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Senate Finance Committee Completes Health Reform Legislation, House Leaders Continue Moving Toward a Single Bill

At 2:08 a.m. on October 2, Senate Finance Committee Chair Max Baucus (D–MT) announced that the Senate Finance Committee completed all sections of its health care reform bill, the America’s Health Future Act of 2009. The announcement ends a committee markup period that began September 22 and covered 564 amendments; a final Finance Committee vote is expected October 6 or 7. Among other changes, the committee accepted amendments weakening the individual insurance mandate, requiring members of Congress to obtain insurance through the bill’s exchanges, and allowing seniors to deduct out-of-pocket expenses exceeding 7.5 percent of their income.

Pharmacy Groups Sue States Over Medicaid Drug Prices

The National Association of Chain Drug Stores, the National Community Pharmacists Association, and other smaller pharmacy groups sued California, New York, and Washington on September 30 over a failure to adjust Medicaid prescription reimbursements to account for new average wholesale prices set September 26. The associations claim that the states violated the Social Security Act by failing to get the new rates approved, and the associations’ lawyers report that failure to implement the change could cost drug stores $200 million annually.

SAMHSA Awards $16.8 Million to States and Communities To Support Healthy Transitions for Mentally Ill Youth

On September 24, SAMHSA announced $16.8 million in state and community grants for integrated home- and community-based services for youth and young adults with serious mental illness. The program, called the Healthy Transitions Initiative, will issue 5-year grants to develop or build upon existing systems to provide youth and their families with educational, employment, and mental health assistance in Georgia, Maine, Maryland, Missouri, Oklahoma, Utah, and Wisconsin.

GAO Report Finds Medicaid Fraud and Abuse Related to Controlled Substances

A Government Accountability Office (GAO) report presented on September 30 to the Senate Homeland Security and Governmental Affairs Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security documented 65,000 instances of improper distribution of controlled substances under Medicaid programs in California, Illinois, New York, North Carolina, and Texas during Fiscal Year (FY) 2006 and FY 2007. The GAO estimates that the fraud and abuse cost $65 million over 2 years, and Senate panel members suggested better Medicaid oversight as a potential source of health reform savings.

KFF Medicaid Directors Survey Finds Enrollment and Cost Increasing

The Kaiser Family Foundation (KFF) Commission on Medicaid and the Uninsured released a report and fact sheet detailing the results of the Medicaid budget survey for states in FY 2009 and FY 2010. The survey found that Medicaid enrollment grew an average of 5.4 percent in FY 2009, while average Medicaid spending increased 7.9 percent over the same time. The survey also determined that, based on initial legislative appropriations, states face an average 6.6 percent enrollment increase and 6.3 percent cost increase for FY 2010. Finally, the survey found that, although the American Recovery and Reinvestment Act funding allowed 36 states to avoid eligibility reductions, 33 states reduced or froze provider reimbursement rates and 39 more are expected to do so in FY 2010.

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