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.
December 12, 2003
The Hawaii attorney general's office has launched an investigation to determine whether adoptive parents and Medicaid were double-billed for the hospital costs of women flown to the state from the Marshall Islands to give birth and then relinquish their newborn children. Christopher Young, the lawyer who directs the attorney general's Medicaid fraud unit, acknowledged that an investigation focusing on the billing practices of the agencies arranging the adoptions had begun. He said subpoenas had been issued to obtain records of adoptions involving recently arrived Marshallese women but declined to discuss details.
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.
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.
September 1, 2011
The Maryland General Assembly mandated that the Medicaid program trim $40 million from its budget during this fiscal year. Rather than making its decisions in a closed room, the Department of Health and Mental Hygiene asked its Medicaid Advisory Committee for help in gathering input from a range of stakeholders through public hearings and an open comment period. Guided by a set of "least harm" principles, the committee and the agency sifted through more than 190 proposals and publicly evaluated less than 20 deemed "viable" for savings in Fiscal Year 2012.