Word: medicaid
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Until the nation's governors staged a public revolt last weekend, few people were paying attention to one of the most far-reaching proposals being considered as part of overhauling the health-care system: a dramatic expansion and redefinition of the Medicaid program. Redefining who is eligible for Medicaid would be one of the major means by which lawmakers hope to achieve universal health coverage - which is one of the reasons that governors, whose budgets are already straining under the program's growing costs, are so wary of the idea. "It depends on what's being proposed," says Pennsylvania...
...Services Secretary Kathleen Sebelius - who until April had been governor of Kansas - her former colleagues vented their anger at the idea of being handed the bill for yet another Washington initiative. Tennessee's Democratic governor, Phil Bredesen, told the New York Times that he regarded the proposed expansion of Medicaid as "the mother of all unfunded mandates" and warned, "Medicaid is a poor vehicle for expanding coverage." (See the top 10 health-care-reform players...
...Medicaid has become the latest sticking-point issue in health reform because of the daunting challenge of how to cover those most likely to find themselves without health coverage. Low-income adults - those who earn under 200% of poverty, or $33,200 for a family of four - account for about half the uninsured in this country. Under the current rules, many of them are not eligible for Medicaid, which was established alongside Social Security in 1965 to cover low-income children, their parents, the poor elderly, the disabled and those in need of nursing-home care. (Read "Cost, Not Coverage...
...units, neonatal care and treating the uninsured. When healthier, fully insured patients migrate away from community hospitals to specialty facilities, their reimbursements go with them. Overall profit margins at specialty hospitals, sometimes as high as 30%, dwarf those of community hospitals. Plus, specialty hospitals don't typically treat many Medicaid patients, which bring in some of the lowest reimbursements available...
...successfully got legislation passed in 1989 that prohibited doctors from, among other things, having a financial stake in labs that performed tests for their patients. The Stark Law, as it became known, has been strengthened over the years to include more facilities and apply to Medicare and Medicaid payments. But the loophole allowing for doctor-owned specialty hospitals has remained open despite repeated attempts to close it. Now that the country is grappling with how to reform the entire health-care system, Congress has another chance to decide whether the costs of this kind of proprietary specialized care are simply...