Medicaid Program

Citing what they say may be a multimillion-dollar abuse, Maryland health officials are tightening controls over emergency medical care provided to residents of foreign countries under the Medicaid program. Health Secretary Nelson J. Sabatini says he suspects that up to $12 million a year in Medicaid funds is being spent improperly to provide health care to aliens who have come to the U.S. expressly for medical treatments that are sometimes expensive and "esoteric." In a series of recent interviews, Sabatini also said he suspects that the problem stems from hospitals that might be steering patients to Maryland for expensive treatments at public expense.

The Ehrlich administration is moving to join an interstate drug-buying cooperative in an effort to curb the soaring cost of medications for Medicaid recipients. Officials at the Maryland Department of Health and Mental Hygiene have begun preparing applications to join Michigan, Vermont, New Hampshire, Nevada and Alaska in a venture that was launched by Michigan a year ago but which received the Bush administration's blessing just last week. Under increasing pressure from states, businesses and senior citizens to control drug costs, the federal Centers for Medicare and Medicaid Services announced approval of the multi-state buying pool, which is expected to save the states already participating more than $12 million in drug purchases for 900,000 Medicaid recipients this year.

WASHINGTON - A federal appeals court has upheld methods used by more than half of the states to control the cost of prescription medicines bought for Medicaid recipients and other low-income people. In its ruling Friday, the court rejected a challenge by the pharmaceutical industry, which had attacked Michigan's strategy for encouraging low-income patients to use lower-cost medicines. The decision is significant because a rapidly growing number of states have adopted "preferred drug lists" like Michigan's as a way to control soaring drug costs.

Gov. Robert L. Ehrlich Jr. said yesterday that his administration has found 16,000 ineligible people on the rolls of the state's Medicaid program for the poor, and expects to find nearly 6,000 more by the end of the fiscal year. The finding is expected to shave $10 million to $15 million this fiscal year from the Medicaid budget. About $40 million is projected to be saved in the next fiscal year which begins July 1. The state Medicaid budget is currently about $4.5 billion. "The money didn't stay in my pocket for long," remarked the governor.

WASHINGTON - Poor and disabled Americans face a possible reduction in health care programs in cash-strapped states this year when a one-time federal subsidy for the Medicaid program expires, according to a survey released yesterday by a nonpartisan study commission. The $10 billion subsidy that Congress authorized last spring raised the federal match of Medicaid funding by less than 3 percent, but that was enough to enable many states to postpone planned cuts or freezes in the health care programs of last resort for about 50 million people nationwide, the Kaiser Commission on Medicaid and the Uninsured survey revealed.

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.

The use of medications to treat emotional and behavioral problems in children and teen-agers more than doubled in the decade ending in 1996, new research shows, raising concerns about the long-term effects of some drugs that have not been studied in young people. The research, appearing today in The Archives of Pediatric and Adolescent Medicine, found that the use of psychiatric drugs - which include antidepressants such as Prozac and stimulants such as Ritalin - doubled in one study group and tripled in two others.

On a waiting list for a heart transplant, Sanusi Cole wishes he had more medical bills. If he had enough -- more than $6,000 worth -- he'd be eligible for the state's Medicaid program. His cardiologist has assured him that he'll get the transplant when his turn comes, regardless of his insurance status. Meanwhile, he's been on an insurance merry-go-round. Sometimes he's covered, sometimes he's not. He got a Medicaid card in mid-August, and for the first time in months he was able to obtain most of his expensive heart, liver and kidney medications.

In the Region Corvis to contract out manufacturing, lay off 30 or more Corvis Corp. announced plans yesterday to contract out much of its manufacturing operations to reduce costs, a move that will lead to 30 or more layoffs in Columbia over the next six months. The company said it has signed a multiyear contract with Celestica Inc., a Toronto technology manufacturer, to make its fiber-optic networking equipment. Corvis will lay off about 30 percent of its 115 manufacturing employees when a transition to Celestica is completed in six months, retaining the rest for work on product development and other operations.

HMOs are expanding their participation in the state's Medicaid program, Debbie I. Chang, deputy health secretary, said yesterday. This month, Chang said, Americaid expanded to cover most of the state, and Priority Partners, which had frozen enrollments in four counties, reopened enrollment throughout the stat e. Two other health maintenance organizations with enrollment limits, Helix Family Care and United Healthcare, lifted their restrictions a...