Vice President Kamala Harris and former President Donald Trump delivered their final pitches to the American public this week ahead of election day on November 5. Both candidates refined their positions on healthcare policy and the people they'd entrust with health matters should they win the White House.
Throughout the campaign...
Researchers found the average Medicaid payment covered about 82% of reported costs, meaning nursing homes typically received 82 cents for each dollar spent on Medicaid residents' care.
Using Medicaid payment data from individual states and Medicare cost reports for freestanding nursing homes in 44 states, ASPE researchers...
The latest issue brief from the Assistant Secretary for Planning and Evaluation (ASPE) outlines Medicaid’s positive effects on low-income children and non-elderly adults while emphasizing how expanded eligibility benefits the country’s health and economy.
Medicaid, established in 1965, is the largest health insurer in the U.S.,...
This week, the National Committee for Quality Assurance (NCQA) announced a partnership with the Arizona Health Care Cost Containment System (AHCCCS) to support participants in the Targeted Investments (TI) 2.0 Program.
The partnership pledges to support health equity accreditation by addressing health disparities on the population...National News
A Republican-controlled Congress coupled with a second Trump presidency could spell Medicaid cuts and bigger barriers to Medicaid access.
After the second presidential debate, KFF couldn't help but notice that the future of Medicaid was never raised in a question to either former President Donald Trump or Vice President Kamala Harris....
The Issue brief defines prior authorization and how this process used by Medicaid fee-for-service programs and managed care organizations (MCOs) requires approval before providing specific items, services, or medications.
Prior authorization (PA) aims to prevent unnecessary utilization, limit improper, fraudulent, and wasteful...
This week in Medicaid a judge sides with the Centers for Medicare and Medicaid Services (CMS) against work requirements, the North Carolina Medicaid expansion remains on pace for over 600,000 additional members and the status of 1115 Waiver renewals nationwide.
The Georgia Pathways to Coverage program was the only one in the nation...Arizona News
The U.S. Department of Justice announced that it has taken action to end a healthcare fraud scheme in Arizona that preyed on elderly patients and defrauded health payers $1.6 billion.
The DOJ announced it had charged 193 people with healthcare fraud in the sweep, all affiliated with companies Apex Mobile Medical LLC, Apex Medical LLC,...National Reports & Surveys
The uninsured rate is likely to climb over the next decade according to projections from the Congressional Budget Office (CBO).
The CBO said that it expects the rise in uninsured Americans was elevated to a higher rate when 23 million people lost benefits during the Medicaid redetermination period last year. More could lose insurance...National News
National health spending continues to skyrocket and is expected to eclipse one fifth of the total U.S. economy by 2032, according to projections released last week by the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary.
The Office of the Actuary estimates that national health spending rose to $4.8 trillion in...National News
The U.S. is in a maternity care crisis with some of the highest rates of maternal mortality in the world and ever-worsening access to reproductive healthcare services and providers due to punitive abortion restrictions and low reimbursement. The Medicare program wants to fix that.
Time reports that the health are system is failing the...
The Task Force on Maternal Mental Health that was ordered by the Biden-Harris Administration last September has issued a national strategy to improve maternal mental healthcare and submitted a report to Congress on their policy recommendations.
The National Strategy is not limited to recommendations for the U.S. Department of Health...
GLP-1 agonist medications are the hot topic of the health world, as the drugs that were initially designated to treat diabetes have demonstrated efficacy in producing significant weight loss. But as more Americans are accessing these drugs, the price tag for the manufacture and distribution of the highly-sought treatment remains a big...CMS Rules
The Biden administration's nursing home minimum staffing rule could have a major impact on states' Medicaid programs, adding another layer of complexity to the highly anticipated and very controversial rule.
The nursing home minimum staffing rule is estimated to cost the residential care home industry up to $6.5 billion in additional...Arizona News
The Biden administration finalized a rule that will allow recipients of the Deferred Action for Childhood Arrivals (DACA) program to receive healthcare under the Affordable Care Act.
More than 100,000 previously uninsured DACA recipients, also known as Dreamers, are anticipated to enroll in the ACA Marketplace and the Basic Health...CMS Rules
The Biden administration finalized rules that would increase transparency and increase protections for Medicaid members in managed care plans. It also finalized the Ensuring Access to Medicaid Services Rule on Monday that requires home care providers to use a minimum of 80% of Medicaid payments to pay aides and nurses.
The new...Arizona News
UnitedHealth Group (UHG) this week is scrambling to remain the victim in the cyberattack that knocked subsidiary Change Healthcare offline for over three weeks, preventing payment for services to providers and disrupting prior authorization requests and pharmacy business nationwide.
On Tuesday, the company announced that it is now in...National News
Medicaid managed care, as it varies state-to-state, is a complex and dynamic umbrella of care delivery. The National Association of Medicaid Directors (NAMD) published an in-depth explainer on Medicaid managed care to illuminate the program's intricacies.
Medicaid agencies contract with managed care organizations (MCOs), usually...
A new report by healthcare research firm ATI Advisory determined that the Centers for Medicare and Medicaid Services (CMS) is not doing enough to reconcile incongruities between the Medicare and Medicaid programs for dually eligible beneficiaries in long-term care.
The ATI Report found that the over one million full benefit...
Last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) held its annual meeting where the draft of the annual March Report to Congress on Medicaid and the Children's Health Insurance Program (CHIP) was presented.
In the meeting, the commission discussed and voted on seven recommendations to change the mechanism for...
