Official Mum on States Cheating Medicaid

[Syrinx]

WASHINGTON (AP) -- Health Secretary Mike Leavitt refused Wednesday to
name the states he says are cheating taxpayers out of $40 billion in
Medicaid funding, even as senators pressed him for details of
President Bush's proposal to force states to curb mismanagement.

The name-them-if-you're-going-to-blame-them challenge is key to the
debate over how much to spend on Medicaid, the state-federal health
insurance program for the poor, as Congress weighs Bush's $2.5
trillion budget request.

Bush has proposed squeezing Medicaid in part by forcing the states to
find $40 billion over a decade by correcting mismanagement on their
end. That would lessen the financial pressure on the federal
government.

Leavitt's refusal before the Senate Finance Committee to name the
states that are mismanaging the money aroused suspicions among
senators that the Bush administration is seeking a spending cut by
another name.

http://www.nytimes.com/aponline/national/AP-Medicaid.html

[oneighty]

1. Red States?

That is all I can think of. How embarrassing to Family Values and the Religious Right and the Law and Order crowd. Now until I am told different I will believe the Red States are cheating.

180

[Princess Turandot]

6. I'm not sure this is aimed at just 'Red' states..

I have no view on why he would not name the states in question. However, I think this money may include funds accessed by some states through the Medicaid 'matching' programs which are not strictly for Medicaid billings. NYS has long had a program to help cover a portion of hospitals' uninsured care which requires hospitals to 'tithe' back to the state a fixed percentage of their inpatient payments from various insurers including Medicaid. That money goes into a pot along with new state money and the total is then submitted for additional matching from the feds. The monies are then gets redistributed to hospitals based on need. (One of the big things it does is provide some of the funding for the NYC public hospitals.)

Theoretically, to the extent that the uninsured 'tithe' is a percentage of a hospital's Medicaid collections (which already included federal matching funds) and that money is submitted to be matched for the uninsured program, that could be construed as 'double dipping'.

They could well be referring to other things, but I know that there has been controversy about this funding mechanism, which involves several hundreds of millions of dollars.

[GetTheRightVote]

2. sounds like a knife in the back from *, I wonder how many red states

will be involved or only blue states ??? Watch for it.

:kick:

[asjr]

3. Isn't it his duty to inform the Sen. Finance Committee?

Where the hell does Shrub come up with these people? It will be blue states. Revenge!

[libodem]

4. why?

are they red states?

[Nordmadr]

5. Does he have any legal grounds for not providing this type

of information to the Senate? Yeah... our checks and balance system is perfectly fine. (Sarcasm)

Olaf

[Sabriel]

7. I have to say, this is a hard headline to figure out. n/t

[rainbow4321]

8. Shrub is probably worried his $upporters might be involved

If any of his $upporters are going to be exposed, shrub may not WANT everything out in the open ...money trails, etc...


Bayer Corp., GlaxoSmithKline make up for Medicaid losses tied to Paxil, Flonase, others


http://www.oag.state.tx.us/oagnews/release.php?id=333


Jan 2004

AUSTIN - Texas Attorney General Greg Abbott today announced that Texas has received $9 million as Texas’ share of a $22 million state/federal Medicaid fraud settlement with pharmaceutical giants Bayer Corp. and GlaxoSmithKline.

The money represents actual losses to Texas’ Medicaid program, plus penalties. The federal government also received settlement payments for federal Medicaid funds spent fraudulently. Forty-eight other states and the District of Columbia also participated in the settlements, thought to be the largest ever among Medicaid fraud cases involving pharmaceutical manufacturers.

The restitution is the result of a lengthy multi-state investigation into the companies’ failure to report their “best price” to the federal Centers for Medicaid and Medicare Services for several drugs – Paxil and Flonase (an antidepressant and nasal spray from GlaxoSmithKline) and Cipro and Adalat CC (an antibiotic and an anti-hypertensive from Bayer).

The fraud complaints alleged Bayer and GlaxoSmithKline failed to pay sufficient rebates to state Medicaid programs nationwide in connection with the private labeling of these four drugs, as required by the federal Medicaid drug rebate statutes. The companies sold the products to HMOs at sharply discounted prices, then concealed and avoided their obligation to pay additional rebates to the states’ Medicaid programs by re-labeling or re-packaging these drugs under the HMOs’ private labels. This scheme is known in the industry as “lick and stick.”