Medicaid Managed Care
Over the next few weeks, the Centers for Medicare & Medicaid Services is expected to unveil an ambitious and comprehensive policy-making effort that promises to completely transform and radically overhaul the Medicaid managed care marketplace.
The common loopholes offered by the Fee for Service model made it harder for governments to maintain balanced budgeting.
The Centers for Medicare & Medicaid Services has announced a proposed rule that would require Medicaid managed care patients to receive the same level of coverage for mental health and addiction treatment as they do for medical and surgical care.
CMS clarifies appropriate use of power strips in long-term care resident rooms ...GAO: Integrating Medicare and Medicaid may not reduce costs on dual-eligible care ... Brookdale discriminated against worker with fibromyalgia, EEOC claims ... State standards for physician access under Medicaid managed care vary widely, OIG finds
Medicaid Fraud Control Units recovered about $10.3 million from nursing facilities in fiscal year 2013, according to an annual report issued Friday. Civil fraud settlements and judgments accounted for the majority of nursing home recoveries last fiscal year, the report showed.
Nearly half of post-acute providers anticipate they will be acquired by an organization with better technological capabilities in 2015, according to survey results released today.
Three-quarters of Medicaid enrollees will receive their benefits through a managed care organization (MCO) as of 2015, according to a new report from healthcare advisory company Avalere Health. Because Medicaid is the primary payer for long-term care in the United States, LTC providers are carefully monitoring the shift to a managed care environment.
Medicaid underfunded long-term care by the greatest margin on record in 2013, according to a new report from the American Health Care Association/National Center for Assisted Living, the nation's largest long-term care provider association.
Medicaid managed care systems have the potential to improve care outcomes, and providers' bottom lines, so operators should embrace them, said LeadingAge President and CEO Larry Minnix.
Better Medicaid managed care oversight needed to protect providers serving high-risk populations: OIGNovember 14, 2013
States are not doing a good job of monitoring how Medicaid managed care enterprises handle providers serving high-risk populations, according to a new government report. Five of six states evaluated in a recent study were not monitoring MCEs' compliance with a federal nondiscrimination provision, the Department of Health and Human Services Office of the Inspector General found.
Providers and long-term care advocates need to embrace Medicaid managed care systems, which have the potential to drive improved health outcomes and bottom lines while helping providers serve those most in need, according to LeadingAge President and CEO Larry Minnix.
Noting that long-term care increasingly is being provided through Medicaid managed care plans, the government has released guidance on how to monitor the quality of care in these systems.
Managed care organizations are set to play a bigger role in how long-term care is provided for people currently eligible for both Medicare and Medicaid, and providers should focus on having the right capabilities in place for them, according to a new report. Released by merchant bank TripleTree, it also identifies technology vendors enabling these capabilities in the long-term and post-acute care settings.
Long-term care providers should be cautious adopters as Medicaid managed care programs grow in scope and number, according to a new report and toolkit from the American Health Care Association. Advisory documents for providers are attached as Appendix B and Appendix D to the toolkit.
Stakeholders in Medicaid managed care programs feel prepared for the enrollment surge that will follow the full implementation of the Affordable Care Act, but there are ongoing concerns related to long-term care and provider capacity, according to a new report.