Thursday, July 2, 2009

Breathe Easy, Ye Who Rely on Medicaid Reimbursements

So said Health and Human Services Secretary Kathleen Sebelius when she rescinded a final rule that would have taken the . As governor of Kansas, keeping Medicaid alive was one of Sebelius' major platforms, according to

Sebelius warned that neither Congress nor the Bush administration planned to extend a one-time increase in Medicaid funding. If the emergency aid is not renewed, Kansas will be forced to cut its Medicaid budget. Sebelius also complained that federal officials have slowed payments to the states in the wake of Medicare and Medicaid reform efforts. If states are forced to cut Medicaid budgets, numbers of uninsured are sure to increase.

The issue was raised back in September of 2007 when then HHS Secretary Mike Leavitt proposed schools be stripped of federal and state reimbursements of Medicaid-eligible reimbursement costs, such as transporting some students to and from therapy sessions and doctor visits, after the Government Accoutability Office discovered some $3.5 billion in fraudulent claims over the previous five years.

Fraud might be the correct term to use in some cases, but certainly not all, as many cases, some involving schools turned out to be paperwork errors. Still, $3.5 billion is $3.5 billion. As for some the alleged perpetrators, Sebelius and U.S. Attorney General Eric Holder announced that 53 people were indicted for schemes to submit more than $50 million in false Medicare claims.

But penalizing schools didn't sit well with Sebelius. In May, HHS and the Center for Medicare & Medicaid Services issued a proposed rule to rescind the transportation rule as well as other that would limit the ability of states to issue reimbursements to agencies and medical services.

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