Archive: Medicaid or Medicare

McClatchy reports Supreme Court justices seem “genuinely split over when and how states can take a share of medical malpractice payments awarded Medicaid beneficiaries.” The case involves a 13-year-old North Carolina girl who has been “profoundly disabled since an allegedly botched caesarian-section delivery,” resulting in “diagnosis of cerebral palsy.” The court’s answer, “expected in June, […]

The AP reports, “More than a dozen serious medical errors were reported at Middle Tennessee hospitals over the past three years – and federal statistics indicate probably 80 more were not reported.” Previously, “hospitals have been reluctant to admit mistakes, fearing malpractice lawsuits.” However, “hospitals are increasingly under pressure to reduce errors, and to do […]

Everyone involved with personal injury claims knows that dealing with Medicare has become a nightmare over the past several years. Without going into detail, following the convoluted process required by Medicare in order to get a verified amount owed (or a statement that nothing is owed) takes months after a settlement is made with the […]

The Washington Post /Kaiser Health News reported, “Medicare is preparing to penalize hospitals with frequent potentially avoidable readmissions,” with the aim of prodding them “to make sure patients get the care they need after discharge. But this new policy is likely to disproportionately affect hospitals that treat the most low-income patients, according to a Kaiser […]

Texas has a handful of physicians taking advantage of Medicaid rules by prescribing inappropriate medications for children. This is not only bad for the kids, but eats up Medicaid money that should go to other people. The problem was detailed in an editorial in the Fort Worth Star Telegram. Here are excerpts: With little oversight […]

In continuing coverage, Business Insurance reported insurers groups and “trial attorneys represented by the American Assn. for Justice” are supporting the Strengthening Medicare and Repaying Taxpayers Act, which “would require Medicare to respond within 65 days of a party’s request for information on Medicare’s final payment demand.” The Medicare Secondary Payer System requires parties to […]

New federal rules regarding Medicare have made life miserable for personal injury claimants and the lawyers who represent them. The crux of the matter is that money must be withheld from the settlement or verdict amount in order to repay Medicare any money it may have paid for the plaintiff’s medical expenses. But getting a […]

According to a recent study from the Insurance Research Council, low reimbursements from public health insurance programs, such as Medicare and Medicaid, have prompted hospitals to shift costs to automobile insurance companies—raising auto injury claim costs and forcing auto insurers to more closely scrutinize and negotiate hospital bills prior to payment. The IRC estimates that […]

The National Journal reports, “Medicaid will no longer pay hospitals or doctors for certain preventable illnesses and injuries, such as operating on the wrong body part, the Health and Human Services Department said Wednesday.” In a statement, Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, said, “These steps will encourage health professionals […]

We are in the midst of some very bad legislative proposals, both in Washington and in Austin. Whether you’re concerned about the loss of Medicare (Washington) or passage of a corporate immunity bill (Austin), you should contact your representatives and make your concerns known. There is a handy site for Texas who want to know […]