The Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) and the Health Care and Education and Reconciliation Act (HCERA) (P.L. 111-152) require major cuts in funding for hospitals that serve a higher-than-average percentage of low-income, uninsured patients in every state. Specifically, both Medicare and Medicaid payments to disproportionate share hospitals (DSH) will drop October 1, 2013, when federal fiscal year (FFY) 2014 begins. The Medicaid expansion was supposed to make up much of the lost funding because adults with incomes up to 138 percent of the federal poverty level (FPL) would be covered, reducing the number of uninsured. When the Supreme Court decision in National Federation of Independent Businesses v Sebelius made the expansion of Medicaid optional, the plan for a continuum of affordability programs was disrupted.
Video: What Is Texas Medicaid?
Protesters in Texas Demand Medicaid Expansion
Separately, hundreds of doctors in white lab coats met privately with legislators, asking for better reimbursement rates for treating Medicaid patients. Currently, the state only covers about 60 percent of the cost of treating recipients of the joint federal-state health care program for the poor and disabled. Doctors and clinics are expected to absorb the losses.
Texas Organizers Add Their Voice: Medicaid Matters
I am pleased to think that I will get to the bus a little early; maybe I would get an aisle seat — or even a front seat. As I pull into the parking lot, though, I see that I am among the last to arrive. As I clamber aboard the bus, I am handed a bag with a potato and egg taco and some cookies in it. Sister Phylis Peters, a Daughter of Charity, has saved me an aisle seat, for which I am grateful.
Zone 4 Program Integrity Contractor (ZPIC) for Medicare and Medicaid Programs is Health Integrity, LCC
When a physician, medical group or other health care provider receives a notice of an audit and site visit from a ZPIC, things happen fast with little opportunity to prepare. A ZPIC will routinely fax a letter to the practice shortly before the end of a business day the day before a site visit/audit to that practice. Auditors will request to inspect the premises, will photograph all rooms, equipment, furniture, and diplomas on walls. They will usually request copies of several patient records to review later. They will request copies of practice policies and procedures, treatment protocols, all staff licenses and certifications, drug formularies, medications prescribed, and medications used in the office. ZPIC auditors will inspect any medication/narcotic lockers or storage cabinets and will request drug/medication invoices and inventories. You will usually be contacted for follow-up information and documentation after the audit and will eventually be provided a report and, possibly, a demand for repayment of any detected overpayments.
Court denies appeal of Randy Halprin, one of the Texas Seven who killed Irving police officer after prison break in 2000
Two of the so-called Texas Seven who escaped prison and killed Irving police Officer Aubrey Hawkins during a robbery on Christmas Eve 2000 have been executed, including George Rivas, the man said to have plotted the prison break. Another, Larry James Harper, killed himself before they were captured in Colorado. The remaining four are on death row, awaiting the outcomes of their appeals.
Charts: This Is What Happens When You Defund Planned Parenthood
The Planned Parenthood clinics that anti-choice legislators booted from the state’s Women’s Health Program serviced nearly 50 percent of the program’s patients. Along with contraceptive counseling, the clinics provided basic screenings for cancer, hypertension, and other key problems. There’s no shortage of need: women in Texas suffer high rates of STIs and unintended pregnancies compared to national figures, and the state ranks 50th for diabetes prevalence in women. Nonetheless, Republican lawmakers went after the clinics in 2011, thanks to their long-standing beef with the organization, and forfeited tens of millions in Medicaid reimbursements to the Women’s Health Program so they could defund Planned Parenthood clinics without breaking any federal rules governing how states have to spend Medicaid money.
Daily Kos: How the GOP gets it all wrong on Medicare in five charts
What these three charts tell you is simple: It’s all about health care. Spending on Social Security is expected to rise, but not particularly quickly. Spending on everything else is actually falling. It’s health care that contains most all of our future deficit problems. And the situation is even worse than it looks on this graph: Private health spending is racing upwards even faster than public health spending, so the problem the federal government is showing in its budget projections is mirrored on the budgets of every family and business that purchases health insurance. Klein’s warning that “private health spending is racing upwards even faster than public health spending” is especially true for Medicare. While there is heated debate about the size of the gap, there is little doubt that the administrative overhead of government-run Medicare is significantly lower than that of private insurers. That is also true of the private Medicare Advantage programs currently used by about 20 percent of beneficiaries. As it turns out, Medicare Advantage policies on average not only feature higher administrative costs, but cost the government much more in monthly premiums than the traditional “public option” Medicare. As Klein explained two years ago: The Medicare Advantage program, which invited private insurers to offer managed-care options to Medicare beneficiaries, was expected to save money, but it ended up costing about 120 percent of what Medicare costs. In 2011, Nobel Prize-winning economist Paul Krugman turned to data from the Centers on Medicare and Medicaid Services to illustrate the comparative cost-savings to the United States Treasury.