article thumbnail

UnitedHealth projects shaky Medicaid redetermination aftermath

Fierce Healthcare

UnitedHealth is predicting an upcoming “disturbance” among its Medicaid programs as members continue to disenroll after the COVID-19 public health emergency. UnitedHealth gave an overview of areas in which the insurer can improve upon, how Medicaid redeterminations will affect the company and thoughts on OptumRx.

Medicaid 280
article thumbnail

Centene looks beyond Medicaid redeterminations

Health Care Dive

The nation's largest Medicaid insurer expects to return to normal operations this year, though redeterminations continue to dog Centene through a mismatch between rates and acuity.

Medicaid 294
Insiders

Sign Up for our Newsletter

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

article thumbnail

MACPAC wants Congress to force states to disclose Medicaid financing streams

Health Care Dive

The influential advisory group has been lobbying the federal government to collect more detailed information on how states loop providers into funding Medicaid for almost a decade.

Medicaid 263
article thumbnail

CMS sets Medicaid payments to home care workers at 80%

Fierce Healthcare

The Centers for Medicare & Medicaid Services is hoping to improve Medicaid enrollees’ access to care through a final rule that better compensates caregiving roles. | CMS released a series of final rules Monday, including Medicaid access regulations that some groups worry will cause providers to close.

Medicaid 300
article thumbnail

MACPAC suggests changes to Medicaid appeals process

Fierce Healthcare

The Medicaid and Chip Payment and Access Commission (MACPAC) voted in favor of seven recommendations during a meeting Jan. Medicaid advisers want to overhaul the denials and appeals process, partly by implementing a clinician-led independent review. 26 that would reshape how beneficiaries are able to appeal for care.

Medicaid 275
article thumbnail

CMS simplifying Medicaid, CHIP enrollment and renewal processes

Fierce Healthcare

The Centers for Medicare & Medicaid Services (CMS) released a final rule Wednesday to help individuals obtain and retain Children's Health Insurance Program (CHIP) coverage. | In a final rule set to take effect in two months, CMS is streamlining its Medicaid and CHIP eligibility, enrollment and renewal processes.

Medicaid 240
article thumbnail

Kansas Medicaid selects UnitedHealth, Blue Cross and Centene

Fierce Healthcare

Three managed care organizations were recently selected to serve Kansas Medicaid members, the state’s department of health and environment announced. KanCare, the state Medicaid program, opted against awarding a bid to Aetna Better Health of Kansas.

Medicaid 166