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Medicaid and Health Equity: CalAIM’s Bold Experiment

Healthcare Law Blog

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. It envisions enhanced coordination, integration, and information exchange among managed care plans (MCPs); physical, behavioral, community-based, and social service providers; and county agencies.

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The New Search for Reproductive Justice in Old Laws

Bill of Health

Passed in 1986, EMTALA requires hospitals accepting Medicaid or Medicare payments from HHS or CMS to provide abortion care necessary to address emergency medical conditions. Because most hospitals rely on Medicaid and Medicare payments, the law currently applies to nearly all hospitals in the U.S. In June 2022, the U.S.

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Reflections on the United States Health Care System and the Right to Health

Bill of Health

America is the only wealthy nation to lack universal health coverage. Many areas have also faced critical staff shortages , which impacted the delivery of safe care and safety net services. By the end of 2022, nearly 1.7 Unfortunately, the unprecedented low rate of uninsurance in 2022, has proved temporary.

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Addressing Ghost Networks in Mental Health Care

Bill of Health

The Consolidated Appropriations Act of 2023 requires Medicaid plans to publish and update accurate and searchable provider directories. In November 2022, Senator Tina Smith (D-Minn.) Insurers should also work to decrease the shortage of mental health care providers in their networks. and Senator Ron Wyden (D-Ore.)

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Payor-Led Initiatives to Strengthen Mental Health Resources

Healthcare Law Blog

1] In addition to the challenges presented by provider shortages, even when patients are able to locate an available mental health provider, many are hesitant to engage in treatment due to cost uncertainties, which often arise due to limited availability for in-network care and the subsequent need to seek out-of-network care. [2]

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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. 79452 (2022)). The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.

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Health Equity and SDoH – 2023 Health IT Predictions

Healthcare IT Today

Financial health must be recognized as inseparable from health. From 2020 to 2022, consumers were more likely to receive the care they needed, but cost concerns have become more common than health concerns. In 2022, 31% of people reported they chose to defer care, due to cost concerns.