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Flashback: 2005 Tennessee Medicaid disenrollment led to increased crime, study finds

Fierce Healthcare

Large-scale Medicaid disenrollment in Tennessee nearly 20 years ago led to increased total crime rates, a new study by the National Bureau of Economic Research found. |

Medicaid 290
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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 299
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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 147
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Ophelia's virtual OUD care now in-network for Medicaid, dual-eligible Highmark Wholecare members

Fierce Healthcare

It is now in-network for Wholecare Medicaid and dual-eligible members. Ophelia works with 13 Medicaid plans overall. . | Ophelia has been part of Highmark Health’s network in Pennsylvania since 2021, serving 2.9 million commercial members.

Medicaid 246
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Medicaid enrollment to decrease by 8.6% in 2024: KFF

Fierce Healthcare

Medicaid enrollment is projected to slide further next year, according to an annual budget survey of Medicaid officials conducted by KFF and Health Management Associates in collaboration with the N | State Medicaid directors once again see redeterminations as one of the biggest challenges they face heading into next year.

Medicaid 317
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CMS opens door for New York Medicaid investments

Fierce Healthcare

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 258
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Many disproportionate share hospitals face lower Medicaid payments under new final rule

Fierce Healthcare

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 261