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Members of the U.S. House voted Monday to pass a bill that could help private health insurers fight fraudulent claims.
The bill is H.R. 525, the "Strengthening the Health Care Fraud Prevention Task Force Act of 2019" bill. The bill calls for the secretary of the U.S. Department of Health and Human Services (HHS) to set up a public-private anti-fraud partnership program. The new partnership program would be open to federal health programs, state health programs, law enforcement agencies, private organizations that fight health care fraud, private health plans, and other entities.
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Multi-billion dollar contracts that are among the most lucrative in state government are up for bid as Louisiana's health department sets about deciding which private companies will manage the care of 1.5 million Medicaid patients.
Louisiana currently contracts with five managed-care companies to oversee services provided to 90 percent of its Medicaid recipients: Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections and United Healthcare Community Plan. The contracts, negotiated by former Gov. Bobby Jindal's administration, expire Dec. 31.
Sioux Falls Argus Leader
When Katelyn Reuter was 15 months old, her parents noticed she was having problems responding to her name.
She was diagnosed with severe autism at age 2.
It was intensive form of therapy called Applied Behavior Analysis — ABA for short — that gave Katelyn the ability to use real words for the first time.
The 10-year-old used those words last week. She journeyed to Pierre and stood before the men and women of the South Dakota House State Affairs Committee.
She asked them to help children like her, who were losing access to ABA therapy.
Senators are questioning top executives of seven pharmaceutical companies about the spiraling cost of prescription drugs that an increasing number of Americans find unaffordable.
"We're all trying to understand the sticker shock that many drugs generate," said Sen. Chuch Grassley, the Iowa Republican who chairs the Senate Finance Committee. "There is a balance between incentivizing innovation and keeping prices affordable for consumers and taxpayers."
Top executives of Pfizer, Merck, AbbVie, AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson and Sanofi were scheduled to testify before the panel on Tuesday.
Atlanta Business Chronicle
The Republican-controlled Georgia Senate voted along party lines Tuesday to authorize GOP Gov. Brian Kemp to seek a federal waiver to expand Medicaid coverage in Georgia outside of the Affordable Care Act.
The 32-20 vote that followed a two-hour debate sent the Kemp-backed legislation to the state House of Representatives.
The fiscal 2019 mid-year state budget includes $1.6 million in state funds to hire a consultant to help Georgia apply for a waiver that would offer Medicaid coverage to Georgians with incomes up to 100 percent of the federal poverty level.
The number of patients who were screened for colorectal cancer in Kentucky increased by more than 200 percent after Medicaid expanded in the state in 2014, according to data published in the Journal of the American College of Surgeons.
Avinash S. Bhakta, MD, of the University of Kentucky Markey Cancer Center, said in a press release that he started seeing more patients from the state's rural, Appalachian population, and wanted to explore exactly how the Affordable Care Act and Medicaid expansion was impacting the state's population.
Legislation was filed Tuesday to block plans to rework how the State Health Plan pays hospitals and other providers, a move that was expected to save the plan $300 million or more a year.
The state's hospital association opposed the change, which N.C. Treasurer Dale Folwell has pushed as a cost-saving measure for employees and taxpayers, and as part of his ongoing fight with hospitals and insurance companies over price transparency.
House Bill 184 would create a study group to look at the issue over the next year and delay Folwell's planned changes until at least 2022.
There is almost no correlation between a patient's out-of-pocket cost and the amount insurers pay or the overall price of a procedure, according to a Pioneer Institute study released Tuesday.
The study looked at the cost for an MRI at 14 Massachusetts hospitals and found that even if there was not much of a difference in what patients paid at each hospital, there was a higher utilization of expensive providers, ultimately driving up premiums, according to co-author and Pioneer Institute Senior Fellow Barbara Anthony.
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NAHU Newswire is a daily brief featuring the latest news of interest to healthcare agents and brokers, selected from thousands of sources by the editors of MultiView. NAHU personnel, in accordance with internal policies, do not approve all stories selected. Any comments regarding content of this publication should be emailed to NAHU. It should not be understood or inferred from the presence of advertisements that NAHU endorses any products or services advertised. Similarly, NAHU is not responsible for the quality of journalism reflected in the articles: it should not be understood or inferred that NAHU supports the information provided. MultiView and NAHU are not liable, for any delays or inaccuracies in the information contained in this brief, nor for any actions taken or outcomes resulting from relying on the information provided herein.
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