MONTPELIER, Vt. (AP) — Vermont has become the first state to let people without health insurance see how much they would pay to get coverage through the federal health overhaul beginning next year.
The state released proposed rates Monday. Examples show that a family of four with an annual income of $32,000 would pay $45 a month out of pocket. A single person making $40,000 would pay $317 a month.
Vermont's rates aren't expected to affect other states'. Andy Hyman of the Robert Wood Johnson Foundation says every state is expected to release theirs over the next month or so.
Vermont embraced the federal health overhaul from the outset and hopes to go further. The state is setting up what would become the nation's first single-payer health care system, to be implemented in 2017.
The Health and Human Services Department has added four Ohio men to their list of most wanted fugitives for taking $970,000 from Medicaid according to investigators at the HHS Office of Inspector General.
The four men created what appeared to be six different ambulette companies for transporting people, but the six companies coordinated all their efforts, acting as a single company. One man was convicted, but fled before going to prison. The other three fled prior to their trial.
Investigators believe the men are currently residing in Sudan.
Investigators at the Health and Human Services Department (HHS) said a single hospital in Indiana improperly billed the U.S. government by $5.8 million for Medicaid, specifically inpatient psychiatric services.
The HHS Office of Inspector General wants the state to refund the money given to Logansport State Hospital, because that facility did not comply with federal "minimum standards that provide a basis for improving quality of care and protecting the health and safety of Medicaid beneficiaries," such as staffing levels and treatment plans, the watchdog said.
Another day, another company illegally billing Medicare.
Today its Florida based American Sleep Medicine, which has agreed to pay the government $15.3 million after charges it illegally billed Medicare for sleep diagnostic services that weren't eligible for repayment.
The company also illegally billed TRICARE, the military health care system, for treatment provided to service members, and the Railroad Retirement Medicare Program, according to officials.
Two medical centers will pay the government $4.4 million after they unnecessarily performed surgery on patients in order to bill Medicare for the services, according to a press release from the Justice Department.
EMH Regional Medical Medical Center and the North Ohio Heart Center, Inc. performed unnecessary angioplasty and stent placement procedures on patients, then billed the government according to officials.
The government has fined Golden Living Nursing Homes nearly $425,000 because the facilities provided "inadequate and worthless wound care" that "resulted in harm to patients" and then billed Medicaid for the services, according to a press release from the FBI.
"The nursing home patients depended on Golden Living to provide them with quality wound care services to help them heal, but, instead, were mistreated. We will not stand for such egregious misconduct by a Medicaid provider," said Georgia Attorney General Sam Olens.
The Louisiana State Medicaid Fraud Control Unit was kept busy between fiscal years 2009 and 2011.
A Health and Human Services Department Office of Inspector General review of the fraud control group found they had recovered $95 million, obtained 192 convictions and 86 civil judgments or settlements and received 1,043 referrals for other cases.
The IG report also said that the unit did not properly report its income in fiscal year 2010 and 2011. However it was a paperwork problem, and the unit had no problem with control of its finances, investigators said.
The Older Americans Act of 1965 provides funds for the elderly and their caregivers to assist the individuals in staying in their homes as long as possible before moving to an assisted living facility. But the funding formula used could be improved by taking into account differences between the states and their elderly populations, said the Government Accountability Office.
The owner and operator of several Florida halfway houses was sentenced to four years, three months in prison for part of a scheme to defraud the government of $205 million in Medicare payments, according to the Departments of Justice and Health and Human Services, the latest conviction from an increased crackdown by the government's Medicare Fraud Strike Force.
A Louisiana non-profit that runs Head Start programs built a million-dollar new headquarters building without asking permission from federal officials first, said the Health and Human Services Office of Inspector General.
The Child Development Council of Acadiana, Inc. paid for construction of the new office building, then used it as collateral on two loans, investigators said.
The non-profit said it did nothing wrong, but HHS is seeking to get the money refunded to the national government.