Critics Call Wisconsin’s Medicaid Fraud Crackdown 'Bullying'

Nurse Debra Zuhse-Green was stunned to learn the state of Wisconsin wanted her to repay $57,000 she had received for providing home care to children with significant medical needs.

An audit conducted in 2013 concluded Zuhse-Green should repay the state for six months of care to the children, who had complex health needs. The audit found she had not submitted claims for reimbursement to the family’s employer-based health plans — even though, Zuhse-Green said, "it had previously been established that the employer-based health plans would not cover the private duty nursing services."

More >> Critics Call Wisconsin’s Medicaid Fraud Crackdown 'Bullying'

Reducing Psychotropic Prescriptions Requires Systemic Reform

The over-reliance on psychotropic medication for children in foster care has been drawing a lot of attention both among policymakers and in the media. A recent study reports that in 2012, Pennsylvania’s foster children were nearly three times as likely to be prescribed psychotropic drugs for behavior problems as other children on Medicaid.

More >> Reducing Psychotropic Prescriptions Requires Systemic Reform

Feds Pay for Drug Fraud: 92 Percent of Foster Care, Poor Kids Prescribed Antipsychotics Get Them for Unaccepted Uses

The release in late March of an alarming new report by federal investigators has confirmed in shocking new detail what has been known for years: Poor and foster care kids covered by Medicaid are being prescribed too many dangerous antipsychotic drugs at young ages for far too long -- mostly without any medical justification at all. The report by the U.S. Department of Health and Human Services (HHS) Inspector General examined in depth nearly 700 claims filed in 2011 in five of the biggest prescribing states -- California, Florida, Illinois, Texas and New York -- and discovered that two thirds of all the prescribing with these popular and costly "second generation antipsychotics" (SGAs) raised high-risk "quality of care" concerns.


More >> Feds Pay for Drug Fraud: 92 Percent of Foster Care, Poor Kids Prescribed Antipsychotics Get Them for Unaccepted Uses

Federal study finds alarming use of antipsychotics among nation's poor children, foster kids

When federal inspectors set out to examine how powerful antipsychotic drugs were being used on children in the nation's public health systems, they found a 4-year-old on four psychiatric drugs, a 10-year-old prescribed without medical records, and a 16-year-old on six psych meds, including a prescription at double the maximum recommended dosage.

More >> Federal study finds alarming use of antipsychotics among nation's poor children, foster kids

Mayo consult service to cut harmful psychotropic RX to kids ...

Primary care doctors will need to check in before prescribing antipsychotics and other dicey psychiatric medications to many children in Minnesota. The state Department of Human Services has hired the Mayo Clinic to provide a new consult service to cut down on doctors who make questionable prescriptions of psychiatric drugs and to improve the quality of child mental health care in the state.

Mayo consult service to cut harmful psychotropic RX to kids ...

Senate Watchdog Targets High-Prescribing Medicaid Docs

An influential U.S. senator is grilling officials in nearly three-dozen states, demanding to know how they are cracking down on physicians who prescribe massive amounts of potentially dangerous prescription drugs.

Senate Watchdog Targets High-Prescribing Medicaid Docs

Some Dentists Reluctant to Treat Kids on Medicaid: Study

Undercover research in Illinois reveals that dentists are far more willing to provide emergency care to children with private insurance than to kids with public insurance such as Medicaid.

Some Dentists Reluctant to Treat Kids on Medicaid: Study

Some doctors handing out prescriptions to kids for potent medications

With little oversight and apparent carte blanche, a relative handful of Texas physicians wrote $47 million worth of Medicaid prescriptions for powerful antipsychotic and anti-anxiety drugs over the past two years, according to a Star-Telegram analysis.

Some doctors handing out prescriptions to kids for potent medications

Medicaid-funded ADHD treatment for children misses the mark

Washington, DC, 7 December 2010 ? The enactment of the Patient Protection and Affordable Care Act of 2010 expands Medicare benefits to scores of previously uninsured individuals including many of our nation's children. While access to treatment is laudable, the quality of such treatment is the subject of an article in the December issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Medicaid-funded ADHD treatment for children misses the mark

Psychiatric practice drops MaineCare

A Bangor psychiatric practice that serves thousands of area residents will stop seeing MaineCare patients next month, citing an untenable reduction in payments from the MaineCare program.

Psychiatric practice drops MaineCare