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November 2011 Archives

November 1, 2011

New York Settles Medicaid Fraud Suit for $70 Million - NYTimes.com

From the New York Times website today:

New York City will pay the federal government $70 million to settle a lawsuit that accused the city of overbilling Medicaid by improperly approving home care for frail and elderly clients, both parties said on Monday.

In the settlement, the city acknowledged that for a decade, from 2000 to 2010, it had re-authorized personal care for certain patients without having physically obtained the required assessments from doctors, nurses or social workers. The city also admitted that it sometimes did not get "independent medical reviews," as required when there was a dispute over the amount of care needed.

Read the full article at the New York Times website.

Congress Asks I.R.S. About Oversight of Nonprofit Hospitals - NYTimes.com

The New York Times reports on a congressional inquiry into the delaying of hospital compliance with the recently revised Form 990:

In August, the Illinois Department of Revenue moved to revoke the property tax exemptions enjoyed by three major nonprofit hospitals after a court ruling determined that a fourth hospital in the state did not provide enough charity care to justify the tax benefit.

Those hospitals, however, remain exempt from federal taxes -- a far bigger benefit -- because the Internal Revenue Service is not collecting information to assess the extent of the care for poor and uninsured patients that nonprofit hospitals nationwide are supposed to provide. . . .

An overhauled tax form for nonprofits would give the federal tax agency that data, but complaints from the American Hospital Association and aspects of the new health care law have prompted the I.R.S. to delay requiring hospitals to fill out the portion of the form on charity care. Hospitals may not have to fill it out this year, either, because the agency has yet to make a decision.

Read the rest of the article at the New York Times website.

November 2, 2011

Governor signs bill mandating insurance for autism care - Times Union

The Albany Times Union covers the new New York autism mandate.

Following years of debate and false starts, Gov. Andrew Cuomo signed a bill Tuesday requiring insurers to cover screening, diagnosis and treatment of autism.

"The children will get the help, the families will get the support," Cuomo said before signing the measure, which was passed by lawmakers last session.

The law could save families with autistic children tens of thousands of dollars, although it will likely contribute to an increase in health insurance premiums in the state. The law takes effect on Nov. 1 of next year.

So it goes. Read the rest of the article at the Albany Times Union website.

Legislative Update



With the signing of the Autism Mandate yesterday, activity on major health-related bills is starting to wane for this year. Still, a few significant bills remain outstanding - they have passed both houses and have yet to be delivered to Governor Cuomo for signature or veto.

Most notable are two bills addressing mail order prescriptions - one generally (A 5502B) and one with respect to fertility drugs (A 7985B). A. 5502 has garnered significant press from both sides of the issue.

November 3, 2011

12 Are Charged in Medicare Fraud Schemes Said to Cost $95 Million - NYTimes.com

From the New York Times "City Room":

Federal agents swarmed several medical clinics and homes in New York City on Wednesday, arresting 10 people on charges of running Medicare fraud schemes that bilked the government out of $95 million, federal officials said.

Read the rest here.

November 7, 2011

State Health Department Awards 4.5 Million to Combat Childhood Obesity

From the DOH website yesterday, November 7:

State Health Commissioner Nirav R. Shah, M.D., M.P.H., today announced that nine organizations have been awarded State grants totaling up to $4.5 million over five years to reduce child and adolescent obesity.

The grants are targeted to help children and adolescents in populations reflecting high incidence of obesity and excess weight, including low-income populations, certain racial and ethnic minorities, and persons with developmental disabilities. The grant funding will support training for health care providers and other initiatives.

Read the rest of the press release and see the list of recipients on the DOH website.

November 11, 2011

Wal-Mart: "We are not building a national, integrated, low-cost primary care health care platform"

The New York Times health section covers a stir around a recent Wal-Mart RFI, which went to several dozen providers and suppliers.

Wal-Mart would not disclose which medical care providers or suppliers received the requests, but analysts said what the retailer is considering the kind of partnerships with hospitals and clinics that are being formed by chains like CVS and Walgreen Company.

Apparently the wording of the RFI raised some eyebrows, as Kaiser Health News published the document itself and also quoted it in an article as illustrating Wal-Mart's intent to "dramatically ... lower the cost of healthcare ... by becoming the largest provider of primary healthcare services in the nation."

Wal-Mart, through Dr. John Agwunobi, President of its health and wellness operations in the U.S., responded with denials both categorical and specific, including this one: "We are not building a national, integrated, low-cost primary care health care platform."

Which is too bad, because that's exactly what we need.

About November 2011

This page contains all entries posted to HEALTH LAW SECTION BLOG in November 2011. They are listed from oldest to newest.

October 2011 is the previous archive.

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