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Churntables: A Look at the Record on Medicaid Redetermination Plans

Bill of Health

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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Better Data for Better Health Among Medicaid Recipients

HIT Consultant

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

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Digital Therapeutics Alliance applauds bill to guide public Rx coverage

Healthcare It News

The Medicaid and CHIP Access to Prescription Digital Therapeutics Act seeks to expand care options that can help improve health outcomes and quality of life for those facing barriers to healthcare. The act would also define "prescription digital therapeutic" in Medicaid and allow U.S. WHY IT MATTERS.

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Long Awaited Approval of the 1115 Waiver Amendment for NYS Medicaid – Just in Time for the New York State Executive Budget State Fiscal Year (SFY) 2025

Health Care Law Brief

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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The Latest KFF Poll on Consumer Experiences with Health Insurance Speaks Volumes About Patients’ Administrative Burden

Health Populi

People love being health-insured, but their negative experiences with health plans create serious burdens on patients-as-consumers. The 2023 Kaiser Family Foundation Survey of Consumer Experiences with Health Insurance updates our understanding of and empathy for insured peoples’ Patient Administrative Burdens (PAB).

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CMS Issues “In Lieu of” Services Guidance to Address Health-Related Social Needs in Medicaid Managed Care

C&M Health Law

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

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Navigating the Intersection of Payment Integrity and Provider Relations in Healthcare

Innovaare Compliance

According to the National Health Care Anti-Fraud Association, the financial losses due to healthcare fraud are estimated to be in the billions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1

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