Medicaid

Six-year-old Mychael Greene doesn't like the look of the hooked tool that dentists use to scrape plaque from teeth, or the sour taste their latex-gloved hands leave in his mouth. But his mother, Shawn Greene, made sure her son opened wide during a recent checkup at the University of Maryland Dental School in Baltimore. Her reason: the death earlier this year of Deamonte Driver, a 12-year-old Prince George's County boy who died after an infection from an abscessed tooth spread to his brain.

Appeals court takes consensual sex case Maryland's highest court agreed yesterday to hear a case that turns on whether consensual sex can become rape if one partner says "no" at any time. Women's advocacy groups, angered by a lower court's ruling, had backed the attorney general's office's request that the Court of Appeals take up the matter. The case stems from a report of a sexual assault in 2003 in Montgomery County. Judges in the state's intermediate appeals court said they had to follow a 1980 decision, which ruled that sex that continues after a woman withdraws her consent is not rape.

A Woodstock man pleaded guilty yesterday in Baltimore Circuit Court to participating in a scheme to fraudulently bill Medicaid for more than $4 million in services that were never performed, according to the Maryland attorney general's office. Guy Anthony Bell, 44, of the 2700 block Tallow Tree Road was the chief financial officer from October 2002 until April 2004 for the Bridges Project, which provides psychiatric rehabilitation and therapy for children and adults in Baltimore, according to prosecutors.

Nursing home fee gaining support Charging nursing homes a state fee would boost their Medicaid reimbursements -- allowing them to hire more staff and buy new equipment -- members of Gov. Martin O'Malley's administration said yesterday. Health and Mental Hygiene Secretary John M. Colmers said Maryland should join 32 other states and the District of Columbia in charging a fee of up to 2 percent of operating income of nursing homes that have at least 45 beds. That money would be matched by the federal government and be funneled back to the homes in Medicaid reimbursements, effectively sending the homes twice what they paid, Colmers said at a hearing in Annapolis.

Gov. Martin O'Malley rolled out a health care plan yesterday that would expand medical coverage for uninsured residents and commit funding for data exchanges that connect the state's hospitals and allow them to share records. More than 100,000 Marylanders would get coverage under the proposal out of nearly 800,000 residents who lack coverage. The plan would cost about $500 million, including $250 million in new state revenue plus federal matching dollars and funds redirected from other areas.

An estimated 788,000 Maryland residents lack health insurance of any kind, and it's time the state got serious about addressing the issue. Not just for humanitarian reasons (although that argument is compelling), but because the lack of coverage is simply too costly for most of the other residents of the state, who pay higher insurance premiums to cover the uninsured's emergency room care. It's a horribly inefficient system, and the spiraling cost of health care is, in turn, only fostering more uninsured each year.

Public health advocates fear that a new federal regulation requiring Medicaid applicants to supply proof of identity and citizenship has resulted in thousands of poor Marylanders losing their health insurance. The requirement, part of the federal Deficit Reduction Act that went into effect in Maryland in September, was designed to prevent illegal immigrants from fraudulently receiving Medicaid, the nation's premier health insurance program for the poor. But advocates and health officers in some Maryland counties insist the rule has burdened citizens who need health care the most and is likely responsible for thousands of Marylanders being kicked off the Medicaid rolls.

WASHINGTON -- President Clinton will send federal officials to all the states to investigate whether they have improperly excluded people from Medicaid or from a new federal health insurance program for children, White House officials said yesterday.At the same time, he will try to get schools across the country to help arrange health coverage for millions of uninsured children.Clinton plans to announce the efforts today when he addresses the 91st annual meeting of the National Governors' Association in St. Louis.

Despite new protests over a transfer of Medicaid enrollees from Prudential to another HMO, Dr. Martin P. Wasserman, state health secretary, said the state expects to move ahead with the transfer next week.An association of non-profit health centers filed a petition with the department yesterday complaining about the notice the department plans to send to some 82,000 Prudential Medicaid members about the switch. Its lawyer said it will go to court next week to block the transfer if it is not satisfied with the health department's response.

The state health department proposed yesterday to increase Medicaid premiums by 1.5 percent in November and another 2 percent in July, but managed care organizations said that may not be enough to keep them participating in the program."

The nation's governors are caught between the crisis of growing numbers of uninsured residents and proposed federal health care solutions that could make a significant dent in their own battered budgets. States received an indication this week of the price they might pay for health care overhaul. The Congressional Budget Office estimated state spending on Medicaid would increase by about $33 billion over a decade under a leading proposal set for a vote in the Senate Finance Committee next Tuesday.

As the crowd filed out of Wednesday's town hall meeting, Andrea Wimmer sat in her wheelchair under a tree, holding a neon-yellow sign that said, "When Obama rations out health care based on the 'worth' of a person, I'm screwed." Two years ago, shortly after her high school graduation, Wimmer was in an auto accident that left her partly paralyzed and in need of weeks of hospitalization and therapy. Wimmer, now 20 and planning to enroll in classes at Hagerstown Community College, attended the town hall meeting along with her mother to show their opposition to the president's plan to overhaul health care.

Companies and special interest groups spent about $13.9 million on lobbying during the six-month period that included this year's General Assembly session, newly released figures from the State Ethics Commission show. While overall spending fell slightly from the same period a year ago, when lobbying costs reached $14.6 million, several entities reported ramping up their lobbying presence despite the economic downturn as they worked to protect their interests in a volatile legislative session.

Health care providers who serve Medicaid patients will get paid less, the University System of Maryland will hire fewer faculty members and 40 state workers will lose their jobs as part of $280 million in budget cuts proposed by Gov. Martin O'Malley. The Democratic governor has compiled a list of budget cuts to be presented today to the Board of Public Works, a three-member body that can approve midyear budget adjustments when the General Assembly is not in session. But the cutbacks won't end there: O'Malley plans up to $470 million in further budget cuts before Labor Day. The next round of spending reductions will target aid to local governments and state employee compensation, O'Malley said during a news conference.

At a time when some cash-strapped states are contemplating reducing Medicaid coverage, Maryland has boldly moved in the opposite direction. Today marks the first anniversary of a program that has brought taxpayer-financed medical assistance to more than 44,000 low-income parents, the vast majority of whom lacked health care before. That's nearly 20,000 more people than advocates had expected to enroll by now, and it's one of the more significant accomplishments of Gov. Martin O'Malley's term in office.

GM to sell Saturn to Penske, saving up to 13,000 jobs General Motors Corp. has reached a deal to sell its Saturn auto unit to Penske Automotive Group, a dealership chain owned by former race-car driver Roger Penske. The bankrupt automaker said the deal to sell Saturn and its distribution network would save up to 13,000 jobs and hundreds of dealerships. It did not release financial terms of the arrangement. It's the latest in asset sales from the Detroit automaker. GM has had Saturn on the block since December 2008.

Your Honor, I was saving jobs." Malefactors of every stripe ought to memorize that explanation. Next time they're in court facing a stiff penalty for wrongdoing, that's clearly what they ought to tell the judge. It's an argument that apparently persuaded the state Senate to shield those who commit fraud against the government from having to pay for it. What nonsense. And what bad news for Maryland taxpayers. The Senate rejection this week of Gov. Martin O'Malley's proposal to crack down on Medicaid fraud is going to open up a gaping $11 million hole in next year's budget - that's how much additional revenue the governor's budget assumed would be generated by the new law. The measure lost in a razor-thin 24-23 vote that likely would have gone the other way had any of four senators simply voted as he or she did on a similar measure last year.

With the state facing a potential $1 billion-plus budget deficit and money getting tighter every day, one might think that collecting an extra $11 million from health care providers who defraud the Medicaid program wouldn't be terribly controversial. But Gov. Martin O'Malley's proposal to do just that has met surprising resistance in Annapolis this year. The Senate has a chance to set matters straight this morning, however, by approving the governor's proposal to allow the state to collect up to triple damages in Medicaid fraud cases.

Expanding Medicaid still fiscally responsible With budgets on the chopping block, one area the state should not cut is health care coverage ("'Devastating' state revenue report may mean cuts in public safety, education," Dec. 17). Here's why: As Maryland expands Medicaid coverage including preventive care, data from other states are showing that expanding health insurance can lead to costs savings down the road. Massachusetts adopted an ambitious program in 2006 that provides incentives for business and individuals to expand health insurance coverage.

As the nation's president-elect and incoming Congress mull a variety of fixes for the nation's ailing health care system, there's at least one relatively simple step that could be taken to make prescription drugs more affordable for hundreds of thousands of Marylanders. It requires only that the federal government give states the power to enable lower and middle-income families to buy prescription drugs at the same prices paid by the Medicaid program. It wouldn't cost taxpayers a dime but would make prescription drugs 40 percent to 45 percent more affordable for participants.