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The Daily Scan

Last Updated: 8:35 AM EST


  • Warning of a nearly $300 million potential shortfall in Kentucky's Medicaid program, officials say they could eliminate health coverage for more than 480,000 people to balance the state's budget. Kentucky's Medicaid program spends about $11.5 billion every year, but most of that money comes from the federal government. Cabinet for Health and Family Services Secretary Adam Meier told state lawmakers Thursday that Kentucky's share of that budget will be $296 million short by 2020 — money that must come from the cash-strapped state. (USNews.com)

  • Opponents of a proposal to expand Medicaid to more low-income Nebraskans are taking their legal challenge to the next level. Former State Sen. Mark Christensen of Imperial and Sen. Lydia Brasch of Bancroft filed notice Wednesday that they plan to appeal their case, after losing in district court.

The two filed a lawsuit last month intended to keep the Medicaid expansion proposal off the November ballot. They argued, among other things, that the proposal contains more than one subject, in violation of the Nebraska Constitution, and does not properly disclose the Nebraska Appleseed Center for Law in the Public Interest as a petition sponsor. (Omaha.com)


  • A resident of Sewickley, PA, pleaded guilty in federal court to charges of unlawfully distributing controlled substances, conspiracy to distribute controlled substances and health care fraud, United States Attorney Scott W. Brady announced today. Michael Bummer pleaded guilty to three counts before United States District Judge Arthur J. Schwab. In connection with the guilty plea, the court was advised that Bummer was a physician practicing at Redirections Treatment Advocates, a Suboxone clinic, located in Washington, PA. Bummer admitted that he and others conspired together to create and submit unlawful prescriptions for buprenorphine, known as Subutex and Suboxone, and then unlawfully dispensed those controlled substances to other persons. Bummer also admitted to committing health care fraud for causing fraudulent claims to be submitted to Medicaid and Medicare for payments to cover the costs of the unlawfully prescribed buprenorphine. (Justice.gov)

  • David Kirkwood was sentenced in U.S. District Court on Wednesday to 70 months in prison and five years of supervised release for running a pill mill in Dayton. In August 2017, Kirkwood and his wife, Beverly Kirkwood, pleaded guilty to health care fraud. David Kirkwood also pleaded guilty to one count of unlawful drug trafficking. According to court documents, David Kirkwood owned and operated Kirkwood Family Practice in Dayton beginning in 1986. David Kirkwood distributed nearly 4,000 units of Oxycodone outside the scope of medical practice and not for a legitimate medical purpose. All of these units were paid for by Medicare or Medicaid. The doctor often used the same billing code for his customers regardless of the service performed, and would accept health care insurance payments for examinations that were not medically appropriate or sufficient for the billing codes submitted. Those bills were submitted on behalf of the practice and with the assistance of Beverly Kirkwood, who has been sentenced to six months in prison. (Justice.gov)

  • A Maryland man who was employed as a personal care aide pled guilty on Wednesday to a federal charge of health care fraud stemming from a scheme in which he submitted more than $66,000 in false claims to the District of Columbia Medicaid program. Between September 2012 and April 2014, Njong caused false claims to be submitted by two home health care agencies to the District of Columbia’s Medicaid program for personal care services that he did not provide or that were tainted by the payment of kickbacks to the Medicaid beneficiary. During the time period, Njong was assigned to provide personal care services to two Medicaid beneficiaries. He submitted false timesheets for work that was not provided. Starting in August 2013, for example, he began working full-time as a teacher in Maryland. Notwithstanding his full-time employment, he continued to submit timesheets to the two home health care agencies claiming to be working full-time for them. In addition, he paid one of the beneficiaries approximately $100 bi-weekly to sign blank or false statements; he also provided the beneficiary with food or other items of value in exchange for the beneficiary’s signature on false timesheets. (Justice.gov)


  • Yesterday, the Office of Justice Programs’ Bureau of Justice Assistance (BJA) released the Fentanyl Safety Recommendations for First Responders’ companion training video Fentanyl: The Real Deal. The video was produced by U.S. Customs and Border Protection to help first responders protect themselves when the presence of fentanyl is suspected or encountered on the job. Fentanyl: The Real Deal provides recommendations to law enforcement on how to navigate safely around the increased prevalence of fentanyl in the illicit drug market. The video provides first responders with unified, scientific, and evidence-based recommendations for protective actions first responders should take when the presence of fentanyl is suspected, when exposure occurs, and when individuals exhibit signs of opioid intoxication. "Exposure to synthetic opioids like fentanyl is one of the most dangerous threats facing law enforcement officers," Deputy Attorney General Rod J. Rosenstein said. "The Department of Justice worked with the White House, other Cabinet agencies, and many law enforcement organizations to produce a new safety video and training recommendations for first responders. I urge law enforcement officers to review the advice and take precautions to stay safe." (Justice.gov)

#Medicaid #Litigation #Regulation


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