With Illinois facing a growing pile of bills from Medicaid providers that is adding to its fiscal woes, the state’s finance authority board on Tuesday gave preliminary approval to a program to speed up payments. Get the full story »
Inside these posts: Medicaid
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Illinois Blue Cross settles allegations that it denied sick kids coverage
Illinois’ largest health insurance company will pay $25 million to settle allegations that it denied coverage to sick children in need of nursing care by “fraudulently” shifting their claims to Illinois’ Medicaid program, state and federal prosecutors said this morning.
The settlement, reached by Illinois Attorney General Lisa Madigan and U.S. Attorney Patrick Fitzgerald, follows several years of complaints from patients and their families. The patients reached out to Madigan’s office after their claims were denied by Blue Cross and Blue Shield of Illinois.
The cost of the medical care, which included so-called private-duty nurses for sick children and other ill patients, should have been covered by Illinois Blue Cross, but instead was shifted to Medicaid at a cost of nearly $12 million, prosecutors said. The claims were denied based on “internal, undisclosed guidelines that were more restrictive than the language provided to patients in plan policy materials,” Madigan’s office said. Get the full story »
Illinois Senate may vote to overhaul Medicaid
Illinois lawmakers are considering a major overhaul of the program that provides medical care to the poor, part of an effort to control costs during a budget crisis and build support for a tax increase.
The legislation would emphasize HMO-style “managed care” and reduce the use of costly institutions for people with physical and mental disabilities. It would require the state to pay Medicaid bills sooner, reducing late-payment penalties. It also would take steps to ensure ineligible people don’t sign up for medical care. Get the full story »
Abbott settles inflated drug price case with feds
Abbott Laboratories and two other drugmakers will pay $421 million to settle allegations that they falsely inflated product prices to gain larger government reimbursement payments, the U.S. Justice Department said Tuesday.
Abbott’s share of the settlement is $126.5 million for violations of the False Claims Act involving pricing of two antibiotics and agents used to facilitate intravenous infusions of other drugs, the Justice Department said. Get the full story »
Aetna, Centene to put 40,000 in Medicaid HMO
The state of Illinois has awarded HMO operators Aetna Inc. and Centene Corp. contracts to provide medical care services to 40,000 seniors and adults with disabilities in suburban Cook, DuPage, Kane, Kankakee, Lake and Will counties beginning next year. Get the full story »
