CMS

Rethinking Medicaid

UPDATED 16:58 PM EDT, May 13, 2013 | BY Phillip Swarts

The auditing arm of Congress is urging the government to revamp the way Medicaid money is distributed, suggesting officials target funds based on the demand, geography and resources in each state.

Currently, Medicaid distributes $300 billion annually to the states to help pay the medical needs of the poor and disabled under a formula known as the Federal Medical Assistance Percentage, or FMAP. Payments are essentially based on each state's per capita income (PCI).

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UPDATED 7:07 AM EDT, March 20, 2013

Medicare's Grocery Card Giveaway

The Department of Health and Human Services has given qualified approval for a Medicare provider to give away $20 grocery gift cards to induce seniors to get more taxpayer-funded health screenings, despite concerns the promotion could run afoul of federal anti-kickback laws.

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UPDATED 15:19 PM EST, January 3, 2013

Medicare's Medication Mistake

The government office that oversees Medicare and Medicaid has reimbursed prescription drugs at market costs, instead of at optional lower rates that could potentially save taxpayers millions of dollars a year, a government investigation has found.

The Centers for Medicare and Medicaid Services (CMS) reimburses prescription drug purchases by beneficiaries through Medicare Part B.  The cost is supposed to be no more than five percent above what it takes to manufacture the drugs. 

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UPDATED 6:25 AM EST, December 12, 2012

Senior Slip-ups

A $1.7 billion initiative by state and local governments to allow Medicare seniors to live more independently is actually sending large numbers of patients to assisted living facilities with licensing or other problems, a federal watchdog warns.

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UPDATED 11:06 AM EDT, October 11, 2012

Medi-Careless

Thousands of Medicare beneficiaries were put at risk of having their private medical information stolen because of security breaches, and the government was slow to notify or help most of the victims, an internal investigation found.

The stimulus law passed in 2009 required the Centers for Medicare and Medicaid Services (CMS) to quickly alert victims of possible identity theft, but the Health and Human Services Office of Inspector General found the agency often was slow to do so for many of the 13,775 beneficiaries put at risk by 14 recent security breaches.

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UPDATED 21:13 PM EDT, September 13, 2012

Day Late, Dollar Short

The Health and Human Services Department overpaid providers $8.4 million because it did not deduct late fees owed by Medicare and Medicaid providers, the agency's internal watchdog has found.

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