May 13, 2013

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(1) Lawmakers in Florida and Missouri are wrapping up their legislative sessions without approving proposals to expand Medicaid under the ACA. In Florida, an estimated 1.3 million Floridians would have been covered under the expanded program, according to a May 5 article in The Washington Post. Florida ended its legislative session May 3. Florida now joins 24 other states that have either decided against expanding Medicaid or are leaning in that direction, according to analysts at consulting firm Avalere Health LLC, the newspaper said. Meanwhile, Republican lawmakers in Missouri have all but scuttled Medicaid expansion in that state, according to a May 8 article in Politico. The move defeats — at least for this year — efforts supported by the Democratic governor to extend basic health coverage to an estimated 250,000 low-income state residents, according to the article. Missouri lawmakers are set to finalize their annual budget this week, and neither chamber included expansion in their blueprints, Politico said. Instead, they’ve opted to create committees to study the issue for the rest of the year and to report on the impact of expansion in early 2014, delaying any decision until after the Jan. 1 start date. (Reprinted from AIS’s Health Reform Week's e-News Alert)

(2) The Office of Inspector General (OIG) for HHS on May 2 issued a report alleging that Cigna HealthCare of Arizona overbilled the Medicare Advantage program for $28.4 million in 2007 .... (more)

(3) The OIG has issued a report raising questions about hospice general inpatient care, particularly when provided in Medicare-certified inpatient hospital units rather than hospitals or skilled nursing facilities .... (more)

(4) WellPoint subsidiary Anthem Blue Cross has agreed to pay more than $3 million to settle claims that the company underpaid interest on late claims to providers between July 1, 2007, and April 30, 2011 .... (more)

(5) The Department of Justice has filed a False Claims Act lawsuit against Vitas Hospice Services, Vitas Healthcare Corporation and their parent company, Chemed Corporation .... (more)

(6) CMS has posted a set of 23 questions addressing the process for outpatient therapy cap exceptions .... (more)

(7) CMS has added sample claims to its temporary instructions for billing Part B after a Part A claim has been denied for medical necessity .... (more)

(8) Sen. Chuck Grassley (R-Iowa) has expanded his investigation into whether a former aide to Sen. Orrin Hatch (R-Utah) passed on insider information about Medicare Advantage rate changes .... (more)

(9) California again has delayed the start date for its huge CMS-backed initiative for Medicare-Medicaid dual eligibles, this time till no sooner than next January .... (more)

(10) The California Public Employees’ Retirement System on May 7 said it started a Dependent Eligibility Verification project to make sure only eligible dependents are covered under health insurance plans it sponsors .... (more)

Have breaking news or an editorial question? E-mail BJ Taylor, editor of GOVERNMENT NEWS OF THE WEEK, at bjtaylor@aishealth.com. If you are interested in sponsoring GOVERNMENT NEWS OF THE WEEK please contact Bailey Sterrett at bsterrett@aishealth.com.

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