the Justice Department announced today.    » read more »

More H1N1 Vaccine Arrives in State; Influenza Activity in New York Now Considered Widespread

October 16, 2009 -- New York Governor David A. Paterson today announced that as of October 15, New York State’s Medicaid program will provide reimbursement to Medicaid enrolled pharmacies for the administration of seasonal and H1N1 influenza vaccines by certified pharmacists to Medicaid fee-for-service enrollees 18 years and older.

Medicaid managed care and Family Health Plus enrollees will be able to access immunization services through their health plans. The Governor also reported that influenza activity in New York State is now considered widespread, with more than 50 percent of counties reporting influenza activity.    » read more »

WASHINGTON -- U.S. Senators Benjamin L. Cardin and Barbara A. Mikulski (both D-MD) announced today that the U.S. Department of Health and Human Services (HHS) has awarded grants of $200,000 to the Garrett County Health Department and $988,177 to the Maryland Department of Health and Mental Hygiene to help find and enroll children who are uninsured but who are eligible for either Medicaid or the Children’s Health Insurance Program (CHIP).    » read more »

September 16, 2009 -- Washington, DC – Vermont Governor Jim Douglas and Blueprint for Health Director Craig Jones, M.D., joined Health and Human Services Secretary Kathleen Sebelius at the White House today for the announcement of a new federal initiative modeled after Vermont’s innovative Blueprint for Health.

The announcement could have positive financial implications for Vermont, as it will enable Medicare to join Medicaid and commercial insurance carriers in state multi-insurer efforts to support primary care medical homes and community health teams.    » read more »

New Jersey University Hospital to Pay Additional $2 Million to Resolve Fraud Claims That Facility Double Billed Medicaid

June 9, 2009 -- WASHINGTON - The University of Medicine and Dentistry of New Jersey (UMDNJ) has agreed to pay the United States $2 million to resolve federal civil fraud allegations that its hospital defrauded Medicaid, the Justice Department announced today.

From 1993 to 2004, UMDNJ’s University Hospital submitted claims to Medicaid for outpatient physician services that were also being billed by doctors working in the hospital’s outpatient centers. By submitting duplicate claims for payment, University Hospital effectively doubled billed the government’s Medicaid program.    » read more »

June 8, 2009 -- WASHINGTON, DC- As Congress begins debate on health care reform U.S. Senator Bob Casey (D-PA), a member of the Health, Education, Labor and Pensions Committee today introduced a Resolution (S.Res.170) calling for health care reform to benefit children and protect Medicaid coverage for the most vulnerable children. The resolution was cosponsored by Senators Chris Dodd (D-CT), Sherrod Brown (D-OH), Sheldon Whitehouse (D-RI) and Bernie Sanders (I-VT).    » read more »

“Empowered at Home Act” would reduce costly Medicaid bias

June 4, 2009 -- WASHINGTON—More than one million Americans are living in nursing homes, but many would prefer to receive the services they need in their own homes, where they would be more comfortable and potentially save the health care system money in the long run. Unfortunately, many Americans who want to be cared for at home can’t because of a costly institutional bias in Medicaid, which pays for nearly two-thirds of the country’s nursing home residents.

While state Medicaid programs are required to provide nursing home care, home and community-based services that are often less expensive are optional, leaving them first in line to be cut in a poor economy.    » read more »

Senator introduces "Healthy Living, Healthy Aging Demonstration Project Act of 2009"

June 4, 2009 -- Washington, D.C. – Seeking to curb the cost of Medicare by promoting healthy lifestyles that lower the incidence of chronic disease, U.S. Senator Ron Wyden (D-Ore.) today introduced the “Healthy Living, Healthy Aging Demonstration Project Act of 2009.”

The legislation would establish a demonstration project to evaluate strategies to lower rates of chronic disease for individuals who are about to enter the Medicare program. Up to six eligible partnerships between public health departments and health centers or rural health clinics would be awarded five-year grants for participating in the demonstration project.    » read more »

Lincoln Talks Health Reform with President Obama

June 2, 2009 -- Washington – Following her meeting with President Obama at the White House today, U.S. Senator Blanche Lincoln said that she was committed to crafting health reform legislation that lowers costs, improves quality of care, and provides access to quality and affordable coverage for all Arkansans.    » read more »

May 28, 2009 -- WASHINGTON – Aventis Pharmaceutical Inc., a wholly owned subsidiary of sanofi-aventis U.S. LLC, has agreed to pay the United States $95.5 million to settle allegations that it violated the False Claims Act by misreporting drug prices in order to reduce its Medicaid Drug Rebate obligations, the Justice Department announced today.

The settlement resolves allegations that between 1995 and 2000, Aventis and its corporate predecessors knowingly misreported best prices for the steroid-based anti-inflammatory nasal sprays Azmacort, Nasacort and Nasacort AQ. Under the Medicaid Drug Rebate Statute, Aventis was required to report to Medicaid the lowest, or "best" price that it charged commercial customers, and pay quarterly rebates to the states based on those reported prices.    » read more »

Initiative will develop and test cost-effective strategies to improve care for Vermont residents who are dually eligible for Medicaid and Medicare

May 26, 2009 -- Montpelier, Vt. – As the nation debates health reform options, Vermont Governor Jim Douglas today announced that Vermont was chosen to participate in Transforming Care for Dual Eligibles, a national initiative that will test innovative models for people who are dually eligible for Medicare and Medicaid (“dual eligibles”).    » read more »

May 20, 2009 -- WASHINGTON -- AARP Executive Vice President Nancy LeaMond released the following statement on today’s announcement on the creation of the Health Care Fraud Prevention and Enforcement Action Team by the departments of Health and Human Services and Justice.

“The skyrocketing costs of health care are hurting Americans’ wallets and the bedrock programs like Medicare that millions of Americans depend on. Too much of that spending is lost to health care fraud. We simply cannot afford to pay for care that is never delivered and equipment that is not needed.    » read more »

May 22, 2009 -- WASHINGTON, D.C. – Assistant Senate Majority Leader Dick Durbin (D-IL) and Senator Richard Burr (R-NC) introduced the bipartisan Medical Homes Act this week to improve health care quality by helping states implement patient-centered medical home programs under Medicaid and SCHIP.    » read more »

Drug Company Allegedly Failed to Pay Hundreds of Millions in Rebates to Medicaid Program

May 18, 2009 -- WASHINGTON – The United States and 16 states have joined in two whistleblower suits filed in the District of Massachusetts against the drug manufacturer, Wyeth, alleging that the company knowingly failed to give the government the same discounts it provided to private purchasers of its drugs, as required by laws governing the Medicaid program.

As a result, Wyeth allegedly avoided paying hundreds of millions in rebates due to state Medicaid programs for its drugs, Protonix Oral and Protonix IV. These drugs belong to a class of drugs known as proton pump inhibitors (PPI), which are used to suppress stomach acid.    » read more »