Tag

Medicaid

All articles tagged with #medicaid

politics3 days ago•2 min saved

Texas Children’s Hospital to Open Detransition Clinic as Part of $10 Million Medicaid Settlement and Doctor Removals

Attorney General Paxton announced a settlement with Texas Children’s Hospital after a probe into Medicaid billing and gender-transition procedures. The hospital must establish the nation’s first detransition clinic, pay $10 million to Texas Medicaid for unallowable interventions, and permanently terminate five physicians’ privileges. The clinic will be funded by the hospital for five years and the hospital will stop providing gender-transition services, with enhanced compliance measures and bylaws to auto-revoke privileges for violations.

via Attorney General (.gov)|

#detransition #gender-transition #medicaid

health-policy3 days ago•6 min saved

Texas Children’s Hospital Ordered to Open Detransition Clinic Under $10M Settlement

Texas Attorney General Ken Paxton secured a settlement with Texas Children’s Hospital requiring the hospital to create the nation’s first detransition clinic and to pay $10 million to the state for Medicaid-billing accusations, with five physicians’ medical privileges revoked; the clinic will be funded by the hospital for five years and offered free of charge to patients, drawing mixed reactions from advocates and lawmakers within the broader debate on transgender healthcare.

via The Texas Tribune|

#detransition-clinic #gender-affirming-care #health-policy

us-news4 days ago•15 min saved

Medicaid Cuts Endanger At-Home Care for Disabled Family Members

Trump-era Medicaid reductions threaten in‑home care for millions by slashing funding for self‑directed caregiver programs; with Maryland already cutting caregiver wages and hours and other states moving toward similar cuts, families like Melissa Gonce’s—who cares for her nonverbal son Jason—face tough choices about keeping loved ones at home and maintaining stability.

via NBC News|

#budget-cuts #caregiving #disability

politics4 days ago•22 min saved

Vance's Maine anti-fraud pitch fuels debate over Trump-era corruption

Heather Cox Richardson argues that the Trump administration’s anti-fraud push, highlighted by J.D. Vance in Maine, is a partisan tactic to smear Democrats, while genuine program fraud is relatively rare and often perpetrated by criminal networks; she notes CMS cautions that “improper payments” aren’t the same as fraud and points to broader patterns of corruption and self-enrichment around Trump and allies—pardons for donors, aggressive fundraising, and overseas ventures—that complicate the narrative about fights against fraud.

via Letters from an American | Heather Cox Richardson | Substack|

#fraud #medicaid #politics

health4 days ago•21 min saved

Federal Medicaid Deferral Hits California’s Home-Health Program in Largest-Ever Move

The Trump administration is suspending about $1.1 billion in California’s Medicaid home-health program (IHSS) over fraud concerns—a claim California says has little supporting evidence and attributes to growth in caseloads and wages. The action could disrupt services for hundreds of thousands of seniors and people with disabilities, and an additional $200 million in administrative claims is also being withheld. California emphasizes safeguards and oversight, while advocates warn of harm amid a broader fraud crackdown and a related six‑month hospice enrollment moratorium, with no clear timeline for funds to be released.

via CalMatters|

#california #fraud #health

politics4 days ago•17 min saved

California Sees Medicaid Withholding as Political Retaliation

California officials condemned the White House’s withholding of roughly $1.3 billion in Medicaid reimbursements as political retaliation, while Vice President JD Vance and CMS Administrator Oz cited fraud flags in the state’s Medicaid records. Democrats warned the move harms patients and providers and signaled potential legal challenges, as Newsom highlighted in-home care programs’ savings and GOP criticisms of federal funding cuts. The action follows a recent anti-fraud crackdown in Los Angeles on hospice and home-health facilities.

via Common Dreams|

#california #fraud #jd-vance

politics5 days ago•6 min saved

Fraud crackdown prompts $1.3B Medicaid deferral for California

The Trump administration defers $1.3 billion in California Medicaid payments as part of a broader anti-fraud push, including reviews of Medicaid Fraud Control Units and a six-month moratorium on new hospice and home-health provider enrollments; officials say the measures aim to curb fraud, but critics warn about potential access issues and question their effectiveness.

via CNN|

#california #cms #fraud

politics5 days ago•2 min saved

Trump administration withholds $1.3B in California Medicaid amid fraud crackdown

The Trump administration will withhold $1.3 billion in federal Medicaid payments to California, citing the state’s inadequate anti‑fraud efforts. Vice President JD Vance announced audits of state Medicaid fraud control units and warned funds could be lost, part of a broader push against fraud in public health programs that has already included halting $259 million in Minnesota funds and a six‑month moratorium on new hospice providers as CMS investigates the industry.

via The New York Times|

#california #cms #fraud

politics5 days ago•5 min saved

Vance Threatens Health-Funding Cuts Over State Anti-Fraud Compliance

Vice President JD Vance warned that federal Medicaid and Medicare funds could be turned off for states that do not aggressively tackle fraud, as CMS freezes new enrollments for hospice and home health agencies while it investigates; the move, part of a broader anti-fraud push, has drawn criticism that it could punish political rivals and threaten patient access, and its legal basis remains disputed.

via The Guardian|

#cms #fraud #medicaid

politics5 days ago•3 min saved

Federal Withholding of $1.3B in California Medicaid Signals Expanded Fraud Crackdown

Vice President JD Vance announced the administration will suspend $1.3 billion in California Medicaid payments and threatened to freeze funding for Medicaid Fraud Control Units in all states if fraud isn’t aggressively prosecuted; CMS chief Mehmet Oz cited red flags in California billing and announced a six-month moratorium on new Medicare enrollments for hospices and home health agencies as part of the anti-fraud push.

via NBC News|

#california #cms #fraud

politics5 days ago•5 min saved

Federal withholds $1.3B in California Medicaid payments over hospice fraud crackdown

The White House, via CMS, is withholding $1.3 billion in California’s Medicaid reimbursements over alleged hospice-fraud gaps—the largest deferral in CMS history—while also pausing new hospice and home-health provider enrollments and pressuring the state to show patients actually received services, in a continuing feud over hospice oversight.

via Politico|

#california #cms #fraud

health-care15 days ago•11 min saved

Ballot-driven Medicaid gains face tougher rules and looming coverage losses

Seven states expanded Medicaid via ballot measures, but six are implementing stricter work rules, increased documentation, fewer exemptions, and earlier enforcement, risking large coverage losses. Urban Institute estimates 3–7 million could lose coverage due to work requirements alone, with Nebraska moving ahead on enforcement and some states exploring AI-assisted oversight. The policy split reflects ongoing battles over how to sustain expansion while addressing concerns about eligibility and fraud.

via Politico|

#ballot-measures #health-care #medicaid

politics16 days ago•19 min saved

Nebraska Tests Trump's Medicaid Work Rules, With Coverage at Risk

Nebraska becomes the first state to implement the work requirements tied to Trump’s Medicaid cuts, testing how many people enrolled through the ACA expansion could lose insurance. While most non-elderly adults on expansion already work or study, exemptions exist for disabilities or caregiving, and the exact impact remains unclear as states prepare for a nationwide rollout by 2027.

via The Bulwark|

#expansion #health-policy #medicaid

politics17 days ago•180 min saved

Nebraska kicks off Medicaid work rule, stirring coverage concerns

Nebraska becomes the first state to implement a GOP‑backed work requirement for Medicaid expansion, mandating able‑bodied adults to work or meet exemptions to keep coverage; the change could shrink enrollment by roughly 16,000–30,000 by 2028, as enrollees will be redetermined every six months under a federal provision; new applicants must show they meet the requirement in the month before applying, and renewals for existing enrollees begin July 31; exemptions include pregnancy, parents of children under 14, medical frailty and certain treatment statuses, while advocates warn about documentation hurdles and potential care gaps, particularly in rural areas, despite state outreach efforts.

via CNN|

#health-policy #medicaid #nebraska

health18 days ago•5 min saved

Nebraska's Medicaid work rules threaten coverage for thousands

Nebraska began implementing Medicaid work requirements, the first state to do so ahead of the federal deadline, potentially stripping coverage from about 25,000 expansion enrollees and affecting up to 72,000 Nebraskans. Enrollees must show 80 hours of work, volunteering, schooling, or apprenticeship each month, or qualify for exemptions such as pregnancy, parenting, disability, or medically frail conditions. New applicants must provide proof now; existing enrollees have until at least July. Reviews will occur every six months (up from annual), and advocates warn the process could disrupt care and leave many without coverage due to bureaucratic hurdles.

via NBC News|

#coverage-loss #health #health-policy