State highlights: Mo. doctors propose Medicaid payment reform project; N.C. Medicaid billing problems persist; Calif. nursing home pays $48M to settle fraud case

Nov 21 2013

A selection of health policy stories from Missouri, North Carolina, California and Virginia.

The Associated Press: Doctors Propose Pilot Program For Mo. Medicaid
Some doctors want to make Missouri's Medicaid program a little more like a health club. A proposal outlined by a pair of doctors Tuesday would create a pilot project in which primary care physicians would be paid a flat monthly amount for each Medicaid patient they accept (Lieb, 11/19).

Raleigh News & Observer: Problems remain with N.C.'s Medicaid payment system
State officials said the troubled Medicaid billing system NC Tracks is operating more smoothly, but lawmakers said it still has significant problems. Doctors, hospitals and others who treat Medicaid patients began complaining about a new computer system as soon as the state started using it July 1 to pay health care bills. State officials have worked to reassure health providers and legislators that it is fixing problems and sending providers their money (Bonner, 11/19). 

Los Angeles Times: O.C. Nursing Home Pays $48 Million To Settle Medicare Fraud Case
Ensign Group Inc., a Mission Viejo company that operates nursing homes in several states, has agreed to pay $48 million to resolve allegations that it billed Medicare for unnecessary procedures performed on its patients. Two former Ensign Group therapists had accused the company in whistle-blower lawsuits of performing the unnecessary rehabilitation therapy at six skilled-nursing facilities in California. Although the lawsuits were filed in 2006, the government contended that the fraud lasted from 1999 to 2011 (Pfeifer, 11/19).

Los Angeles Times: Health Care Regulator's Move To Kaiser Under Investigation
California authorities are investigating whether laws were broken when a government regulator went to work for health care giant Kaiser Permanente, a company she spent years investigating for the state. Marcy Gallagher was a supervising attorney at the California Department of Managed Health Care, where she participated in several investigations of Kaiser. Last year, she left state employment and joined the company, where she works in a unit that responds to California regulators (Megerian, 11/19).

California Healthline: Building A New Health Care Workforce
Legislators called attention to what they called acute shortages of health care workers in the Central Valley during an Assembly hearing last week in Bakersfield. Shortages are likely to increase over the next few years for a variety of reasons, according to Assembly member and workforce committee chair Rudy Salas (D-Bakersfield). "Here in the Central Valley, we have a great need [for health care providers]," Salas said at Thursday's legislative hearing of the Assembly Select Committee on Workforce and Vocational Development in California which focused only on health care workers (Gorn, 11/19). 

Richmond Times-Dispatch: Legislators Touch On Health Care And Other Goals For 2014 Session
When the Virginia General Assembly convenes in January 2014, the Senate will be split between an equal number of Republicans and Democrats, the Republicans will outnumber Democrats 68-32 in the House of Delegates, and a new governor, Terry McAuliffe, a Democrat, will take the reins from outgoing Republican Gov. Bob McDonnell. State Sens. Ryan McDougle, R-4 (Mechanicsville), and Donald McEachin, D-9 (Henrico), each of whom represent portions of Hanover County, along with Del. Chris Peace, R-97 (Hanover), outlined diverse legislative agendas at a Nov. 14 meeting of the Hanover Business Council at Randolph-Macon College (Deal, 11/20).