Medicaid

LeadingAge rallies against proposed Medicare, Medicaid changes

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A leading nursing home advocate is mustering support to combat massive changes the administration has proposed for Medicare and Medicaid participation.

It's pretty clear what they're really committed to

It's pretty clear what they're really committed to

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It was quite a week for ironic juxtaposition in the nation's capital.

Obtaining critical claims data may soon get easier

Obtaining critical claims data may soon get easier

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The government plans to make new claims data and other resident-care information available to providers and entrepreneurs as never before. Is it too good to be true?

Nursing homes blamed for high opt-out rates in dual eligible demo

Nursing homes blamed for high opt-out rates in dual eligible demo

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Huge numbers of dual-eligible beneficiaries are leaving a demonstration project that hopes to improve payments for people eligible for both Medicare and Medicaid.

GAO: Medicaid demonstration project costs not justified

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A new report to Congress says more justification is needed for the $146 billion being spent on demonstration projects, most of which have not been clearly shown to further the objectives of the Medicaid program. Medicaid funds more than two-thirds of U.S. nursing home care.

Also in the News for Thursday, May 14

Medical transport company failing to get patients to appointments on time, audit says ... Ohio settles Medicaid lawsuit ... Nursing home owner charged in Mohawk case

Also in the News for Wednesday, May 13

States look at protection for long-term care insurance buyers ... Right-to-die trial underway in Minnesota ... Unionized nursing home workers push legislators on Medicaid reimbursements

Weak data, unclear policy plague Medicaid payments: GAO report

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Medicaid provider payments are seriously hindered by limited data and "unclear policy," according to a new report to Congress that calls for greater oversight at numerous government-owned facilities where payments far exceed actual costs.

GAO: Small percentage of Medicaid beneficiaries costing much more

The Government Accountability Office last week released findings showing 5% of Medicaid-only eligible enrollees accounted for nearly 50% of the billions of government dollars paid in Medicaid-only eligible claims.

Playing fast and loose with Medicaid termination

Playing fast and loose with Medicaid termination

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There are many benefits to communicating to your cohorts in neighboring states, and not the least of it may be knowing when a provider is kicked out of Medicaid.

Senate to vote this week on new federal budget

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The U.S. Senate is scheduled to vote this week on a federal budget that promises to balance itself in nine years through billions of cuts in social programs and billions of extra dollars to defense.

Shady practitioners often go undetected across state lines: Report

Shady practitioners often go undetected across state lines: Report

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Nursing homes with visiting physicians or providers would do well to uncover their troubled histories with Medicaid or Medicare programs in other states or face billing nightmares, and worse, federal scrutiny.

Nursing home association wants no part of Medicaid managed care

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Managed care is not being warmly embraced by long-term care providers everywhere. Nearly 40 states are in various completion phases of transitioning to privatized Medicaid managed care systems, but Louisiana's nursing homes are defiantly resisting efforts there to have them join the party.

What will it cost you to stay in the post-acute care game?

What will it cost you to stay in the post-acute care game?

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More than just collecting data, providers need to use standardized, nationally recognized measures. Especially in this era of ACOs and alternative payment models. In the past, many individual providers used their own methodology to create their own "data driven" story.

Budget cut-hungry GOP walks fine line, eyeing 2016 elections

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House and Senate Republican lawmakers began working on a budget this week that could propose slashing Medicare and Medicaid in an effort to work toward a balanced budget without fiddling with tax rates, according to published reports.

Medicaid expansion a boon for early adopters: Report

Medicaid expansion a boon for early adopters: Report

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A new report produced for the prestigious Robert Wood Johnson Foundation concludes that Medicaid expansion provides a "win-win" for participating states and the government.

White House forums eyeball Medicaid funding concerns

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The White House Conference on Aging is collecting comments from long-term care stakeholders through a series of regional forums across the U.S. about their concerns regarding the future of Medicaid funding.

Advocates: Cost-relief decision hurts Medicare beneficiaries

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After giving the ruling a few days to sink in, several patient advocate groups now say a Supreme Court decision will end up hurting Medicaid beneficiaries more than anyone.

Also in the News for Friday, April 3

AHCA supports MedPAC vote on three-day stay policy ... CMS issues guidance on biosimilars, including for Medicare Part B ... HHS chief technology officer retiring ... Florida Dems push for Medicaid expansion

Supreme Court: Providers can't sue for higher Medicaid rates

Supreme Court: Providers can't sue for higher Medicaid rates

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The Supreme Court dealt a serious blow to Medicaid residential care providers on Tuesday in a ruling that prohibits them from suing for higher reimbursement to recoup escalating costs.

Non-whites get readmitted more often after joint replacement surgery: Study

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Non-whites covered by Medicaid and Medicare are significantly more likely to be readmitted to a hospital within 30 days after total joint replacement surgery than whites, according to a new study that was unveiled on Thursday at the 2015 Annual Meeting of American Academy of Orthopaedic Surgeons.

Also in the News for Thursday, March 26

Insurance companies struggle with long-term care ... Missouri's Medicaid program lost out on $27M, audit says ... B. Smith testifies on Alzheimer's at Senate hearing ... NLRB playing catch-up due to Supreme Court decision

Also in the News for Tuesday, March 24

OMB begins review of Medicaid managed care ... Medicaid expansion has led to surge in diabetes diagnosis...Statins can stop for terminal patients, researchers advise

Proposed House budget would slash Medicaid by $913 billion

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Few have ever heard a federal budget referred to as a "moral document," as one GOP budget committee lawmaker described it on Tuesday. That's when the House unveiled a 10-year budget whose $5.5 trillion in cuts are likely to be called anything but "moral" when the long-term care industry finishes analyzing it.

Medicaid IT systems need quality check: GAO

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A new report to Congress casts significant doubts on the integrity and effectiveness of information systems many state Medicaid programs use to process claims, and CMS has agreed with it its recommendation that they verify those systems when applying for Medicaid funds.

NAACP: Medicaid expansion would negate lost subsidies in NC

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The NAACP is pushing hard for lawmakers to approve Medicaid expansion efforts in North Carolina to give half a million state residents an alternative should they lose private insurance subsidized by the government under the Affordable Care Act.

Medicaid expansion plans fade in several states

Medicaid expansion plans fade in several states

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Several so-called "red states" are leaning toward or have outright abandoned plans to allow expansion of their Medicaid programs, bucking a nationwide groundswell of program enrollment under the president's signature healthcare reform law.

Medicaid expansion leading HCBS programs to rethink strategy: Researchers

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Researchers on Wednesday proposed ways to better identify the most susceptible nursing home candidates in order to ease the expected burden on programs designed to keep the chronically ill and frail elderly at home.

Swelling Medicaid rolls have states, providers worried

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California's Medicaid-eligible rolls are swelling as part of a nationwide expansion of the program under the Affordable Care Act, a finding that should give other states' Medicaid agencies pause over the coming year.

Federal judge orders the return of $90 million in Medicaid credits

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The state of Georgia may be the mouse that roared after convincing a federal court last week to force the government to return a bungled $90 million credit, even after ruling Health & Human Services had every right to reject the state's request.

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