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Search results for "Medicaid" ...

  • GMA Gets Answers

    This series takes a hard look at the problems Americans are facing with insurance carriers, both public and private. In each story, Anchor Chris Cuomo profiles people fighting battles against insurance companies that are denying their claims. The investigators tried to get answers to claimants' questions about why their claims were being denied, even though they appeared to be following their insurance policy rules to a tee. They found that many consumers find themselves enmeshed in a complex and confusing system that allows insurers to wrongfully deny or delay claims with little possibility of penalty.
  • Prescription for Profit

    Conditions in the county hospital were deplorable, a culture of callousness pervasive and impoverished patients faced many barriers to care. Yet the system is rolling in money, primarily because it raised rates so that it could game federal Medicaid money that was supposed to help the poor. Rather than using it for that purpose, the taxpayer-financed system banked the money or invested it to try to attract insured patients, as highlighted by decisions to purchase a boutique hospital and a clinic in a high-income area. Officials of the healthcare system also misled the public, the hospital board and county officials about the finances and conditions in the hospitals and clinics.
  • Unapproved Drugs

    The government is paying millions for risky medications that have never been reviewed for safety and effectiveness but are still covered under Medicaid, an Associated Press analysis of federal data has found. Tax payers have shelled out at least $200 million since 2004 for such drugs. Yet the Food and Drug Administration says unapproved prescription drugs are a public health problem, and some unapproved medications have been dozens of deaths. Millions of private patients are taking them as well, and their availability may create a false sense of security. The AP analysis found that Medicaid, which serves low-income people, paid nearly $198 million from 2004 to 2007 for more than 100 unapproved drugs. Data for 2008 were not available but unapproved drugs still are being sold. The AP checked the medications against FDA databases, using agency guidelines to determine if they were unapproved. The FDA says there may be thousands of such drugs on the market. The medications are mainly for common conditions like colds ad pain. They date back decades, before the FDA tightened its review of its review of drugs in the early 1960s. The FDA says it is trying to squeeze them from the market, but conflicting federal laws allow the Medicaid health program for low-income people to pay for them.
  • Sick

    "'Sick' tells the story of eight individuals from around the country to examine what happens when people struggle to pay for their medical care. Along the way, it also tells the story of health insurance in America- how it evolved, how it operates today, and what's likely to happen to it in the future."
  • Coronary: A True Story of Medicine Gone Awry

    The book "investigated and documented the roles played by physicians, hospital administrators and corporate executives in a ten-year scheme to defraud Medicare and private insurers of tens of millions of dollars by performing unnecessary invasive tests and heart surgery" on patients.
  • EMS Taxi: Health Care Dysfunction on Wheels

    An analysis of the public records database found that Cleveland residents were calling 911 to be picked up by Emergency Medical Service ambulances for minor ailments. This is because dispatchers can't say no. The result is that response times are slow and the transportation is a high cost for the city.
  • Drilling for Dollars: Children's Dentistry Investigation

    After a five month investigation WJLA found that the leading chain of dental clinics, Small Smiles, for Medicaid children used assembly line treatment that rewarded profit over compassionate care. The parent company of Small Smiles "set daily production goals for its 63 clinics and gave enormous bonuses to the clinics that billed the most to Medicaid."
  • State of Decay: West Virginia's Oral Health Crisis

    West Virgina has the highest percentage of "older adults who have had all their natural teeth removed. The state's Medicaid program will pay for pulling teeth, but not saving them." Also "dentists were billing the state more for pulling low-income children's teeth than for cleaning them."
  • Infant Mortality in the South

    In 2005 Mississippi infant mortality has "shot up" by 18 percent. Despite the large increase, "the only substantial change that affected public health in Mississippi in 2005 was Governor Haley Barbour cutting the Medicaid roles by 19 percent when he implemented restrictive eligibility guidelines."
  • Health-Care Goldmines

    Workers are having to pay more for health insurance or having to drop covearage completely because of rising health care, which increases the numers of unisured people. The secret tactics of how the health insurers, pharmacy benfit managers, and others help to boost profits in isurance is exposed in this series.