Bill of Health

APRIL 13, 2022

When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. Continuity of Coverage.

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Medicaid Medicaid COVID-19 Public Health 144

Compliancy Group

FEBRUARY 12, 2024

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Fierce Healthcare

SEPTEMBER 19, 2023

Troubled insurtech Bright Health must shell out about $380 million to the Centers for Medicare & Medicaid Services (CMS) over the next 18 months, according to a recent

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ACA Medicaid Medicaid Medicare 61

Kaiser Health News

APRIL 16, 2024

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

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Hall Render

FEBRUARY 21, 2023

For SNFs, the data would be reported by completing the Form CMS-855A Medicare enrollment application (“CMS-855A” or “Form”). For NFs, the data would be reported via means prescribed by the particular state Medicaid agency.

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Center for Health Insurance Reform

MARCH 31, 2023

The Affordable Care Act (ACA) recently celebrated its 13th anniversary with historic enrollment growth in the health insurance Marketplaces and the lowest-ever recorded uninsured rate.

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Health Insurance ACA Medicaid Medicaid 97

Health Populi

JULY 31, 2019

Among Democrats and people leaning Dem, the most popular health reform “form” is to expand coverage further building on the Affordable Care Act (ACA) (55%) versus replacing it with a Medicare-For-All plan (39%) for which Bernie Sanders and Elizabeth Warren passionately argued in last night’s debate.

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ACA Health Care Reform Health Insurance Medicare 56

Health Populi

SEPTEMBER 12, 2019

The big headline in this poll following last night’s third Democratic Presidential debate is that 55% of Democrats and Democrat-leaning Independent voters prefer a candidate that will build on the Affordable Care Act (ACA) versus a President that would replace the ACA with a Medicare For All plan (M4A). The post Most U.S.

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ACA Medicare Medicare Medical Billing 52

Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

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Medicaid Medicaid ACA Public Health 52

Health Populi

AUGUST 28, 2019

These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?”

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Medicare Medicare ACA Prescription Drug Pricing 94

Center for Health Insurance Reform

MARCH 31, 2022

In the proposed Notice of Benefit and Payment Parameters for 2023, the Centers for Medicare & Medicaid Services asked for feedback on how to promote health equity through ACA marketplace operations and plan certification standards.

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ACA Health Insurance Medicaid Medicaid 94

Compliance Now

JANUARY 13, 2022

To comply with the ACA, non-grandfathered health plans cannot require a participant to pay more out-of-pocket during the plan year than the amounts listed below. Under the ACA, the out-of-pocket limitation requirement directly applies to essential health benefits. This is a $.13

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Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. United States Dep’t of Health & Hum. 20-50963, 2022 WL 807554, at *1 (5th Cir. The Risk-Adjustment Program.

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ACA US Department of Health and Human Services Health Insurance Medicaid 52

Health Populi

DECEMBER 6, 2023

The future of Medicare and Medicaid as well as access to mental health care also rank high among two-thirds of U.S. Stay tuned to IRA components addressing prescription drug costs, and Medicare and Medicaid status (provider payments for the former, state-level moves for the latter).

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Prescription Drug Pricing Medicaid Medicaid ACA 81

Kaiser Health News

FEBRUARY 8, 2022

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.

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Kaiser Health News

DECEMBER 23, 2021

Some of the largest increases are in Florida, Texas, Georgia and nine other states that have not expanded Medicaid under the Affordable Care Act. Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. The previous marketplace enrollment record was 12.7

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Health Insurance ACA Medicaid Medicaid 93

Healthcare IT Today

DECEMBER 22, 2020

CMS has released a proposed rule that will require Medicaid managed care plans and other insurers offering products on the ACA Exchanges to support the sharing of patient data amongst themselves.

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ACA Medicaid Medicaid Medicare 145

Health Populi

JUNE 18, 2021

workers with private insurance more likely report poor access to health care, greater costs of care, and lower satisfaction with care versus people covered by public health insurance plans — whether Medicaid, Medicare, VHA or military coverage. Health Populi’s Hot Points: U.S. households. households.

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ACA Health Insurance Medicaid Medicaid 133

HIT Consultant

FEBRUARY 6, 2024

Expanding Payer Reach and Expertise Based in Chicago with 160 experienced professionals, HealthScape offers comprehensive consulting services to payers across all segments, including commercial, Medicare, Medicaid, ACA, and federal.

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ACA Medicaid Medicaid Medicare 52

Kaiser Health News

MAY 21, 2024

“We want the Centers for Medicare & Medicaid Services to hold these brokers criminally responsible for ripping people off this way,” he told KFF Health News. Finally, he wants the agency to review private-sector platforms used by agents and brokers to enroll consumers in ACA plans.

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ACA Medicaid Medicaid Doctors 97

Bill of Health

FEBRUARY 27, 2023

For example, Medicaid, the Children’s Health Insurance Program, many aspects of the Public Health Service Act, and the National Emergencies Act all rely on both federal administration and partnership with states to implement federal goals. Federal statutes enacted after these decisions in the mid-1990s tend to include a federal fallback.

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Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

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ACA Prescription Drug Pricing Health Insurance Hospitals 113

Kaiser Health News

JULY 6, 2022

Since late 2010, when this provision of the ACA took effect, many patients have paid nothing when they undergo routine mammograms, get one of more than a dozen vaccines, receive birth control, or are screened for other conditions, including diabetes, colon cancer, depression, and sexually transmitted diseases. The ACA does set parameters.

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Healthcare IT News - Telehealth

AUGUST 29, 2022

Galileo first launched with in-home care for Medicare and Medicaid patients, creating a framework to include social determinants of health in clinical analysis and to bridge gaps in healthcare education. We currently power UnitedHealthcare's Virtual-First ACA Exchange plan in multiple states with more coming in 2023.

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Telemedicine ACA Medicaid Medicaid 151

Bill of Health

FEBRUARY 10, 2023

Failing to anticipate litigation that challenges our efforts, such as with the ACA or the upcoming attempt to “codify Roe v. That is why the ACA’s Medicaid expansion doesn’t exist in 11 states , why the penalties for failing to have insurance under the “individual mandate” has been set to $0.00.

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Public Health Health Care Reform ACA COVID-19 261

MedTrainer

MAY 10, 2024

This process is vital for enhancing the accessibility and affordability of mental health services, aligning with the comprehensive healthcare coverage expansions under the Affordable Care Act ( ACA ). It can also be a prerequisite for enrolling with an insurance network or Medicare for the first time. Effective Jan.

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Licensing ACA Medicare Medicare 52

Healthcare IT Today

FEBRUARY 21, 2024

Based in Chicago with 160 professionals, HealthScape helps payers across all segments, including commercial, Medicare, Medicaid, ACA, and federal, navigate the evolving healthcare landscape.

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ACA Medicaid Medicaid Medicare 94

HIT Consultant

JANUARY 31, 2024

Expanding Access and Improving Quality Through this collaboration, both organizations aim to deliver high-quality care through value-based arrangements to patients with diverse insurance coverage, including Medicare, Medicaid, ACA Marketplace, and commercial plans.

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ACA Medicaid Medicaid Medicare 52

Kaiser Health News

OCTOBER 13, 2022

Meanwhile, open enrollment for Medicare begins Oct. 15, when beneficiaries can join or change private Medicare Advantage plans or stand-alone prescription drug plans. Democrats were aware of this problem even as they passed the ACA. The Obama administration had decided that only Congress could fix the glitch.

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Medicare Medicare ACA Governance 67

Healthcare Law Blog

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

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ACA Medicaid Medicaid Compliance 105

HIT Consultant

NOVEMBER 22, 2021

Health Fidelity’s technology uncovers insights that enable better care planning and more complete revenue capture; giving health plans and providers the ability to succeed in risk-sharing arrangements across Medicare Advantage, Affordable Care Act (ACA), Medicaid, and Accountable Care Organization programs.

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ACA Medicaid Medicaid Medicare 52

Bill of Health

MAY 12, 2023

No state Medicaid program covers IVF. HIPAA and the ACA both responded to concerns about “job lock” – that employer-sponsored insurance restricted job mobility and entrepreneurship. Individual-market plans sold on the exchanges in those 15 states that have infertility benefit mandates will have some coverage; the rest may not.

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Healthcare Law Blog

DECEMBER 11, 2023

Permitting states to expand Medicaid eligibility by disregarding more income and resource threshold standards for individuals that are excepted from the application of the Modified Adjusted Gross Income financial methodology. for Medicare & Medicaid Servs. On November 24, 2023, the U.S.

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Medicaid Medicaid ACA Medicare 52

CMS.gov

NOVEMBER 2, 2018

CMS BLOG: Medicare for All? Seema Verma, Administrator, Centers for Medicare & Medicaid Services . Medicare Part C. Medicare Part D. Medicare for All? When listening to those advocating ‘Medicare for All’ it’s good to be skeptical about their promises. keya.joy-bush@…. Fri, 11/02/2018 - 21:32.

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Governance Medicare Medicare ACA 55

Health Law RX

MAY 3, 2022

Federal appeals courts have been split on whether such damages are available to plaintiffs bringing discrimination claims under the Rehabilitation Act of 1973 (Rehab Act) and the Patient Protection and Affordable Care Act (ACA). The Rehab Act bars funding recipients from discriminating because of disability.

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ACA Medicaid Medicaid Medicare 52

Health Populi

JANUARY 24, 2019

The first chart notes important nuances under the majority support for a national health plan which, in this case, asked whether people favored a plan “sometimes called ‘Medicare for all.'” ” I note that note all national health plan designs would need to be tied to Medicare. from a low of 10.9

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ACA Medicare Medicare Health Insurance 62

The Health Law Firm

JANUARY 29, 2015

This hypothetical situation begs the question: Why would physicians agree to treat Medicaid patients? Treating Medicaid patients has never been a money maker for physicians. However, for the past two years, Medicaid programs have been required to reimburse primary care providers at Medicare levels, which is typically higher.

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