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IndyStar's yearslong investigation reveals extent of Indiana nursing home scheme

IndyStar's yearslong investigation reveals extent of Indiana nursing home scheme

Yahoo23-03-2025
It's a great Sunday to love basketball, isn't it, Indiana?
While IndyStar readers open their Sunday editions or log on to IndyStar.com for their morning news ritual this Sunday, I'm sure I'll have already grown wistful over the encroaching end to my favorite weekend of the year.
But I'm writing this on Thursday, filled with anticipation ahead of the first tip-off of the NCAA men's and women's basketball tournaments. While it's hard to focus beyond the apex weekend for my favorite pastime, I'm also filled with gratitude for IndyStar subscribers' support of our mission to inform and empower Central Indiana through essential and exclusive local journalism.
So, before we return to the warm glow of televised basketball, indulge me for a few updates on what we've been up to at 130 S. Meridian St. and places beyond.
Just what is essential and exclusive local journalism, you ask? IndyStar investigative reporter Tony Cook has been delivering it for years.
Cook's latest reporting is a continuation of a 2020 investigation into Indiana county hospitals diverting Medicaid funds meant for the nursing homes they operate. That scheme has allowed the hospitals to to pad their bottom lines and pay for construction and other projects unrelated to nursing home care at a time when nursing home staffing in Indiana is among the worst in the nation.
Cook's reporting published this week uses data that was partially obtained through a public records lawsuit filed by IndyStar in 2022 to show, as he wrote, that "County-owned hospitals in Indiana have diverted away more than $2.5 billion in Medicaid money intended to provide care at nursing homes, leaving sick and elderly residents to languish in some of the most poorly staffed facilities in America."
A companion piece published Thursday shows that despite efforts to slash federal spending in President Donald Trump's second term, there's little appetite so far to address this scheme that's impacting the care of Indiana's most vulnerable residents.
Cook's dogged reporting is emblematic of IndyStar's commitment to watchdog and accountability journalism. Our investigative and expanded government accountability teams have worked independently and in collaboration to bring readers revelatory reporting about how decisions by Indiana's most powerful organizations impact our daily lives.
Two weeks ago, I put out the call for Indiana historians interested in contributing to our weekly Retro Indy feature. With more than 20 people sharing their qualifications and interest, it's clear I have some extra reading to do.
With a busy end to March ahead and May being dominated by Indy 500 coverage, we'll look to make some headway toward a selection in April. Until then, those interested in Indiana history should turn to today's sports section or head to IndyStar.com/sports for high school sports reporter Kyle Neddenriep's piece on how basketball's inventor, Dr. James Naismith, discovered his game's future here in Indiana. It's a great read.
Finally, IndyStar columnists James Briggs and Gregg Doyel both publish popular mailbag columns where they answer reader questions. Given that it's something I already do on a daily basis via e-mail, and perhaps I can provide answers more broadly, I'll try to emulate their success.
E-mail me at ericlarsen@indystar.com with the subject line "Ask the editor," or fill out the form at the end of the online version of this column to send in your question. Maybe you'll see it, and my answer, in a future edition.
Thanks for reading. Have a great week.
Eric Larsen is IndyStar executive editor. E-mail him at ericlarsen@indystar.com.
This article originally appeared on Indianapolis Star: IndyStar investigation reveals extent of Indiana nursing home scheme
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Care about babies and moms? This Big Beautiful Bill cut should scare you
Care about babies and moms? This Big Beautiful Bill cut should scare you

Miami Herald

time4 hours ago

  • Miami Herald

Care about babies and moms? This Big Beautiful Bill cut should scare you

An unseen provision in the recent congressional overhaul of Medicaid will bankrupt poor families with sick newborns — and raise costs for us all. Hidden within the 940 pages of the One Big Beautiful Bill Act is a reduction in Medicaid's ability to pay for care retroactively (care that has already been delivered) from 90 to 60 days. Shortening this window of payment targets parents of newborns, and will burden families with thousands of dollars of medical debt. Neonatologists and pediatricians care for critically-ill babies, including those with prematurity or congenital heart or intestinal defects. Many of the premature infants we care for have missed an entire trimester of development. Weighing 1 to 2 pounds at birth, they must overcome underdeveloped lungs, brains and immune systems. Their complex and expensive care begins in the first seconds of life. There is no time to apply for Medicaid. The previous 90-day retroactive period accounted for the practical aspects of applying for health insurance while being a new mother. Parents face obstacles negotiating the Medicaid system, especially in the context of a traumatic birth. A new mom recovering from a complicated delivery or cesarean section, and dealing with postpartum complications while trying to learn how to care for a newborn is not well positioned to immediately submit a Medicaid application. Additionally, it takes states — which control Medicaid enrollment — time to confirm parental income, residency and other requirements to qualify for Medicaid. The process can be cumbersome and is prone to backlogs. Nationally, roughly 15% of Medicaid applications are excessively delayed, meaning even if superhuman mothers applied the day their infant was born, many would be forced to pay for the first two weeks of neonatal intensive care, which costs $10,000 to $20,000 a day — too expensive for all of us. Ironically, this measure comes at a time when the White House is actively trying to increase the U.S. birth rate through baby-friendly policies such as one-time cash incentives of $5,000 per baby and federally subsidized fertility education. The problem is significant. Medicaid remains the largest single insurer of children, and pays for 40% of all newborns. Critically ill babies are overrepresented in Medicaid, as almost half rely on the program for coverage. Now, parents will receive astronomical medical bills when in the past Medicaid covered babies from their birthday. Parents of healthy newborns will be affected too. A healthy newborn spends 2 to 4 days in the hospital and typically has three or more outpatient visits in the first month of life. All these medical services risk being unpaid under the shorter retroactive period. Our fellow pediatricians are already worried the newborn care they provide will be unpaid, and they will have to limit the number of babies they see. 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Video/Pic: Trump demands drug companies lower prices
Video/Pic: Trump demands drug companies lower prices

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Video/Pic: Trump demands drug companies lower prices

President Donald Trump sent 17 pharmaceutical companies letters on Thursday and demanded that the companies lower prices for Americans. The president warned that the 'unacceptable burden' of prescription drug prices will 'end' with his administration. During a press briefing on Thursday, White House Press Secretary Karoline Leavitt said, 'The president signed an executive order earlier this year to solve the problem of exorbitant pharmaceutical pricing.' 'According to recent data, the prices that Americans have been paying for brand-name drugs are more than three times the price other similarly developed nations pay,' Leavitt added. 'The president is determined to solve this problem and took further action today. He has signed 17 letters to pharmaceutical companies' CEOs.' .@PressSec reads one of the letters sent by @POTUS today to the CEOs of pharmaceutical companies: "Moving forward, the only thing I will accept from drug manufacturers is a commitment that provides American families immediate relief from the vastly inflated drug prices…" — Rapid Response 47 (@RapidResponse47) July 31, 2025 Leavitt also shared the letter Trump wrote to the CEO of Eli Lilly and Company. In the letter, Trump warned Eli Lilly and 16 other pharmaceutical companies that the 'unacceptable burden' of brand-name drugs costing 'up to three times higher on average' for Americans than for citizens of other countries 'ends with my administration.' Trump told the pharmaceutical companies, 'Most proposals the Trump administration has received to resolve this critical issue promised more of the same shifting blame and requesting policy changes that would result in billions of dollars in handouts to industry.' The president added, 'Moving forward, the only thing I will accept from drug manufacturers is a commitment that provides American families immediate relief from the vastly inflated drug prices and an end to the free ride of American innovation by European and other developed nations.' READ MORE: Video: Trump order against 'Big Pharma' aims to reduce drug prices While Trump explained that a collaborative effort to reach 'global pricing parity' would be most effective for pharmaceutical companies, the U.S. government, and U.S. patients, he warned that his administration will 'deploy every tool in our arsenal to protect American families' if pharmaceutical companies refuse to take action. In addition to the letter sent to Eli Lilly and Company, Trump sent letters to AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, EMD Serono, Genentech, Gilead Sciences, GSK, Johnson and Johnson, Merck, Novo Nordisk, Novartis, Pfizer, Regeneron Pharmaceuticals, and Sanofi. In the letters, Trump gave the companies 60 days to extend 'Most-Favored-Nation' pricing to Medicaid and provide 'full portfolios' of drugs for Medicaid patients, guarantee Most-Favored-Nation pricing for new drugs, negotiate with 'foreign freeloading nations' and return 'increased revenues abroad' to patients in the United States, and allow Americans to directly purchase drugs at Most-Favored-Nation prices. Today, @POTUS sent letters to 17 drug manufacturers outlining steps they must take to bring down prescription drug prices. If they refuse to step up, the Administration will use every tool to protect Americans from continued abusive drug pricing practices. Letter to Eli Lilly: — Rapid Response 47 (@RapidResponse47) July 31, 2025

California Removes 900,000 People From Health Care Plan
California Removes 900,000 People From Health Care Plan

Newsweek

timea day ago

  • Newsweek

California Removes 900,000 People From Health Care Plan

Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Hundreds of thousands have been removed from a health care plan in California over the course of two years, according to data from KFF, a nonprofit health policy research and news organization. About 900,000 Americans were disenrolled from Medicaid in the state as part of the unwinding process happening nationwide after Medicaid coverage was expanded following the COVID-19 pandemic. Newsweek has contacted the California Department of Public Health via email for comment. Why It Matters The unwinding process has resulted in significant drops in Medicaid enrollment across the U.S. There is now growing concern about the rising population of those without health insurance and the wider impacts this could have, such as worsening health outcomes, increasing strain on emergency services and rising medical costs. The worry has been amplified by the recent passing of President Donald Trump's One Big Beautiful Bill, in which funding cuts, a focus on "waste, fraud and abuse" and work requirements are in store for Medicaid. Many have voiced concern that the measures will result in millions losing health coverage. File photo: A doctor walks with a young boy through a hospital. File photo: A doctor walks with a young boy through a To Know In California, there were 14,285,643 covered by Medicaid in March 2023, but by March 2025, that number was 13,392,566, KFF data shows. This was because during the pandemic, some states expanded Medicaid coverage under the Affordable Care Act (ACA), causing nationwide enrollment levels to increase. Federal rules forced states to keep most Medicaid enrollees on the program, even if their eligibility status changed, until March 2023, when they were then allowed to start rolling recipients off the program. This marks a change of about 900,000, a decline that was smaller than other highly populated states like Texas, Florida and New York. In March 2025, the number of people with Medicaid coverage in California was still higher than pre-pandemic levels, by 16 percent. The reason why Medicaid coverage is unwinding at different rates in states is because "states approached the process of reviewing the eligibility of their Medicaid beneficiaries with fundamentally different strategies," Michael Sparer, professor and chair of the Department of Health Policy and Management at Columbia University, told Newsweek. He said that Florida and Texas began the review process "as fast as they could and immediately declared ineligible those beneficiaries who did not promptly respond to review notices." "There is clear evidence that many beneficiaries who were still eligible lost coverage simply because they did not timely navigate the administrative hurdles to recertification," he added. Meanwhile, he said that New York and California "were far more deliberate in how they approached the review process, thus the number who've lost their eligibility via this process is far fewer." What People Are Saying Michael Sparer, professor and chair of the Department of Health Policy and Management at Columbia University, told Newsweek: "Medicaid enrollment surged during the pandemic for several reasons, including increased unemployment combined with a requirement that in exchange for additional federal funding, states could not recertify beneficiary eligibility until the "public health emergency" was declared over. Put simply, millions signed up during the pandemic and their eligibility could only be reviewed beginning in the spring 2023. "There is reason to be quite concerned about how this has played out and also what it suggests may happen when Medicaid work requirements, which create their own set of administrative hurdles, are implemented. First, persons who are eligible for coverage should not lose coverage. Bad health outcomes will follow. Second, persons who are no longer Medicaid eligible should be guided to other options, such as subsidized ACA marketplace coverage. Finally, the variation in how states conduct Medicaid eligibility reviews leads to unfortunate inequities." What Happens Next As the unwinding continues, more reductions in enrollment are expected in California and across the country. With millions already having lost health coverage, concerns remain about access to care for low-income individuals and families.

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