For the third year in a row, a record number of people have signed up for health insurance plans through the Affordable Care Act's (ACA) federal marketplace.
Federal officials estimate that more than 19 million people will enroll in 2024 coverage by the end of the enrollment period in January. According to the New York Times, already...
A new report by Syntellis and the American Hospital Association (AHA) could drive the fight between hospitals and Medicare Advantage providers to reach a head, as the analysis shows MA plans' claims denials are directly contributing to declines in cash reserves.
Claims denials increased 56% for the median hospital between January 2022...Arizona News
About a third of Arizona Medicaid members (128,960) were disenrolled for procedural reasons, which means although the Arizona Health Care Cost Containment System (AHCCCS) had information the member was ineligible, they failed to respond to the agency's request for information during the renewal process.
The unwinding from the...
Senator Krysten Sinema announced that she will co-sponsor the Rural Health Clinic Burden Reduction Act, a bipartisan bill that would update the original Rural Health Clinic Statute.
The bill, originally proposed in May by Senators John Barrasso (R-Wyo.), Tina Smith (D-Minn.), Marsha Blackburn (R-Tenn.) and Michael Bennet (D-Colo.),...
Arizona's Medicaid program announced this week that it hit the mid-point of the renewal process and boasted one million retentions to the program. During the quarterly Arizona State Medicaid Advisory Committee (SMAC) meeting this week, AHCCCS reported since April 2023, those losing Medicaid coverage in the state total 320,000 with...National News
Fewer Americans are uninsured than ever before according to new data from the Centers for Disease Control and Prevention (CDC). These numbers are anticipated to rise as Medicaid redeterminations continue.
The U.S. Department of Health and Human services (HHS) announced the milestone on August 3, boasting a 7.7% uninsured rate for the...Arizona News
The federal government is worried that procedural disenrollments are too high as the Medicaid redetermination process proceeds.
On Monday, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra published a letter requesting that states take advantage of allowances and flexibilities authorized by HHS in their...CMS Rules
States are employing tech vendors to help facilitate communications for the Medicaid redeterminations process, but they can't curb the high volume of enrollees losing coverage.
More than 90 million Americans must undergo eligibility review over the next several months and the U.S. Department of Health and Human Services has estimated...
Beginning next week, every skilled nursing facility in the country will undergo a five-claim audit as the Centers for Medicare and Medicaid Services (CMS) aims to get improper payments under control. Meanwhile, nursing homes are expressing concern about the effects that Medicaid redeterminations and subsequent disenrollment's could have...
As states proceed with Medicaid redeterminations after three years of a pause on eligibility review, hundreds of thousands of Americans are losing insurance coverage, according to early data reports. The Centers for Medicare and Medicaid Services (CMS) are stressing the importance of limiting the number of lost enrollees and facilitating...White Papers, E books, Reports and more
In honor of the tenth anniversary of the Affordable Care Act's (ACA) health insurance insurance exchange, consultancy McKinsey and Co. released a report evaluating the performance of the health insurance market in 2023.
The report relies on information collected from every health insurance exchange in the country and the 33...
Humana has revised its outlook, confident that its expected Medicare Advantage enrollment will increase even more than it originally anticipated in 2023. But Centene has reported the opposite, expecting to lose money in Medicare Advantage and from Medicaid redeterminations.
Centene released its first quarter (Q1) corporate reports on...
The first Medicaid redeterminations since the beginning of the COVID-19 pandemic have been underway in at least five states since the beginning of the month. Health advocacy groups are pressuring U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra to ensure that a "health equity and civil rights disaster" does not...
An analysis from the U.S. Department of Health Services found that unnecessary cancellations of Medicaid coverage during the redetermination process could impact 74% of enrolled children - Arizona is one of four states highlighted for its use of state and federal databases to determine family income as opposed to relying upon...
The COVID-19 national emergency has formally come to an end after President Joe Biden signed legislation that passed in the House in January along party lines and was sponsored by Arizona Republican Representative Paul Gosar.
At the end of last month, the Senate also passed the measure 68-23 with nearly two dozen Democrats supporting...
This week, the Arizona State Hospital (ASH) gets closer to being led by an independent governing board as the Arizona Senate approved SB 1710, sponsored by Senator Gowan.
As the Arizona Public Health Association (AzPHA) notes, the bill is widely supported because it resolves the current conflict of interest for the Arizona Department...Arizona News
With the Great Unwinding looming at the end of spring, insurers are now speaking up about their role in Medicaid redeterminations and a special enrollment period (SEP) for enrollees who may lose coverage in the process.
In a memo released at the end of January, the Centers for Medicare and Medicaid Services (CMS) announced that the...National News
As the COVID-19 public health emergency winds down, insurers of Medicaid managed care plans are bracing to lose membership.
Centene is expecting it will lose 2.2 million Medicaid members during the redetermination process over the next year. According to Modern Healthcare, the company had 16 million Medicaid members at the end of...National News
What major coverage transitions can we expect after the Public Health Emergency expires and state Medicaid agencies resume normal eligibility determinations and a predicted 18 million in the U.S. lose coverage?
The emergency declaration is expected to expire in April 2023 - people in Medicaid are expected to make the following...News
The Urban Institute reports its analysis of the June 2022 Health Reform Monitoring Survey finding that 62% of adults with family Medicaid enrollment had heard nothing at all about Medicaid renewals resuming creating a significant information gap among enrollees about the change once the PHE ends, which is now likely to be extended to...