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Upcoming Medicaid redeterminations could hamper hospitals, payers

Healthcare Dive

Medicaid eligibility checks beginning in April will likely curb hospital revenue and enrollment growth for payers, Moody's Investors Service said in a report

Medicaid 299
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North Carolina becomes 40th state to expand Medicaid

Healthcare Dive

The expansion puts an end to a decade-plus political battle in North Carolina over Medicaid and illustrates mounting support for the program

Medicaid 236
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Medicaid enrollees largely unaware of upcoming redeterminations, survey finds

Healthcare Dive

About 64% of adults in a Medicaid-enrolled family said they did not know they may lose coverage once pandemic-era policy ends and eligibility checks resume on April 1, a survey from the Robert Wood Johnson Foundation found

Medicaid 309
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Prison Health Care is Broken Under the Medicaid Inmate Exclusion Policy

Bill of Health

As a first step to protecting incarcerated individuals’ right to health, Congress should repeal the Medicaid Inmate Exclusion Policy (MIEP). The MIEP, established in 1965, prohibits Medicaid from covering incarcerated individuals, despite any prior eligibility. By Sarah Wang.

Medicaid 276
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Maven raises $90M, fueling push into Medicaid, CMO says

Healthcare Dive

Roadblocks for the startup inclulde shifting requirements state-by-state and historically low margins in Medicaid

Medicaid 269
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Google plans to boost Medicaid information during redeterminations

Healthcare Dive

Google also shared an a updated version of its medical artificial intelligence that can answer clinical questions at an “expert” level at its annual healthcare event on Tuesday

Medicaid 317
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One Medical’s innovation chief on Amazon, Medicaid and more

Healthcare Dive

Rushika Fernandopulle discussed how remote work trends are affecting the business, One Medical’s ongoing shift toward risk and its interest in Medicaid

Medicaid 268
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Majority of states plan to take their time with Medicaid redeterminations

Healthcare Dive

Some states are proposing to unwind Medicaid coverage more slowly, while others are moving more quickly to focus on reducing budgetary costs, according to a survey from the Kaiser Family Foundation

Medicaid 269
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Could Medicaid redeterminations cause short-term health plan signups to spike?

Healthcare Dive

Short-term plan operators will likely ramp up their marketing in April to nab new consumers from the Medicaid churn, but health policy experts largely aren't concerned

Medicaid 300
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Medicaid redeterminations will restart Saturday. Here’s what we know

Healthcare Dive

States can begin disenrolling ineligible beneficiaries from Medicaid on April 1, in an event the CMS has called the biggest health coverage transition since the first ACA open enrollment

ACA 130
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California revises Medicaid contract awards, adding 2 insurers

Healthcare Dive

Five insurers will now receive lucrative contracts to provide managed care services, starting in 2024, in the country's largest Medicaid market

Medicaid 212
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Omnibus bill restarts Medicaid checks, lowers Medicare physician pay cuts

Healthcare Dive

Lawmakers are rushing to speed passage of the $1.7 trillion omnibus spending package as they near a Friday deadline for government funding

Medicaid 316
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Molina, Elevance, Centene win big with Medicaid contracts in California

Healthcare Dive

The managed care organizations already held Medicaid contracts with the state, but the overhaul in counties served is causing one payer to consider appealing the proposed contracts

Medicaid 223
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South Dakota Voters to Decide Medicaid Expansion

Kaiser Health News

South Dakota voters will decide in November whether the state should become the 39th to expand Medicaid under the Affordable Care Act, a move that would provide coverage to 42,000 low-income residents. It would apply to the Medicaid initiative in November.

Medicaid 137
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Manager of Dental Office Sentenced to One Year Prison Term for Defrauding Medicaid Out of More Than $813,000

The Health Law Firm Blog

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. By George F. Indest III, J.D., M.P.A.,

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18M projected to lose Medicaid coverage at end of COVID-19 emergency

Healthcare Dive

Many people who are currently enrolled in Medicaid will transition to other coverage, but 3.8 million people will completely lose insurance, according to the Robert Wood Johnson Foundation

Medicaid 253
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Molina, Elevance nab Iowa Medicaid contracts on heels of California win

Healthcare Dive

Iowa will soon have three health insurers to manage its $7 billion Medicaid program

Medicaid 247
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Centene Agrees to Pay $19 Million to Washington State For Medicaid Fraud Allegations

The Health Law Firm Blog

By George F. Indest III, J.D., M.P.A., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations.

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Dental Office Manager Sentenced to 12 Months in Prison for Defrauding Medicaid Out of More Than $813,000

The Health Law Firm Blog

On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. By Carole C. Schriefer, J.D. Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according to the U.S.

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Rollback of pandemic protections to test Medicaid managed care organizations

Healthcare Dive

At question is whether insurers will be able to shift Medicaid members who lose coverage to subsidized marketplace plans

Medicaid 209
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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.

Medicaid 137
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Stakes are high in California’s Medicaid market shakeup

Healthcare Dive

Four insurers that lost out on lucrative contracts in the state’s first-ever competitive process are challenging the managed care provider selections

Medicaid 275
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Medicaid stakeholders warn of hurdles for redeterminations process

Healthcare Dive

Resuming the process of determining whether people are still eligible for Medicaid may sound easy, but stakeholders caution it's much more nuanced than flipping a switch, and poor planning risks massive enrollment losses

Medicaid 264
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End of Medicaid continuous coverage may leave millions of children uninsured, analysis finds

Healthcare Dive

Children are at highest risk in Texas, Florida and Georgia when states resume checking Medicaid eligibility after the public health emergency expires, Georgetown University researchers found

Medicaid 317
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Centene Will Pay $19 Million to Washington State For Medicaid Fraud Allegations

The Health Law Firm Blog

By George F. Indest III, J.D., M.P.A., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations.

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Proposed CMS rule would streamline Medicaid, CHIP enrollment

Healthcare Dive

The proposal comes as states begin to notify Medicaid beneficiaries about potential losses of coverage due to the impending end of the COVID-19 public health emergency

Medicaid 195
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Centene Will Pay $19 Million Settlement to Washington State For Medicaid Fraud Allegations

The Health Law Firm Blog

By George F. Indest III, J.D., M.P.A., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations.

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Supreme Court throws out Medicaid work requirement cases

Healthcare Dive

On Monday, the high court said the requirements were now moot given the Biden administration's dismissal of the policies, and sent them back to the trial court with instructions to dismiss prior judgments

Medicaid 361
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Centene to Pay Washington State $19 Million to Resolve Medicaid Fraud Allegations

The Health Law Firm Blog

By George F. Indest III, J.D., M.P.A., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations.

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North Carolina Republicans draft Medicaid expansion bill

Healthcare Dive

The proposal, signaling growing support for expansion among state lawmakers after years of opposition, would add 600,000 low-income adults to the safety net health insurance program

Medicaid 233
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Centene Reaches $166 Million Settlement With Texas Over Its Medicaid Drug Pricing

The Health Law Firm Blog

Board Certified by The Florida Bar in Health Law The nation's largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. By George F. Indest III, J.D., M.P.A.,

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Insurers may be padding Medicaid physician networks, study finds

Healthcare Dive

Some doctors listed in managed care provider network directories didn't file any Medicaid claims over the course of a year, according to new research published in Health Affairs

Medicaid 206
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First Medicaid mobile mental health service to launch in Oregon

Healthcare Dive

The program supports the 988 national hotline and is part of President Joe Biden's strategy to combat the country's mental health crisis

Medicaid 264
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Humana inks deal to expand in Medicaid managed care

Healthcare Dive

The payer acquired Wisconsin-based Inclusa on the heels of its $2.8 billion divestiture of Kindred at Home's hospice and personal care units

Medicaid 272
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Are You the Target of a Medicaid Audit? Tips Health Professionals Should Be Following

The Health Law Firm Blog

By George F. Indest III, J.D., M.P.A.,