Molina closes $60M acquisition of Cigna's Medicaid contracts in Texas

Health Care Dive

Molina is known for being acquisitive, but has been on a recent tear as it looks to capitalize on tailwinds in the Medicaid program

Health centers raise alarm about rolling back Medicaid coverage post-public health emergency

Health Care Dive

The clinics are worried about people with Medicaid coverage being deemed ineligible and losing insurance once states revert back to pre-pandemic Medicaid policies and eligibility, a new survey found

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Trending Sources

Nevada awards Medicaid contracts to 4 insurers

Health Care Dive

It's a big win for Molina, which will join three incumbents in the state: UnitedHealthcare, Centene and Anthem Blue Cross Blue Shield

Aveanna Takes Stock of Medicaid ‘Rate Wins’

Home Health Care

For the first time in Tony Strange’s career, he has managed care plans, state Medicaid agencies and even the U.S. Centers for Medicare & Medicaid Services (CMS) reaching out and asking what can be done to increase access to home- and community-based services.

Eligibility Levels for Pregnancy-Related Coverage in Medicaid and CHIP

NASHP

Eligibility Levels for Pregnancy-Related Coverage in Medicaid and CHIP. Eligibility Levels for Pregnancy-Related Coverage in Medicaid and CHIP Updated April 2022. Map and Chart : State’s Efforts to Extend Medicaid Postpartum Coverage. Policy CHIP Eligibility Medicaid pregnant

Federal data shows ACA, Medicaid coverage kept uninsured rate steady as open enrollment kicks off

Health Care Dive

And the numbers suggest ACA and Medicaid enrollment may be continuing the momentum notched last year as consumers turned to the programs in droves after losing job-based coverage

Medicaid, ACA policies for COVID-19 kept rate of uninsured steady, researchers find

Health Care Dive

The uninsured rate remained at 11% from March 2019 to April 2021, thanks to a freeze in Medicaid disenrollment and increased ACA subsidies, according to a report from the Urban Institute

Churntables: A Look at the Record on Medicaid Redetermination Plans

Bill of Health

When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding.

Louisiana AG sues UnitedHealth, alleging drug overcharges in Medicaid

Fierce Healthcare

Louisiana AG sues UnitedHealth, alleging drug overcharges in Medicaid. pminemyer. Wed, 04/20/2022 - 17:41

Insurers may be padding Medicaid physician networks, study finds

Healthcare Dive

Some doctors listed in managed care provider network directories didn't file any Medicaid claims over the course of a year, according to new research published in Health Affairs

Mobile Crisis: Maximizing New Medicaid Opportunities

NASHP

To help build this capacity, the American Rescue Plan Act, among other resources to states, authorized a new Medicaid payment mechanism for Medicaid mobile crisis services, and awarded planning grants to twenty states to prepare for implementation.

End of Medicaid continuous coverage may leave millions of children uninsured, analysis finds

Healthcare Dive

Children are at highest risk in Texas, Florida and Georgia when states resume checking Medicaid eligibility after the public health emergency expires, Georgetown University researchers found

Supreme Court nixes appeal on Arkansas' Medicaid work requirements program

Fierce Healthcare

Supreme Court nixes appeal on Arkansas' Medicaid work requirements program. rking. Mon, 04/18/2022 - 11:15

Study: Only small amount of docs in some Medicaid managed care networks offer care to Medicaid patients

Fierce Healthcare

Study: Only small amount of docs in some Medicaid managed care networks offer care to Medicaid patients. rking. Wed, 05/04/2022 - 15:36

Brave Health Raises $10M for Virtual Behavioral Health for Medicaid

HIT Consultant

What You Should Know: – Brave Health , a Miami-based virtual behavioral health provider for Medicaid, today announced it has closed a $10M Series B round ($20.75M in total) led by City Light Capital, Union Square Ventures and Able Partners, bringing its total funding to $20.75M.

Supreme Court throws out Medicaid work requirement cases

Healthcare Dive

On Monday, the high court said the requirements were now moot given the Biden administration's dismissal of the policies, and sent them back to the trial court with instructions to dismiss prior judgments

CBPP: Managed care plans need to prep for major coordination with states on Medicaid redeterminations

Fierce Healthcare

CBPP: Managed care plans need to prep for major coordination with states on Medicaid redeterminations. rking. Wed, 05/18/2022 - 16:29

Why Medicaid Programs Need to Update Their Information Systems

HIT Consultant

Medicaid systems are struggling as potential expansion looms Clearly, many state unemployment information systems are in dire need of upgrades. For Medicaid, the threat comes as potential expansion looms. Following are three suggestions for a way forward for the Medicaid of tomorrow: 1.

Medicaid and Health Equity: CalAIM’s Bold Experiment

Healthcare Law Blog

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. Medicaid Health Equity

Medicaid stakeholders warn of hurdles for redeterminations process

Healthcare Dive

Resuming the process of determining whether people are still eligible for Medicaid may sound easy, but stakeholders caution it's much more nuanced than flipping a switch, and poor planning risks massive enrollment losses

View Each State’s Efforts to Extend Medicaid Postpartum Coverage

NASHP

View Each State’s Efforts to Extend Medicaid Postpartum Coverage Updated February 8, 2022. Extending Medicaid coverage to postpartum people beyond 60 days is emerging as a key state strategy to address the maternal mortality crisis. Policy Coverage extend Medicaid postpartum

View Each State’s Efforts to Extend Medicaid Coverage to Postpartum Women

NASHP

View Each State’s Efforts to Extend Medicaid Coverage to Postpartum Women Updated September 3, 2021. Extending Medicaid coverage to postpartum women beyond 60 days is emerging as a key state strategy to address the maternal mortality crisis. Policy Coverage extend Medicaid postpartum

NAMPI 2021: Advancing Medicaid Program Integrity in the Current Environment

Health Policy News

Along with approximately one-thousand state and federal Program Integrity professionals and experts, PCG’s Health team sponsored, attended and presented at the 2021 National Association of Medicaid Program Integrity (NAMPI) virtual.

Centene reaches $72M settlement with Illinois, Arkansas for alleged Medicaid overcharges

Health Care Dive

The two states allege Centene failed to disclose relevant discounts and inflated dispensing fees. The latest settlements come months after similar agreements were reached in Ohio and Mississippi

State Approaches to Extending Medicaid Coverage Beyond 60 Days Postpartum

NASHP

States have an increasing interest in extending Medicaid coverage from 60 days to 12 months postpartum, driven by states’ priorities for ensuring continuity of coverage and addressing the maternal mortality crisis.

State Medicaid officials face daunting fall amid low vaccination rates, record enrollment

Health Care Dive

Telehealth and behavioral health service needs are also a challenge as the COVID-19 pandemic drags on and the Biden administration encourages more people to get on the rolls

Exploring Approaches to Serving Children and Youth in Foster Care Under Medicaid

NASHP

Exploring Approaches to Serving Children and Youth in Foster Care Under Medicaid May 2022. The two maps and accompanying chart highlight key characteristics of states’ Medicaid programs for serving CYFC.

Midwife Medicaid Reimbursement Policies by State

NASHP

Midwife Medicaid Reimbursement Policies by State April 15, 2022. You can also download the charts on Certified Nurse-Midwife State Medicaid Reimbursement Policy and Midwife Licensing and State Medicaid Reimbursement Policy. Medicaid Reimbursement. Medicaid Reimbursement.

Who pays more for hospital and physician services: commercial payers, Medicare or Medicaid? And how much more?

Healthcare ECONOMIST

Medicaid vs. Medicare rates. 2021 found that Medicaid reimbursement was 72 % of Medicare rates on average across that nation. That means that if Medicare reimbursement was to a provider was $100, the physician would only get $72 for providing the same service to a Medicaid beneficiary.

CMS Begins Option to Extend Medicaid Postpartum Coverage

Healthcare Law Blog

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”).

Who doesn’t text in 2022? Most state Medicaid programs

Healthcare It News

Postal Service and an online account this summer to connect with Medicaid enrollees about the expected end of the covid public health emergency, which will put many recipients at risk of losing their coverage. West Virginia has more than 600,000 Medicaid enrollees.

Physician venture investor talks telehealth, digital therapeutics, Medicaid tech

Healthcare It News

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. You are passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area.

HHS: ACA coverage expands to record 35M people as more states expand Medicaid

Fierce Healthcare

HHS: ACA coverage expands to record 35M people as more states expand Medicaid. rking. Fri, 04/29/2022 - 15:55

KFF: Up to 14M enrollees could lose Medicaid coverage as states restart eligibility checks

Fierce Healthcare

KFF: Up to 14M enrollees could lose Medicaid coverage as states restart eligibility checks. rking. Mon, 05/09/2022 - 15:43

Aetna misrepresented network to secure Pennsylvania Medicaid contract, lawsuit claims

Fierce Healthcare

Aetna misrepresented network to secure Pennsylvania Medicaid contract, lawsuit claims. pminemyer. Wed, 09/15/2021 - 11:33