News in brief - July 25, 2005

Dr. Nelson named to Medicaid panel - Illinois agrees to provide more money for children's health care - Pa. HMO settles false claims charges - Supreme Court to hear case involving protests outside abortion clinics

Dr. Nelson named to Medicaid panel

American Medical Association Immediate Past-President John C. Nelson, MD, MPH, in July was named to a federal commission tasked with reforming the Medicaid system.

The panel, which Health and Human Services Secretary Michael Leavitt selected, will advise the department on ways to stabilize the health program for low-income and disabled people. Under the chairmanship of former Tennessee Gov. Don Sundquist, members will draft a report by Sept. 1 with recommendations on how to reduce Medicaid spending by $10 billion over the next five years.

Dr. Nelson will advise the commission but will not be able to vote on its final recommendations. The AMA also nominated Carol Berkowitz, MD, president of the American Academy of Pediatrics, for the group. She will serve as a nonvoting member as well.

Illinois agrees to provide more money for children's health care

Illinois officials settled a 13-year-old lawsuit last month when it agreed to devote more financial resources to help promote better health care for low-income children, including higher reimbursements for physicians who accept Medicaid patients.

The settlement, which a federal judge provisionally approved, also calls for increased payments to federally qualified health centers. Children's advocates sued the state saying that it was not providing the care promised to children under Medicaid.

Pa. HMO settles false claims charges

AmeriChoice of Pennsylvania, a Philadelphia-based Medicare and Medicaid HMO, in June settled false claims allegations by agreeing to pay the federal government $1.6 million.

The government accused AmeriChoice of violating federal civil false claims laws by failing to process or pay physician or other health care claims in a timely fashion and making inaccurate reports of claims processing data to the state between 1995 and 1998. AmeriChoice, which operates in 13 states, denied any wrongdoing. It was acquired by UnitedHealth Group in 2002.

Supreme Court to hear case involving protests outside abortion clinics

The U.S. Supreme Court later this year will hear a case involving protests outside abortion clinics, a topic that has made frequent appearances in the federal court system.

The case, which pits the National Organization for Women against Joseph Scheidler and his Pro-Life Action League, asks if abortion clinic protestors should be held accountable for actions under federal anti-racketeering and anti-extortion laws.

The court ruled in 2003 that protesters could not be held accountable for their actions under two federal laws dealing with those issues. But the case is going before the high court again because an appeals court had further questions about the high court's ruling.