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

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.

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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

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.

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

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.

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.

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.

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

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

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

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.

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

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.,

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

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

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

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

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

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

Brave Health Raises $40M for Medicaid Virtual Health Platform

HIT Consultant

What You Should Know: – Brave Health , a virtual mental health provider and engagement platform focused on serving Medicaid populations raises $40M in Series C funding round led by Town Hall Ventures , with existing investors Union Square Ventures, City Light Capital and others joining as well.

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

HHS approves Medicaid housing intervention program in Arizona

Healthcare Dive

It’s the latest demonstration approval from the agency, following others in Oregon and Massachusetts targeted at expanding access to coverage and addressing nutrition and housing needs

UnitedHealth bracing for Medicaid redeterminations to resume

Fierce Healthcare

UnitedHealth bracing for Medicaid redeterminations to resume. pminemyer. Fri, 10/14/2022 - 07:30

Abortion rights, Medicaid expansion win in state midterms

Healthcare Dive

Voters in California, Michigan and Vermont passed measures codifying abortion rights, while those in conservative Kentucky rejected an anti-abortion measure

CMS aims to mandate state quality reporting for Medicaid, CHIP

Healthcare Dive

The proposed rule would require states to report on quality measurements for the two growing programs for the first time

Who doesn’t text in 2022? Most state Medicaid programs

Healthcare It News

Postal Service and an online account this summer to connect with Medicaid enrollees about the expected end of the covid public health emergency, which will put many recipients at risk of losing their coverage. West Virginia has more than 600,000 Medicaid enrollees.

Former Dental Office Manager Sentenced to One Year in Prison 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.,

Abortion access, Medicaid expansion, medical debt on state ballots

Healthcare Dive

The battle over abortion rights continues to play out at the state level in wake of the Supreme Court's ruling that overturned Roe v.

15M Medicaid enrollees risk coverage loss when PHE ends, HHS reports

Healthcare Dive

A disproportionate number of those who stand to lose coverage are children and young adults, according to the agency

Delaware awards statewide Medicaid contracts to 3 insurers

Healthcare Dive

Coverage under the managed care program will begin next year

Manager of Dental Office Sentenced to Prison 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., Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according.

4 ways Medicaid could manage high-price drugs

Fierce Healthcare

4 ways Medicaid could manage high-price drugs. fdiamond. Mon, 11/21/2022 - 15:09

Nebraska awards Medicaid managed care contracts to 3 insurers

Healthcare Dive

The health plans, selected from a field of five, will receive five-year contracts

BCBSA study: Maternal health disparities exist across commercial, Medicaid populations

Fierce Healthcare

BCBSA study: Maternal health disparities exist across commercial, Medicaid populations. pminemyer. Wed, 09/21/2022 - 16:11

Brave Health Secures $40M in Series C Funding to Expand Access to Mental Health Services for Medicaid Populations

Healthcare IT Today

Brave Health , the largest virtual mental health provider and engagement platform focused on serving Medicaid populations, today announced a $40M Series C funding round led by Town Hall Ventures, with existing investors Union Square Ventures, City Light Capital and others joining as well.

Urban Institute: Most adults unaware of looming Medicaid eligibility redeterminations

Fierce Healthcare

Urban Institute: Most adults unaware of looming Medicaid eligibility redeterminations. rking. Wed, 11/16/2022 - 17:17

Ineligible Medicaid Provider Arrested for Defrauding Medicaid of More Than $68K

Healthcare Compliance Blog

An ineligible Medicaid provider was arrested in Florida for defrauding Medicaid of more than $68,000. According to a Medicaid Fraud Control Unit investigation, the provider had failed to disclose his former felony convictions that precluded Medicaid from accepting the application.

Three Clinical Labs and Their Owner Charged with Medicaid Fraud and Kickbacks

Healthcare Compliance Blog

The post Three Clinical Labs and Their Owner Charged with Medicaid Fraud and Kickbacks appeared first on Med-Net. Client Alerts client alerts Fraud Kickbacks Medicaid

Fraud 87

Q&A: Ensuring digital health programs work for the Medicaid population

Mobi Health News

Ochsner Health Chief Digital Officer Dr. Denise Basow discusses the health system's remote monitoring pilot program for Medicaid patients with chronic conditions like hypertension and Type 2 diabetes

Brave Health Raises $10M for Virtual Behavioral Health for Medicaid

HIT Consultant

What You Should Know: – Brave Health , a Miami-based virtual behavioral health provider for Medicaid, today announced it has closed a $10M Series B round ($20.75M in total) led by City Light Capital, Union Square Ventures and Able Partners, bringing its total funding to $20.75M.

Molina to pay $150M for Wisconsin Medicaid firm in latest acquisition

Healthcare Dive

Acquisitions are key to Molina’s growth strategy, CEO Joe Zubretsky has said

CMS aims to streamline Medicaid, CHIP enrollment process

Fierce Healthcare

CMS aims to streamline Medicaid, CHIP enrollment process. rking. Wed, 08/31/2022 - 17:03