Arizona struggles with severe Medicaid cuts; Medicaid fraud task force targets abuse in Iowa

Phoenix Business Journal: "Doctors and health advocates are up in arms over significant cuts to Arizona's Medicaid program to save $27 million, but the worst is yet to come: A $1 billion budget shortfall is expected next year. A federal matching program that would give the state Medicaid program about $1 billion expires in July 2011, which means Arizona will need to make up that loss, said Jennifer Carusetta, chief legislative liaison for the Arizona Health Care Cost Containment System, the state's version of Medicaid. AHCCCS currently receives a federal matching rate under the American Recovery and Reinvestment Act — a one-time boost to help states during the worst of the recession. Carusetta said it has not been determined how the state will make up the lost funding" (Gonzalez, 10/8).

Arizona Daily Sun: "A federal appeals court has rejected arguments by several Arizona hospitals that they were short-changed by the federal government for caring for low-income patients. The judges rejected arguments by Roger Morris, attorney for the hospitals, that the U.S. Department of Health and Human Services used an improper formula to determine reimbursement for services. They said the method used to determine that funding is correct. Morris said the system has since been changed. But he said the legal question is important to the hospitals for practical reasons: He figures they wound up with $20 million less than the amount to which they were entitled. And that, he said, does not count accumulated interest" (Fischer, 10/9).

The Quad-City (Iowa) Times: "Former Gov. Terry Branstad says he believes using telemedicine to prescribe and dispense abortion-inducing pills is inappropriate and the practice should be discontinued in Iowa. … At issue is a practice by Planned Parenthood of the Heartland whereby licensed physicians use a remote-controlled system to conduct medical assessments with patients in rural Iowa clinics via a two-way, closed circuit audio-video hookup in real time and dispense Mifepristone, also known as RU-486, in the early stages of a pregnancy. However, Gov. Chet Culver, Branstad's opponent in the Nov. 2 election, said such a move would 'pull the plug on progress' by curtailing all telemedicine activities that pose great potential for reducing costs and delivering services to rural Iowa" (Boshart, 10/9).

Des Moines Register reports on efforts by the "Iowa Department of Inspections and Appeals' Medicaid Fraud Control Unit, an 11-person task force that last year quietly pursued dozens of cases involving elder abuse and Medicaid fraud. Over the past two years, the unit has stepped up its enforcement efforts, ferreting out more forms of fraud and winning significantly more criminal convictions. It's a unit of government that pays for itself — and then some. During the 12-month period that ended in March, the unit recovered $11.1 million in Medicaid overpayments. The unit's expenses consumed only $1.1 million in state and federal resources" (Kauffman, 10/10).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.