Fierce Healthcare

JANUARY 9, 2024

Centers for Medicare & Medicaid Services approved New York's amended Medicaid section 1115 demonstration on Tuesday, spurring the agency to invest in behavioral health and health equity initiat | CMS is helping revamp Medicaid in New York, including more than $3 billion in investments for high-risk social needs services.

Medicaid 255

Medicaid Medicare 255

Fierce Healthcare

FEBRUARY 21, 2024

Medicaid disproportionate share hospital (DSH) payments are being cut by $8 billion annually during the current and next four federal fiscal years under a new Centers for Medicare and Medicaid Serv | Published Tuesday and set to go into effect in two months, the final rule limits the calculation of a hospitals Medicaid shortfall to beneficiaries with (..)

Medicaid 258

Medicaid Hospitals Medicare 258

Fierce Healthcare

JANUARY 26, 2024

State Medicaid agencies are required to cover Hepatitis C medications for people who have the disease or a substance use disorder, states were "encouraged" earlier this week.

Medicaid 292

Medicaid 292

Health Care Dive

APRIL 2, 2024

Threats of fines, procedural errors and 19 million Americans disenrolled: Here are the major headlines from the past year of states unwinding Medicaid.

Medicaid 244

Medicaid 244

Health Care Dive

APRIL 10, 2024

The number of people enrolled in Medicaid soared over the pandemic, but many enrollees may not have known their coverage had continued, new research suggests.

Medicaid 157

Medicaid 157

Fierce Healthcare

NOVEMBER 17, 2023

A coalition including the NAACP and other civil rights organizations released a scorecard Thursday grading each state on its policies handling the Medicaid unwinding period. Just one state received a passing score on Medicaid redeterminations from a coalition of nationally recognized civil rights groups.

Medicaid 313

Medicaid 313

Fierce Healthcare

APRIL 4, 2024

Centene appears to be crying foul to Texas over the state's scoring of its Medicaid proposal. Centene feels they have received unfair treatment from the state of Texas over how the state scored its Medicaid bid.

Medicaid 157

Medicaid 157

Fierce Healthcare

MARCH 29, 2024

As public health officials nationwide sound the alarm on a “tripledemic”—the emergence of the respiratory syncytial virus (RSV), the influenza virus and the COVID-19 virus simultaneously—pregnant w | Given that Medicaid and CHIP cover a significant portion of all pregnancies in America—especially for historically disadvantaged groups—policy actions (..)

Medicaid 284

Medicaid 284

Fierce Healthcare

AUGUST 30, 2023

In a letter sent to all states (PDF), the Centers for Medicare & Medicaid Services ( | As more Medicaid beneficiaries are wrongly kicked off the program, CMS is requiring states to reevaluate its eligibility systems and auto-renewal process.

Medicaid 329

Medicaid Medicare 329

Fierce Healthcare

OCTOBER 23, 2023

A new report projects that if states holding out from expanding Medicaid reversed course, 2.3 million people would get access to healthcare.

Medicaid 322

Medicaid Healthcare 322

Fierce Healthcare

OCTOBER 4, 2023

Mental health provider Brightside Health is partnering with Centene, Optum, Lucet, Blue Cross and Blue Shield of Texas and other payers to serve 50 million people in Medicare and Medicaid. Brightside Health announced expanded partnerships with major health payers including Centene, Optum and Lucet on Thursday.

Medicaid 291

Medicaid Medicare 291

Fierce Healthcare

JANUARY 18, 2024

2024 | This week, Humana announced workforce reductions, a study associated Medicaid expansion with reduced lung cancer mortality and Bright Health moved its corporate headquarters. Below is a round-up of payer-centric news for the week of Jan.

Medicaid 284

Medicaid 284

Fierce Healthcare

JANUARY 10, 2024

Elevance Health is launching a new initiative that aims to put smartphones in the hands of Medicaid members who otherwise cannot connect to virtual services. In the wake of the COVID-19 pandemic, virtual care and digital health tools are more popular than ever.

Medicaid 340

Medicaid 340

Health Care Dive

MARCH 1, 2024

It’s the second recent Medicaid state loss for Molina, despite executives expressing confidence about the insurer’s ability to retain contracts.

Medicaid 232

Medicaid 232

Fierce Healthcare

DECEMBER 15, 2023

The Centers for Medicare & Medicaid Services is rolling out a new payment model that aims to support state Medicaid agencies in offering whole-person maternal care. |

Medicaid 259

Medicaid Medicare 259

Fierce Healthcare

MARCH 29, 2024

Virtual mental health company Brightside Health picked up $33 million in fresh funding to help propel its expansion into Medicare and Medicaid populations. | Virtual mental health company Brightside Health picked up $33 million in fresh funding to help propel its expansion into Medicare and Medicaid populations.

Medicaid 144

Medicaid Medicare 144

Health Care Dive

MARCH 28, 2024

It’s the “most robust and meaningful” regulation streamlining Medicaid eligibility since the Affordable Care Act was implemented a decade ago, one lawyer said.

Medicaid 157

Medicaid Regulations 157

Health Care Dive

JANUARY 19, 2024

It’s not yet clear how much the new Medicaid managed care contract is worth. The state’s previous contract with insurers, including Centene, allocated $6 billion in funds over five years.

Medicaid 167

Medicaid 167

Health Care Dive

FEBRUARY 21, 2024

Under the new definition, hospitals can only receive disproportionate share hospital Medicaid reimbursements for beneficiaries who are primarily insured by the safety-net program.

Medicaid 224

Medicaid Hospitals 224

Health Care Dive

JANUARY 26, 2023

Medicaid eligibility checks beginning in April will likely curb hospital revenue and enrollment growth for payers, Moody's Investors Service said in a report.

Medicaid 296

Medicaid Hospitals 296

Health Care Dive

SEPTEMBER 22, 2023

Nearly 500,000 people will regain Medicaid or Children’s Health Insurance Program coverage after being improperly removed from the rolls during redeterminations, according to the HHS.

Medicaid 284

Medicaid 284

Fierce Healthcare

JANUARY 26, 2024

Blue Shield of California is offering to foot the bill for Medicaid enrollees who want to earn a General Education Diploma and become high school graduates. | The program, being rolled out in Los Angeles and San Diego counties, addresses a trend of fewer people graduating from high school.

Medicaid 278

Medicaid 278

Fierce Healthcare

NOVEMBER 28, 2023

Patients have to navigate too many hurdles when enrolling for and managing their Medicaid coverage. Fortuna Health launched earlier this year to simplify Medicaid navigation. The startup picked up $4 million in seeding funding to accelerate state expansion.

Medicaid 274

Medicaid 274

Fierce Healthcare

SEPTEMBER 27, 2023

The expansion of Medicaid coverage under the Affordable Care Act helped address the problem to some extent, but not all states elected to take advantage of that opportunity. Structural racism encompassing groups, not bigotry targeting individuals, drives much of the healthcare inequity in the U.S., according to a study in Health Affairs. |

Medicaid 300

Medicaid Healthcare 300

Fierce Healthcare

NOVEMBER 21, 2023

The day her Medicaid coverage ended, Beverly Likens was in the hospital after a scary trip to the emergency room. Millions of people nationwide have lost Medicaid benefits after a pandemic-era mandate for coverage expired in March—most of them for administrative reasons unrelated to their actual eligibility.

Medicaid 273

Medicaid Healthcare Hospitals 273

Fierce Healthcare

OCTOBER 9, 2023

Boulder Care, a telehealth provider for substance use disorder, has met all of its performance quality measures in a value-based payment arrangement with a managed Medicaid insurer in Oregon. | The contract with Umpqua Health Alliance links reimbursement to a set of patient outcomes.

Medicaid 301

Medicaid Medical Services 301

Health Care Dive

MARCH 31, 2023

States can begin disenrolling ineligible beneficiaries from Medicaid on April 1, in an event the CMS has called the biggest health coverage transition since the first ACA open enrollment.

Medicaid 293

Medicaid 293

Health Care Dive

FEBRUARY 21, 2023

About 64% of adults in a Medicaid-enrolled family said they did not know they may lose coverage once pandemic-era policy ends and eligibility checks resume on April 1, a survey from the Robert Wood Johnson Foundation found.

Medicaid 308

Medicaid 308

Healthcare ECONOMIST

MARCH 28, 2024

One reason is that reimbursement rates for Medicaid are lower than for Medicare or commercial insurance. Another (often overlooked) factor, however, is physician’s risk of payment denials and the administrative hassle they face trying to get reimbursed by Medicaid. A paper by Dunn et al. A paper by Dunn et al.

Medicaid 95

Medicaid Doctors Medicare 95

Health Care Dive

JUNE 21, 2023

An analysis by KFF found state spending on Medicaid fell during the COVID-19 pandemic even as enrollment soared. But spending will likely increase as the federal government begins to pare back its increased contribution.

Medicaid 301

Medicaid 301

Fierce Healthcare

JULY 20, 2023

The Office of Inspector General (OIG) is urging the feds and states to take on greater oversight of prior authorization denials in Medicaid managed care. | The Office of Inspector General is urging the feds and states to take on greater oversight of prior authorization denials in Medicaid managed care.

Medicaid 246

Medicaid 246

Fierce Healthcare

FEBRUARY 13, 2024

Cityblock is expanding its services to Medicaid patients in the New York City area through a partnership with Centene-owned Fidelis Care. Cityblock will collaborate with the health plan to provide primary care, mental health and social services to thousands of members in the New York City area and Long Island.

Medicaid 190

Medicaid Primary Care 190

Health Care Dive

OCTOBER 3, 2023

The health insurer expected to be offered a contract to manage the care of Medicaid seniors in a new long-term services and supports program, but wasn’t able to stand up a dual-eligible special needs plan in time.

Medicaid 167

Medicaid 167

Health Care Dive

MARCH 13, 2024

States that have expanded Medicaid for a year after pregnancy might see similar coverage gains, researchers wrote.

Medicaid 176

Medicaid 176

Fierce Healthcare

JULY 20, 2023

The Centers for Medicare & Medicaid Services (CMS) has approved proposals from California and Kentucky for community-based mobile crisis intervention teams to provide Medicaid crisis services.<

Medicaid 246

Medicaid Medicare 246

Health Care Dive

NOVEMBER 29, 2023

Medicaid enrollees are more likely to understand and be satisfied with their plans, despite reporting poorer health outcomes, according to a new report from KFF.

Medicaid 212

Medicaid 212

Health Care Dive

FEBRUARY 21, 2023

Short-term plan operators will likely ramp up their marketing in April to nab new consumers from the Medicaid churn, but health policy experts largely aren't concerned.

Medicaid 300

Medicaid 300