How hard will a Republican work to deny a poor person health care? Pretty hard, if his name is Deal or Brownback

People wait to receive a wristband number for medical treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia July 20, 2012. RAM clinics bring free medical, dental and vision care to uninsured and under-insured people across the country...

How hard will a Republican work to deny a poor person health care?
by Joan McCarter
Daily Kos
Apr 22, 2014

Back in February, news broke of Georgia Gov. Nathan Deal's efforts to make sure that no governor of Georgia could ever decide to take Medicaid expansion, giving the legislature veto power over any future governor's decision to do so. But it's not just Deal. Kansas's Gov. Sam Brownback (R) is doing it too.

Georgia and Kansas have left a combined 487,000 residents uncovered under Obamacare because they refused to expand Medicaid. And, though the law remains unpopular, a recent poll found that majorities of Georgians (54 percent) and Kansans (55 percent) support Medicaid expansion.

This 32-Year-Old Florida Woman Is Dead Because Her State Refused To Expand Medicai

Charlene Dill died because Florida Republicans refused to expand Medicaid that would have paid for her heart health care CREDIT: GoFundMe

This 32-Year-Old Florida Woman Is Dead Because Her State Refused To Expand Medicaid
By Tara Culp-Ressler
Think Progress
April 9, 2014

Charlene Dill, a 32-year-old mother of three, collapsed and died on a stranger’s floor at the end of March. She was at an appointment to try to sell a vacuum cleaner, one of the three part-time jobs that she worked to try to make ends meet for her family. Her death was a result of a documented heart condition — and it could have been prevented.

Dill was uninsured, and she went years without the care she needed to address her chronic conditions because she couldn’t afford it.

Under the health reform law, which seeks to expand coverage to millions of low-income Americans, Dill wasn’t supposed to lack insurance. She was supposed to have access to a public health plan through the law’s expansion of the Medicaid program. But Dill, a Florida resident, is one of the millions of Americans living in a state that has refused to accept Obamacare’s Medicaid expansion after the Supreme Court ruled this provision to be optional. Those low-income people have been left in a coverage gap, making too much income to qualify for a public Medicaid plan but too little income to qualify for the federal subsidies to buy a plan on Obamacare’s private exchanges.

Florida has one of the highest uninsurance rates in the nation, and is home to a disproportionately large number of residents who struggle to afford health services. Nonetheless, lawmakers have continued to resist accepting generous federal funds to expand Medicaid to an estimated 750,000 low-income Floridians like Dill.

Although Florida Gov. Rick Scott (R) initially indicated that he was in favor of accepting the funds for expansion, he’s since walked back that position. Meanwhile, Republicans in the legislature don’t even plan to schedule a vote to address Medicaid expansion during their current session, suggesting that the federal government won’t actually come through with the funding to support the policy.

Dill made about $9,000 annually by babysitting, cleaning houses, and selling vacuum cleaners. As the Orlando Weekly reports, she was optimistic about her coverage options under President Obama’s administration. She tried to sign up for Obamacare using the online calculator on HealthCare.gov, but quickly found out she fell within the coverage gap.

In the absence of health coverage, Dill’s best friend, Kathleen Voss Woolrich, occasionally turned to crowdfunding sites on the internet to raise the money Dill needed to pay for her heart medication. Last month, Woolrich crowdfunded to pay for Dill’s funeral.

In an emotional blog post published on the site Women on the Move at the end of last month, Woolrich blamed Florida politicians for her friend’s early death.

“You see the main argument Republicans use is that it’s some lazy person who needs Medicaid expansion. That those of us living without healthcare or dental care are lazy. But my friend, a single beautiful mother, worked three jobs,” Woolrich wrote. “I am burying my best friend because of the policies of the Republican Party. I am burying my best friend because had Medicaid expanded, her needs would have been met.”

And Dill won’t be the only one. A recent study conducted by Harvard researchers estimated that as many as 17,000 people will die directly as a result of their states refusing to expand Medicaid. In Florida, that translates to about six deaths like Dill’s every single day. This issue is exacerbated by the fact that the low-income residents in states that have resisted Medicaid expansion tend to have more health problems than the residents in other states.

Democratic officials in Florida have responded strongly to Woolrich’s story. Rep. Alan Grayson (D) — who told the Orlando Weekly that his colleaugues’ resistance to Medicaid expansion “has put the GOP’s appalling disregard for human life on full display” — entered Woolrich’s blog post into the Congressional record.

“I memorialized Charlene’s life and death in the Congressional Record, because the Republicans want to pretend that none of this is happening. That Charlene didn’t die as a result of their callous neglect — that no Floridians will die as a result of their willful refusal to expand Medicaid at no cost,” Grayson explained. “But I’m not going to let them forget. I’m not going to let them pretend. This is not a game; this is very real. This is life and death.”

Bayer pays $242 million for knowingly misreporting its "best price" to HCFA and underpaying its Medicaid rebates for private labels for Kaiser

Bayer has agreed to pay $242,126,570 in damages and penalties to the federal and state governments for knowingly misreporting its "best price" to HCFA and underpaying its Medicaid rebates for Cipro and Adalat CC that was private labeled for Kaiser and PacifiCare from its determination of "best price.

CURRAN ANNOUNCES OVER $300 MILLION NATIONAL
SETTLEMENT WITH DRUG MANUFACTURERS
Maryland to Receive Approximately $2 Million
Maryland Attorney General
April 16, 2003

Attorney General J. Joseph Curran, Jr. announced today that his Medicaid Fraud Control Unit is among 48 Units nationally to reach settlements, in principle, with GlaxoSmithKline GSK and Bayer Corporation for violating the federal Medicaid drug rebate statute by failing to report "best price" information and their resulting failure to pay sufficient rebates to the state Medicaid programs in connection with their private labeling of certain drugs for health maintenance organizations.

In addition to the civil settlement, amounting to $87,600,922 in damages and penalties to the federal government and the states, GSK will enter into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General. At the insistence of the National Association of Medicaid Fraud Control Units, GSK will be required to certify its "best price" methodology. This will add a new responsibility for the manufacturer and will enhance future state enforcement.

Bayer has agreed to pay $242,126,570 in damages and penalties to the federal and state governments for knowingly misreporting its "best price" to HCFA and underpaying its Medicaid rebates for Cipro and Adalat CC that was private labeled for Kaiser and PacifiCare from its determination of "best price." Bayer will plead guilty to a charge of violating the Food, Drug and Cosmetics Act in federal district court in Boston. The government will recommend that Bayer pay a fine of $5,590,800. An addendum with new obligations will be added to Bayer’s current Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General. At the insistence of the National Association of Medicaid Fraud Control Units, the CIA will require Bayer to certify its "best price" methodology. This new responsibility will enhance future state enforcement.

The National Association of Medicaid Fraud Control Units represents the 48 federally certified Medicaid Fraud Control Units that investigate and prosecute Medicaid provider fraud.

These settlements, which include 49 states and the District of Columbia, together with two major drug manufacturers represent the largest national Medicaid fraud settlements ever.

Both Bayer and GlaxoSmithKline sold products to HMOs at deeply discounted prices, and then concealed and avoided their obligation to pay additional rebates to the Medicaid programs. This was accomplished by re-labeling or re-packaging these drugs under the HMO’s private label. This fraud scheme is referred to as "lick and stick."

The federal Medicaid drug rebate statute is designed to return money to the Medicaid program in the form of rebates from drug manufacturers. Under the statute, in order to have the pharmaceuticals eligible for Medicaid payment, all pharmaceutical manufacturers must provide "best price" information to the Centers for Medicare and Medicaid Services (formerly HCFA). "Best price" is the lowest price that a manufacturer offers its products for sale to commercial purchasers. CMS uses this "best price" information to calculate rebates payable to the state Medicaid programs under the statute.

GlaxoSmithKline

The U.S. Attorney’s Office for the District of Massachusetts conducted an investigation into alleged improprieties relating to the reported "best price" for Flonase, a nasal spray, and Paxil, an anti-depressant. Flonase was manufactured and sold by Glaxo Wellcome and Paxil was manufactured and sold by SmithKline Beecham. These two companies merged and became GlaxoSmithKline in December 2001.

Through a private labeling agreement with Kaiser Permanente, an HMO in California, Glaxo Wellcome manufactured, packaged and shipped Flonase to Kaiser, but substituted the Kaiser unique identifying number for the Glaxo Wellcome unique identifying number on the label. The purpose of the private labeling arrangement was to provide Kaiser additional price discounts on Flonase without having to report the discounted price as Glaxo Wellcome’s "best price", thereby avoiding the obligation to pay additional rebates to Medicaid under the Medicaid rebate program. Similarly, SmithKline began private labeling Paxil for Kaiser. Paxil was manufactured, packaged and shipped by SmithKline to Kaiser, but SmithKline substituted Kaiser’s unique identifying number for SmithKline’s unique identifying number on the label. SmithKline provided Kaiser additional price discounts on Paxil without reporting the newly discounted price to the Medicaid rebate program, thereby avoiding payment of additional rebates.

Medicaid improves health and budgets of poor

Medicaid improves health and budgets of poor
Jul 7, 2011
(Reuters)

Medicaid, a government health insurance program designed to help the poorest of the poor, is giving people unprecedented access to doctors and also improvihttp://www.blogger.com/img/blank.gifng their finances, a study co-authored by the Harvard School of Public Health has found.

The study, released on Thursday, showed that new recipients of Medicaid reported better physical and mental health and were less likely to go into debt to pay their medical bills.

The fate of Medicaid -- the health program for people and families with low incomes and resources -- has been hotly debated for its role in the ballooning U.S. deficit. The Obama administration's healthcare overhaul passed last year requires all U.S. states to extend eligibility to millions more people by 2014.

The study followed health outcomes a year after a 2008 Medicaid expansion in Oregon, where 10,000 uninsured low-income adults won coverage through a lottery.

The results show that Medicaid helps poorer Americans well beyond the default safety net options that exist for people without coverage, according to the researchers from Harvard, the Massachusetts Institute of Technology, the National Bureau of Economic Research and Providence Health & Services...

Health-care law: Arizona tries new approach to get by federal Medicaid rules

Health-care law: Arizona tries new approach to get by federal Medicaid rules
By N.C. Aizenman
Washington Post
January 23, 2011

Republican efforts to repeal or limit the reach of the new health-care law took a new direction last week when Arizona lawmakers approved a novel and controversial attempt to cut Medicaid for 280,000 of the state's poor.

The bill, requested and signed by Gov. Jan Brewer (R), empowers her to make a formal request, most likely this week, for a federal waiver to avoid complying with provisions of the law that prohibit states from tightening their eligibility requirements for Medicaid.

Twenty-nine Republican governors, including Brewer, have signed a letter calling on President Obama and congressional leaders to remove the provision from the law.

But Arizona is the first state to, in effect, play chicken with the Obama administration by directly requesting a reprieve and daring Health and Human Services Secretary Kathleen Sebelius to refuse.

The move is widely regarded as a long shot. While a spokesman said the White House had no comment on Arizona's request, administration officials have shown scant interest when asked about the idea in the past.

Still, Arizona's move reflects two pressing realities: Many states face large budget shortfalls because of continuing economic difficulties, and Republican governors point to Medicaid cuts as one of the most logical ways to balance those budgets...