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Above: Rep. Paul Ryan, R-Wis., points to piles of the health care overhaul legislation during a markup hearing before the U.S. House Budget Committee last year in Washington, D.C.

The addition of Rep. Paul Ryan to the GOP ticket is certain to elevate health care as a campaign issue this fall. Most of the debate is likely to be about Medicare, and Ryan's controversial plan to transform the popular program for the elderly and disabled.

But some of the attention is likely to focus on Medicaid, the health care program for those with low incomes, as well.

Medicaid not Medicare is actually the nation's largest health insurance program, covering some 60 million Americans with very limited incomes. But you'd be excused for not knowing that, because Medicaid doesn't get nearly as much attention as Medicare does.

That may be changing, however. The Supreme Court earlier this summer put the program in the news when it ruled that the Medicaid expansion in the 2010 health law must be optional for states.

That's given more ammunition to Republicans, including presidential candidate Mitt Romney, who want to offer states far more responsibility for Medicaid.

"The state is the best place to determine what is the best way to help those poor," Romney said in a health care speech at the University of Michigan in 2011. "And so I would therefore block grant to the states' Medicaid funds, and say to the states, 'You now use these monies as you feel appropriate to care for your own poor.' "

Only there's a catch, said President Obama in a speech to Associated Press editors in April. Under the Republican congressional budget Romney has endorsed, Medicaid funding would not only be turned back to the states, it would be cut substantially.

"They would have to be running these programs in the face of the largest cut to Medicaid that has ever been proposed," he said, "a cut that, according to one nonpartisan group, would take away health care from about 19 million Americans."

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Medicaid Fight Enlivened With Romney-Ryan Ticket

ATLANTA--(BUSINESS WIRE)--

LexisNexis Risk Solutions today announced the availability of LexisNexis Provider Integrity Scan, an advanced data solution to assist private and public health care payers in verifying and monitoring health care provider licensing and credentials, and detecting and preventing fraudulent or criminal provider activity. Organizations using Provider Integrity Scan benefit from reduced health care costs by identifying potentially fraudulent providers and businesses enrolled or attempting to enroll in health-related programs.

In todays health care environment, if an improper claim payment is made, health plans have a less than 50 percent chance of recovering the funds. CMS estimates Medicaid fraud, waste, and abuse alone to be over $30 billion annually, while NHCAA estimates conservatively that overall fraud accounts for 3 percent of our nation's annual health care spending or approximately $69 billion. These factors require health plans to systematically monitor payment activities and diligently ensure that the risk of improper payments and other forms of provider fraud is reduced.

Health care payers continue to be challenged with increasing regulations from the Centers for Medicare and Medicaid Services (CMS) to ensure enrollment is limited to legitimate providers and suppliers, pending standards within state agencies and rising losses associated with fraud and improper payments, said Harry Jordan, vice president and general manager, health care, LexisNexis. Knowing the best way to reduce fraud, waste, and abuse is to prevent it, LexisNexis helps payers take a proactive approach to uncovering derogatory attributes linked to providers. This approach reduces a payers exposure to fraud before it impacts their bottom line, regulatory compliance and patient safety.

LexisNexis Provider Integrity Scan automates a variety of provider verification searches and ongoing monitoring options, and provides automatic red flag alerts for a wide range of high risk indicators. It gives payers the ability to efficiently process multiple searches and obtain critical information contained within massive volumes of provider data within the nations public and private health plans.

The solution offers payers efficiency in processing power, utilizing LexIDSM and access to more than 40 billion public and proprietary records from more than 10,000 sources.LexID is among the fastest linking technology available, enabling customers to identify, organize information quickly and link records together. This speed and accuracy is important in combating fraudulent providers who use family and cohorts to set up new businesses in other cities or states once theyve been flagged or sanctioned by health care payers.

For more information about LexisNexis Provider Integrity Scan, please visit http://www.lexisnexis.com/risk/hc-identity-management.aspx .

About LexisNexis Risk Solutions

LexisNexis Risk Solutions (www.lexisnexis.com/risk/) is a leader in providing essential information that helps customers across all industries and government predict, assess and manage risk. Combining cutting-edge technology, unique data and advanced scoring analytics, Risk Solutions provides products and services that address evolving client needs in the risk sector while upholding the highest standards of security and privacy. LexisNexis Risk Solutions is part of Reed Elsevier, a leading publisher and information provider that serves customers in more than 100 countries with more than 30,000 employees worldwide.

Our health care solutions assist payers, providers and integrators with ensuring appropriate access to health care data and programs, enhancing disease management contact ratios, improving operational processes, and proactively combating fraud, waste and abuse across the continuum.

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LexisNexis® Provider Integrity Scan Identifies Fraudulent Providers and Organizations, Reduces Health Care Payer Costs

TAHLEQUAH Women across the U.S. no longer have to pay for certain health care services, including birth control, which are now covered under the Patient Protection and Affordable Care Act.

Effective Aug. 1, PPACA requires most health insurance plans to cover eight preventive care measures without charging a co-payment or deductible: well-woman visits; gestational diabetes screening; domestic and interpersonal violence screening and counseling; FDA-approved contraceptive methods and education; breastfeeding support, supplies and counseling; HPV DNA testing for women 30 and older; and STD counseling, and HIV screening and counseling.

In May, more than 40 Catholic institutions filed 12 lawsuits in federal jurisdictions, asserting the contraception rule violated religious tenets. But according to the U.S. Department of Health and Human Services, the law allows some nonprofit religious employers to choose whether to cover contraceptive services.

Kathleen Sebelius, secretary of HHS, said an additional element has been added: Nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until Aug. 1, 2013, to comply. Employers who want the extra time must certify they qualify for it.

According to a recent report by Bloomberg, organizations such as churches, which may not provide insurance coverage for contraception, are still exempt from the requirement, as are primary and secondary schools affiliated with religious organizations. But universities, charities, hospitals and other religiously-connected entities must comply.

Despite the recent Supreme Court ruling that PPACA is constitutional, Becky Bernhardt, assistant press secretary for Sen. Tom Coburn, R-Okla., said he believes the rule is unconstitutional. Coburn says it dangerously expands the federal governments role in health care, and takes away even more of our individual and religious freedoms.

Coburn is a physician who specializes in obstetrics and gynecology. He is also opposed to PPACA.

Forcing Americans to finance contraceptives and abortifacients is an assault on religious freedom and individual liberty, said Coburn. This mandate is also completely unnecessary, as these products are already widely available at extremely low prices at clinics across the country. This mandate has nothing to do with serving women, and everything to do with expanding governments control over health care.

Dr. Jena Rogers, M.D., who specializes in internal medicine at Tahlequah Medical Group, believes the ruling is beneficial for all women.

No matter what community you are talking about, preventive health visits for women, and for men, are beneficial, said Rogers. Technology and education in health care have improved so much over time that it is much easier and safer to get tested. The percentage of women who now have mammograms have almost doubled in the past 15 years. Screening for diabetes is also much easier and cost-effective.

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Law expands preventive care for women

Republican Paul Ryan's blueprint for Medicare could prove as polarizing in the campaign as President Barack Obama's health care overhaul has been. Even Mitt Romney may not want to go there.

Here is the original post:

GOP VP pick's Medicare plan back in spotlight

Several area hospital leaders say they need more time to determine how a new bill to control health-care costs will impact their institutions, but they agree action is necessary to make health care more affordable.

The first-in-the-nation 349-page bill was signed into law by Gov. Deval Patrick on Aug. 6.

"It's an extremely complex bill, and we don't really know how it's all going to play out," said Patrick Muldoon, president and CEO of HealthAlliance Hospitals. "We said consistently that it's terrific we have health-care reform, but now we have to figure out how to make it affordable because the system we have now is unsustainable."

Norm Deschene, president and CEO of Lowell General Hospital, said the bill meets the goals of the hospital community to deliver quality and affordable care.

"The bill clearly recognizes that there needs to be a number of different approaches to meeting those goals; we agree with many of those programs," wrote Deschene in an email.

The bill is intended to save up to $200 billion in health-care costs over the next 15 years by moving the state toward a payment system in which doctors receive an annual budget for each patient's care, known as a "global payment system," rather than having them charge a fee for each service or test provided. Like the 2006 universal-access law; however, it could be years before its changes are fully implemented and its impacts known.

While the law's critics say it represents a thicket

The law says medical costs must grow at the same rate as the state's economy until 2017. After that, health-care costs must grow even slower.

A state board, known as the Health Policy Commission, will help hospitals meet these goals. Deschene credits lawmakers for preventing the board from automatically taxing or punishing hospitals that don't meet the benchmarks. Hospitals will instead be required to file a performance-improvement plan.

As a last resort, the bill does allow the board to fine providers up to $500,000 for failing to file or faithfully implement its improvement plan.

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Health-care reform's impact as yet unseen