The N.Y. audits have been successful in recouping funds but have created an industry backlash. Florida, at the heart of the lawsuit against the federal health law that will expand Medicaid, is trying hard to get approval from the Obama administration to revamp its program.
The New York Times: Under Pressure, New York Moves To Soften Tough Medicaid Audits
New York State was paying for the medical care of dead people when Gov. George E. Pataki and the State Legislature created the Office of the Medicaid Inspector General to curb billions of dollars in fraud and misspending by health care providers. ... But a backlash from the politically powerful health care industry has erased broad support for the crackdown (Bernstein, 3/18).
NPR: Florida Challenges Medicaid Spending 'By Force'
When Florida's Republican Gov. Rick Scott rolled out his 2012 budget, he brought along a chart -- a graph with two lines. One showed that since 1999, Florida's budget has grown 30 percent. The other line showed that Medicaid spending is up 180 percent. ... Health care advocates [note] that Medicaid spending in Florida is a third less than state economists predicted eight years ago (Allen, 3/19).
Also, California consumer groups are looking at cutbacks there.
California Healthline: Pediatric Centers Argue Retroactive Payments Don't Make Sense
California's 14 pediatric day health centers are a form of home health agency serving a 21-and-under population. Those are two groups exempted from the state's 10 percent Medi-Cal provider rate reductions in June. ... DHCS officials now say the pediatric facilities have to pay the 10 percent difference for all of those months during which the status of PDHCs was in question. That's 10 months' worth of cash PDHCs don't have, according to Terry Racciato, president of two Together We Grow pediatric day health centers in San Diego (Gorn, 3/19).