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Wisconsin Medicaid Being Used as Model for New York
Gov. Andrew Cuomo has hired a former top Wisconsin health official to overhaul Medicaid in New York. However, the Wall Street Journal reports that may not help the state reduce costs. The Journal explains: Medicaid spending overall has shot up in Wisconsin—12% in the last fiscal year—and the amount of money that officials from that [...]
Continue reading...WI Nurse Charged with Medicaid Fraud
3. January 2011
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A Sheboygan nurse is charged with stealing more than $15k from Medicaid. Sarah K. Becker will be in Sheboygan County Circuit Court on the charges later this month. Authorities say she billed Medicaid for work she never did, the Sheboygan Press reports.
Continue reading...Center for Medicare and Medicaid Innovation Should Help Health Care Services Delivery
4. December 2010
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Edited excerpt from the November Fraud Alert Newsletter. To read the entire story, or view other articles in the newsletter, click here (PDF). Recently, the Centers for Medicare & Medicaid Services (CMS) formally established the new Center for Medicare and Medicaid Innovation (Innovation Center). Created by the Affordable Care Act, the Innovation Center will examine [...]
Continue reading...Boy’s Transplant Leads to Medicaid Reform
5. November 2010
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Little Charlie Knuth needed a bone marrow stem cell transplant – but he would not be getting it if lawmakers and the public had not intervened in his case. Medicaid had denied coverage of the life-saving surgery, but reversed its decision after outrage from public officials and others. Knuth will get the surgery he needs [...]
Continue reading...WI Adds Investigators to Prevent Medicaid Fraud
14. October 2010
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The Wisconsin Shares program has been a book for fraudsters looking for a quick buck. The state is trying to change that by adding nearly three dozen new anti-fraud investigators. More than a dozen daycare providers were charged with duping the Wisconsin Shares program out of more than $20 million a year. According to the [...]
Continue reading...Obama Appointed New Medicaid/Medicare Chief
9. July 2010
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This week, President Obama appointed Dr. Donald Berwick as the chief of Medicare and Medicaid. Berwick is an expert at reducing healthcare costs, according to The New York Times. The Centers for Medicare and Medicaid Services has been without a leader for four years.
Continue reading...Tribe Receives BadgerCare Plus Grant
19. April 2010
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A more than $90,000 grant will enroll children of of the Bad River Band of Lake Superior Tribe of Chippewa Indians into BadgerCare Plus. The funds will be used to get health insurance for children not already on the program. The Centers for Medicare and Medicaid Services awarded the grant, the Milwaukee Journal-Sentinel reports.
Continue reading...Suspect Medicaid Fraud? Here’s How to Report It
11. April 2010
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Do you suspect Medicaid fraud, but aren’t quite sure if it is wrong – or how to report it? The U.S. Department of Health and Human Services says you should watch out for these items: Cash payment for your Medicaid number. Everyone in a group patient setting receives the same treatment, pharmaceuticals or equipment, like [...]
Continue reading...New Healthcare Law Could Force Patients Off BadgerCare Plus
6. April 2010
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Some low-income families on BadgerCare Plus could be forced off the program in favor of other paying programs, Wisconsin officials say. In a recent Milwaukee Journal-Sentinel story, officials said certain families who fall into a higher income bracket could move to commercial plans or a state plan similar to BadgerCare Plus. From the story: The [...]
Continue reading...Healthcare Reform Bill Raises Questions on Care
6. April 2010
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The debate over healthcare reform continues as more articles suggest it will take patients longer to get the care they need because the system will be flooded. Some also have concerns over how doctors will get paid. The Patient Protection and Affordable Care Act says they should receive the same reimbursements for Medicaid patients as [...]
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12. January 2011
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