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Weekly Medicaid RoundUp: Week of May 22nd, 2017

 

HOUSEKEEPING – A few quick items: Here’s a link to my current thoughts on the impact of AHCA, current as of Thursday (after the 2nd CBO report)- http://bit.ly/2rm9tro

Also, I am joining some of my friends at Matrix Healthcare to do a webinar for RISE next week. All about quality withholds in Medicaid. You can sign up here (If you’re a RISE member it’s free, else it costs)- http://bit.ly/2r9BRgl

 

“People Sleep Peacefully in Their Beds at Night Only Because Rough Men Stand Ready to Do Violence on Their Behalf”- This is our annual time here in RoundUp Land (and in all the U S of A) to remember those who have died to protect our rights as American citizens. Memorial Day (Monday) honors the men and women who died while serving in the U.S. military. It is NOT the kickoff party for summer, but they died so that we idiots could have freedom to think even stupid things like that. Please take a moment to remember them grill-side on Monday as you enjoy the blessings made possible by their sacrifice.

 

Service Members Who have Died in MAY 2017 AS OF THE 25th

 

Senior Chief Petty Officer Kyle Milliken. Died May 5, 2017 Serving During Operation Iraqi Freedom. Hometown: Falmouth, Maine.

 

Service Members Who Died in APRIL 2017

 

1st Lt. Weston C Lee. Died April 29, 2017 Serving During Operation Iraqi Freedom. Hometown:

Bluffton, Georgia.

 

Sgt. Joshua P Rodgers. Died April 27, 2017 Serving During Operation Freedom’s Sentinel. Hometown: Bloomington, Illinois.

 

Sgt. Cameron H Thomas. Died April 27, 2017 Serving During Operation Freedom’s Sentinel

Hometown: Kettering, Ohio.

 

Staff Sgt. Mark R De Alencar. Died April 8, 2017 Serving During Operation Freedom’s Sentinel

Hometown: Edgewood, Maryland.

 

 

See more heroes @ http://thefallen.militarytimes.com

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FULL, FREE newsletter: http://eepurl.com/ep81Y . News that didn’t make it and sources for those that did: twitter @mostlymedicaid . Trystero: Faðirinn sendi soninn til að bjarga heiminum

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Weekly Medicaid RoundUp: Week of May 15th, 2017

Soundtrack for today’s RoundUp pessimist readers (technically a movie clip this week)- http://bit.ly/2rvupJk

For optimist readers – http://bit.ly/2rvJIC0

 

IS THIS THING ON? As is our custom here in Roundup-Land, after a long hiatus (client work, gardening), I make it up to you by starting off with the Fraud Follies instead of saving them until the end. But this time, there’s a catch. I translated this week’s Farrises Fantastic Fraud Follies into Russian. You have to take an extra step and use Google Translate to get it back to English (or your preferred language). Do you give up now and move on to the next quick blurb in your news feed? Are there secret messages and memos in this week’s roundup? Leaks, even? You will never know unless you head on over to Google Translate and paste this puppy in there now. NOTE: I have also reverse-translated and there are some good transliterations that happened. Some things get lost in translation. Some things get better. I am excited for you about this. Here’s the link to Google Translate: https://translate.google.com/

 

И ТЕПЕРЬ МОШЕННИКИ СЛЕДУЮТ, ТОВАРИЩИ – Ахад Лотфи из округа Ван Бурен, штат Мичиган, был на этой неделе в суде за обвинения в мошенничестве, связанные с заказными вкладышами для обуви, проданными в его клиниках хиропрактики (всего украдено- 200 тыс. Долларов). Цезарь Тавера и Андрес Айала из Черри Хилл, Нью-Джерси признают себя виновными на этой неделе в мошенничестве с Medicaid. Их преступление? Кража $ 1.5M от Medicaid с использованием их ролей в некоммерческих целях местного сообщества. Г-н Тавера хорошо провел время – в одном случае он снял 35 000 долларов с банковского счета некоммерческих организаций, находясь в казино. Огайо получит 447 000 долларов США от CareCore как часть мультигосударственного урегулирования. Кажется, CareCore платит всем, чтобы перестать приставать к ним об обвинениях, которые они планировали, чтобы автоматически одобрить радиологические тесты, которые не были необходимы с медицинской точки зрения (CareCore – это компания, предоставляющая льготы, и они должны выплатить всего 54 млн долларов). Ев-Грей из Чикаго признал себя виновным в краже 7 млн ​​долларов от Medicaid, работая с электронным заявлением о медицинской записи, которое помещало законсервированный язык в медицинские документы, чтобы удостовериться, что Medicaid заплатит (они становятся умнее, люди). Мистер Грей – Вы выигрываете награду на этой неделе! Ваши очки за инновации привлекли вас к вершине.

 

A FEW OTHER QUICK HITS-  Oregon said it may have spent hundreds of millions on members who were not eligible. Info still coming in on this one so probably smart to be patient. The California Medicaid expansion bill comes due this year, and its $1.3B in state funds for 2017. Several incumbent Illinois MCOs did not submit proposals on time for the new awards and won’t be in the race. After a ton of pressure, PA Medicaid will cover HeP C miracle drugs. BCBS and Amerigroup got hitched in NC in prep for the inevitable managed care switch there. Oklahoma is considering pulling plans to bring managed care in. And Ohio is trying to find $600M now that the federalis have said they can’t tax MCOs anymore.

 

That’s it for this week. As always, please send me a note with your thoughts to clay@mostlymedicaid.com or give me a buzz at 919.727.9231. Get outside (I need rain, do you need rain?) and keep running the race (you know who you are).

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FULL, FREE newsletter: http://eepurl.com/ep81Y . News that didn’t make it and sources for those that did: twitter @mostlymedicaid . Trystero: Apa elküldte a Fiút a világ Megváltójaként