Challenge nets $4.8 million for Medicaid

August 21, 2012

State Attorney General Rob McKenna said Washington is due to receive $4.8 million for Medicaid through a national settlement against drug wholesaler McKesson Corp.

Officials said the company violated the Federal False Claims Act and state false claims acts by reporting inflated pricing information for a large number of prescription drugs, overcharging the state Medicaid program.

The case revolved around the average wholesale price benchmark used by most states to set pharmacy reimbursement rates for drugs dispensed to Medicaid beneficiaries.

State officials said McKesson Corp. reported inflated average wholesale price data to First Data Bank, a publisher of drug prices, thereby inflating many average wholesale prices used by the state to set reimbursement rates.

Through a national settlement, Washington recovered $10.3 million, including the $4.8 million for the state Medicaid program.

Issaquah senator sponsors bill to reform Medicaid

March 12, 2012

NEW — 6 a.m. March 12, 2012

Lawmakers — including local state Sen. Cheryl Pflug — passed legislative to crack down on Medicaid fraud and recover taxpayer funds.

The measure, Senate Bill 5978 or the Medicaid Fraud False Claims Act, aims to create additional tools for the state to pursue Medicaid fraud. Supporters said the effort could raise millions of dollars in fraud recoveries in the years ahead. The legislation is modeled on a longstanding federal program.

The measure relies on whistleblower tips to learn about fraud from health care companies out to defraud the state Medicaid system.

The act encourages health care company employees to alert state regulators to fraud. The legislation then awards a portion of funds recovered during a successful investigation.

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Issaquah senator backs bill to tackle Medicaid fraud

May 21, 2011

NEW — 10 a.m. May 21, 2011

Cheryl Pflug

The state is a step closer to cracking down harder on Medicaid fraud, after lawmakers passed a measure to more aggressively prosecute fraud in the program and recover state funds.

State Sen. Cheryl Pflug, a registered nurse and a 5th Legislative District Republican, signed on as a cosponsor and, in a bipartisan effort, pushed the bill to colleagues. (The district includes Issaquah and East King County.)

Modeled on federal legislation, the state measure outlines incentives and whistleblower protections to employees who witness fraud in the workplace. The legislation allows the state to receive a greater share of recovered funds.

In addition, the measure empowers the state attorney general to contract out cases if the office is unable to pursue them.

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Washington state gets a ‘B’ on national dental exam

March 16, 2010

Thinkstock The Pew Center on the States graded Washington state’s pediatric oral health with a ‘B.’

A national study has given the state of Washington a “B” grade for its pediatric oral dental care.

The Pew Center on the States recently released its report, “The Cost of Delay: State Dental Policies Fail One in Five Children.” It graded all 50 states in eight categories on whether and how well they are employing what the Pew Center deems as “cost-effective policy solutions to ensure dental health and access to care for children.”

The Pew Center graded each state on the following criteria:

-Share of high-risk schools with sealant programs

-Hygienists can place sealants without dentist’s prior exam

-Share of residents on fluoridated community water supplies

-Share of Medicaid-enrolled children getting dental care

-Share of dentists’ median retail fees reimbursed by Medicaid

-Pays medical providers for early preventive dental health care

-Authorizes new primary care dental providers

-Tracks data on children’s dental heath.

Washington met or exceeded six of the eight, qualifying it for a B grade, tying it with eight other states, including Alaska, Colorado, Idaho, Illinois, Main, New Hampshire, Ohio and Texas. Read more

State cuts free immunizations

August 18, 2009

Lauren Anderson (right) inoculates her daughter Anna Zornes in 2006 with the vaccine at Virginia Mason's Issaquah Pediatrics and Adolescent Clinic as a protection against HPV, which infects about 6.2 million sexually active Americans sometime during their lifetime. File

Lauren Anderson (right) inoculates her daughter Anna Zornes in 2006 with the vaccine at Virginia Mason's Issaquah Pediatrics and Adolescent Clinic as a protection against HPV, which infects about 6.2 million sexually active Americans sometime during their lifetime. File

Parents, get your wallets and insurance cards out: Washington state is scaling back on free vaccinations for minors.

In July, Washington stopped using state funds to provide free vaccines for the human papillomavirus. Come May 2010, the state will stop subsidizing all childhood vaccinations, including measles, mumps and rubella, chickenpox, polio, hepatitis B and the diphtheria, tetanus and pertussis vaccine.

By cutting its Universal Vaccine Program, the state will save $48.5 million over the next two years.

The program began in 1990, when the state began providing free vaccinations for children under 19. In 1994, the federal government provided additional funds through the Vaccines for Children program. Read more