June 22, 2002
Maryland's Medicaid program violated federal rules when it refused to reimburse Johns Hopkins Hospital for two teen-agers' life-saving liver transplants after the state said the operations were not "appropriate," Maryland's highest court said yesterday. Federal Medicaid guidelines clearly state that only medical necessity - not whether a life-saving procedure is "appropriate" - is the standard that applies to patients under age 21, the Court of Appeals said in a unanimous ruling. The case, which stems from a pair of operations costing a total of $264,000, could affect a range of Medicaid-funded procedures for children that require preauthorization under Maryland regulations, such as other transplants and mental health services, lawyers said.
October 1, 2004
As pressure builds for governments to import medicine from Canada or take other measures to cut spending on prescriptions, Maryland is saving millions of dollars more than anticipated through an initiative to win rebates on drugs purchased domestically. Although the state initially estimated it would save $20 million a year by developing a "preferred-drug list" for Medicaid patients, the program has been so successful that it expects to save $31 million, said Nelson J. Sabatini, who retires today as state health secretary.
September 19, 1996
A Columbia pharmacist pleaded guilty yesterday to defrauding the state's Medicaid program by billing for prescriptions that were never filled, the attorney general's office said.Jim Su Pak, 35, who owns the Hickory Plaza Pharmacy on Hickory Ridge Road, was sentenced in District Court in Baltimore to a year of probation before judgment and was ordered to pay a $500 fine. He also was ordered to repay $361.76 to the Medicaid program, the money that was paid to him from the fraudulent billings.
March 20, 2014
Regarding your article on Connecticut's health exchange ( "Maryland looks to Connecticut as exchange model," March 14), Maryland should copy that state's one-payer Medicaid system for the poor. In 2012, Connecticut's Medicaid program jettisoned its private insurance plans, a system similar to Maryland's Medicaid program, and formed "Husky," a state-administered Medicaid plan with only one payer - the state. The impetus for the change came after outside audits of two private Medicaid insurers in Connecticut showed significantly less money going to actual medical care than reported by the insurers.
February 27, 2014
Maryland must spend as much as $30.5 million more to provide Medicaid coverage to Marylanders because the state's glitch-riddled health exchange website can't tell whether they are still eligible. It's another problem exacerbated by the software that has been causing headaches since the exchange website launched on Oct. 1 for those trying to get into the expanded Medicaid program or buy private insurance with subsidies. This issue identified in a legislative report only applies to people already in Medicaid, the federal-state program for the poor.
May 11, 2011
Reader Suzanne R. Schlattman ("Ryan budget would hurt Maryland," May 9) writes, "we here in Maryland … know far better" how to run the state's Medicaid program. I couldn't agree more. So why does she oppose the reforms that passed the U.S. House, which would give Maryland officials unprecedented flexibility to run their program? Could it be because those reforms would also require Marylanders to pay for more of their own bright ideas? Michael F. Cannon, Washington The writer is director of health policy studies for the Cato Institute.