Tag Archives: medicaid

Potential billing abuse by Medicaid dental providers a fertile area for coverage

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Once the ACA covers children's dental care, will parents drop their dental insurance?

Photo by ianus via Flickr

An estimated 8 percent of Medicaid dental providers in California submitted questionable bills to the program during one recent year, a recent federal report concluded.

Half of the dentists whose bills raised concerns worked for dental clinic chains.

The findings are the latest in an unfolding examination of Medicaid dental billing practices led by the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG). Continue reading

Covering how King v. Burwell decision could affect subsidies

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Lauren Sausser

Lauren Sausser

Lauren Sausser of The Post and Courier in South Carolina was surprised by an email from a reader asking her to write more about Medicaid expansion in South Carolina – specifically, the state’s refusal to expand the low-income health insurance program under the Affordable Care Act.

This year, health insurance subsidies have played a much more prominent role in The Post and Courier’s health care coverage. Like other news outlets, her newspaper is waiting to find out what the Supreme Court decides in King v. Burwell. If the court rules in favor of the plaintiffs, subsidies will end in states using the federal exchange.

In South Carolina, a King victory would mean that coverage will become unaffordable for an estimated 200,000 people who have purchased subsidized policies through the federal insurance marketplace. It’s been a big story. Meanwhile, Medicaid expansion, with a few exceptions, is relatively stagnant there.

Read more about her reporting on the topic.

Florida dentist accused of abuse, fraud in treatment of young patients

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

CNN filed its “Nightmare Dental Procedures Done on Kids” report under “Stories that Shock,” along with tabloid-worthy accounts of a child being dragged by her school bus and a woman kidnapped after responding to a personal ad on Craiglist.

The piece opens with the surreptitiously recorded sounds of instruments whirring and a child wailing, then shifts to a scene on a public sidewalk in Jacksonville, Fla., where angry protesters have gathered outside the office of a 78-year old pediatric dentist, Howard S. Schneider. Continue reading

Some dental clinics seeing influx of Medicaid clients under ACA

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Thanks to Medicaid expansion and stepped up enrollment efforts under the Affordable Care Act, adults in some states including Oregon, are now eligible for dental benefits.

video platformvideo managementvideo solutionsvideo playerReporter Grace Joyal, of KTVZ-Bend, Ore., recently visited a rural dental clinic that has been coping with a significant increase in new patients.

“Since January 2014, the Oregon Health Plan reports that almost half a million people have signed up for the state’s version of Medicaid,” Joyal reported. “The Affordable Care Act has meant a massive influx of patients for dental clinics.” Continue reading

Journalists expose weaknesses in Idaho’s fragmented, threadbare mental health system

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Audrey Dutton

Audrey Dutton

Emilie-Ritter-Saunders.jpg

Emilie Ritter Saunders

Last fall, The Idaho Statesman newspaper and NPR member station Boise State Public Radio ran a series titled, “In Crisis,” that explored Idaho’s fragmented and underfunded mental health care system.

Statesman business reporter Audrey Dutton (@IDS_Audrey) and Emilie Ritter Saunders (@EmilieRSaunders), who was then the BSPR digital content coordinator, collaborated on the series. Both journalists produced stories for print, radio and online.

Dutton and Saunders found that Idaho’s threadbare mental health care system does not serve well the many Idahoans who need quality, timely and appropriate behavioral and mental health care.

Their work could serve as a blueprint for journalists covering this challenging story in any state. In the series, Dutton and Saunders reported that the state does not have enough psychiatrists or treatment facilities for the population they serve and that it doesn’t have enough mental health resources for the state’s poorest residents.

They also report that about 25 percent of the state’s residents are living with a mental illness, which is a bit higher than the national average of 20 percent. And, they found, Idaho has one of the highest suicide rates in the country, about 48 percent higher than the national rate.

As is common throughout the United States, Dutton and Saunders wrote that, in addition to leaving many Idahoans without proper care, the mental health system is so frayed that the police are often called when a patient suffers a mental health crisis and the state’s courts and jails are among the largest providers of mental health care. Sadly, they added, those with mental illness frequently are hospitalized because more appropriate settings for mental health care are unavailable. They also found that the state Medicaid program serves those in need inadequately.

Read more about how they did the reporting in this article for AHCJ members.

What that recent emergency department survey didn’t tell us

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

emergency-roomEarlier this month many of us received a news release from the American College of Emergency Physicians about a survey that indicates emergency department visits are rising along with coverage expansion under the Affordable Care Act. This was happening even though one important goal of the health law is to connect people with primary care physicians so they wouldn’t feel compelled to go to the ED for primary care.

While many of us ignored the release or, at most, wrote a brief; some large news outlets did give the survey big play, even linking the increase to expanded Medicaid coverage. The tone of that coverage, at least in a few pieces I saw, was that this was a negative development. Continue reading

Reporters offer state, local story ideas for covering ACA #ahcj15

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

The first day of Health Journalism 2015 featured a session “The ACA: Will it survive? And how to cover it now” with Kaiser Health News’s Julie Appleby and Vox’s Sarah Kliff. Their major themes included:

Julie Appleby & Sarah Kliff

Julie Appleby & Sarah Kliff

  • The King v. Burwell Supreme Court case over federal subsidies
  • What’s next in Congress?
  • Exchanges
  • Medicaid
  • And – the topic that got by far the most attention from the crowd – narrow networks.

Here are some of their highlights and story suggestions, with an emphasis on stories that state and local reporters can tackle. (Here are Kliff’s slides.) Continue reading

Maintaining Medicaid ‘bump’ a state-by-state endeavor

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Medicaid pay rates for doctors in many states traditionally have been extremely low – so low that most physicians didn’t want to participate in the program, or take on more Medicaid patients than they already had.

Joe Moser

According to the Kaiser Family Foundation, Medicaid had paid only 59 percent of what Medicare did for primary care before that.

The Affordable Care Act raised the rates for primary care providers to be equal to Medicare pay. Medicaid had paid only 59 percent of what Medicare did for primary care before that, according to the Kaiser Family Foundation. The snag: the Medicaid “bump” lasted for only two years, until the end of 2014. And Congress has not renewed it, although there has been a bit of preliminary talk about it. Continue reading

Personal story illustrates multiple barriers to health care, need for navigators

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Image by FutUndBeidl via Flickr

Image by FutUndBeidl via Flickr

Elizabeth Piatt begins the narrative of her reluctant journey into the Medicaid dental care system this way:

“In the spring of 2010 a terribly infected tooth forced my sister, Veronika, to the emergency department (ED). This story began, however, several months before. It is flica story of Medicaid, access to the best care, information and misinformation, and the gap between the haves and the have-nots.”

Piatt’s piece, “Navigating Veronica: How Access, Knowledge and Attitudes Shaped My Sister’s Care” was featured in February’s Health Affairs. (AHCJ members have free access to Health Affairs.)

Piatt, an assistant professor and chair of the Sociology Department at Hiram College in Hiram Ohio, brings a social scientist’s eye and a story-teller’s flair to the tale. Continue reading

In global struggle to care for aging populations, plenty of room for improvement

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology and Home Care Technology report. She is a senior fellow at the Center for Health, Media & Policy at Hunter College in New York City, and co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Photo: Chester Paul Sgroi via Flickr

Photo: Chester Paul Sgroi via Flickr

Compared with other industrialized nations, patients age 65 or older in the U.S. are generally in poorer overall health and have more challenges paying out-of-pocket expenses than their counterparts in other industrialized nations, according to a new study in the November 2014 issue of Health Affairs. (Remember, AHCJ members get free access to Health Affairs.)

Older adults in 11 nations – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States – were asked by telephone about their health and health care delivery. Among the 15,617 adults, age 65 or older, who participated in the 2014 Commonwealth Fund International Health Policy Survey of Older Adults, 20 percent of respondents in every country except France reported problems with care coordination. Access to primary care was most challenging in Canada, the U.S., and Sweden. Continue reading