Officials with the Wisconsin Department of Health Services acknowledge they've had trouble with a new $64.2 million computer system that handles Medicaid services. Glitches with the automated system caused a backlog of claims, preventing the state from processing some prior authorizations for therapies and medical equipment. The agency has been unable to process about 10% of its claims for prior authorization within the 20-day time period required under state law, and some requests have taken four times longer to be approved.
The chairman of the Arkansas State Medical Board was critically injured when a powerful car bomb exploded outside his West Memphis home as the physician prepared to leave for work, federal and local authorities said. West Memphis Police Chief Bob Paudert said there is no immediate evidence that Trent Pierce had been threatened or took part in controversial medical procedures. Arkansas State Police spokesman Bill Sadler, however, said investigators will meet with board members and other staffers to find out if the attack might have been related to his work on the panel.
A convicted rapist fired in August from his job as a Los Angeles County hospital X-ray technologist was rehired by county managers through a contractor a short time later to do the same work at an East Los Angeles health clinic, officials acknowledged. Gariner Beasley, 48, was fired again Tuesday and escorted from the Edward R. Roybal Comprehensive Health Center, said county Supervisor Gloria Molina. County officials struggled to explain how they had rehired a man they fired in August, calling his criminal record incompatible with a job that required he work alone with patients in "very vulnerable and compromised positions."
As President Obama prepares to push for an overhaul of the medical system, providers of U.S.-backed health plans for the elderly are raising prices. Humana Inc., Health Net Inc., and nearly 200 other providers increased 2009 premiums by 13% on average, or more than five times as much as last year, for people who use Medicare Advantage, according to consulting company Avalere Health.
Recent legal settlements with big health insurers may allow some managed-care plan participants to begin recovering some of the money they may have overpaid for using out-of-network doctors and hospitals. So far, insurers UnitedHealth Group Inc., Aetna Inc., and Health Net Inc. have agreed to make millions of dollars in funds available to patients and, in some cases, physicians for possibly having shortchanged them in the past. A number of other legal actions are pending that seek redress for patients and healthcare providers who claim they were underpaid by insurers for out-of-network services.
Congress convened last month with 16 medical doctors, including three newly elected members of the House of Representatives as well as a freshman senator, according to the latest tally by the Chicago-based American Medical Association. "The number of physicians in Congress continues to grow, with 16 physicians in the 111th Congress, demonstrating intense physician interest in making a difference in people's health and their lives," said Nancy Nielsen, MD, president of the AMA. Often, doctors are known to push an agenda that would increase access to medical care by boosting payments to programs that pay doctors and other medical-care providers.