Word: medicaid
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...Medicare marked its third birth day last week, its growing pains were all too evident. Both Medicare, the fed erally financed program that pays hos pital bills for all Americans over 65, and the related Medicaid, which is financed jointly by Washington and the states and assists the poor of all ages, have been plagued by huge cost underestimates, administrative tangles and messy scandals. Now doctors who treat patients under both programs will have to contend with the Internal Revenue Service and Senate investigators...
...evidence of kickback arrangements involving nursing homes, doctors and drug suppliers. At the same time, the IRS announced that it planned to conduct a special audit of the income tax returns of an estimated 10,000 doctors who had received more than $25,000 apiece in Medicare and Medicaid payments from the Government last year...
Last-Minute Reprieve. The prospect that even a few doctors were overtoiling the state and federal governments was especially disturbing in view of the states' growing reluctance or inability to shoulder their share of Medicaid's relentlessly spiraling costs. So far only 40 states have set up Medicaid programs (the 40th, Virginia, began operation last week), and some have already been forced to cut back services. Last week close to 200,000 of New York City's low-income Medicaid recipients were dropped from the rolls when the state lowered the eligibility level to an annual income...
Concerned about Medicaid's rising costs, the Department of Health, Education and Welfare issued a new regulation last week designed to limit the fees charged by doctors and dentists. Such fees accounted for about 29% of the $2.4 billion spent by Washington and the states on Medicaid last year (the Federal Government spent an additional $6 billion on Medicare). Under present regulations, Medicaid fees are determined by the states. The new rule establishes federal standards that will limit fees in most states to the level that prevailed last January. Increases will be permitted, but only under a formula based...
Medicare and Medicaid payments are no guarantee of profitability. The American Nursing Home Association says that Medicare paperwork has become so snarled that some homes are still waiting for reimbursement for their 1967 bills. All payments are subject to adjustment after Government auditors define just what nursing-home costs are "reasonable"; quite a few chains have not set aside reserves for possible rebates. Some flatly turn down Medicare recipients, whose payments for basic care generally range from $1015 a day. Private patients...