Medicaid
publication date
Payer
AHIP Announces Medicaid Redeterminations Coalition and Associated Report
AHIP to lead Connecting to Coverage Coalition, a one-stop shop for multi-stakeholder redetermination resources.
Payer
Medicaid Health Plans Try to Protect Members — and Profits — During Unwinding
With states poised to start disenrolling Medicaid enrollees in April who no longer qualify, insurers hope to keep those still...
Finance
Lakeland Regional Medical Center Agrees to $4M Settlement Over Non-bona fide donations
The government accused the healthcare provider of making improper donations.
Payer
CMS Issues Payment and Coverage Guidance as Pandemic Waivers Approach Expiration
The agency has issued a fact sheet addressing flexibilities authorized during the COVID-19 federal public health emergency (PHE).
Payer
Medicare Advantage Margins Doubled Other Insurance Markets
Analysis of health insurer financial performance in 2021 finds Medicare Advantage (MA) plans had significantly higher gross margins.
Payer
More than 60% of Adults Unaware of Medicaid Eligibility Redetermination
The impending renewal process could mean enrollees are left without coverage.
Payer
Centene to Pay $215M to Resolve Medi-Cal Drug Overcharges
Centene admits no wrongdoing in the settlement, but will pay back twice the value of its inflated price reporting.
Payer
As Pandemic-Era Medicaid Provisions Lapse, Millions Approach a Coverage Cliff
States face steep challenges: making sure they don't disenroll people who are still entitled to Medicaid and connecting the rest...
Payer
HHS Allows States Flexibility to Address Medicaid Beneficiaries' Social Needs
States will have the opportunity to give additional benefits through the use of "in lieu of services and settings."
Payer
3 Providers Will Pay $22.5M to Settle Medi-Cal False Claims Allegations
Prosecutors say the settlements resolve allegations of an 'organized scheme to wrongfully retain federal funds.'
Payer
2023 Marketplace Coverage: Part 2 — The Transition Arc
As the public health emergency extends (PHE) into 2023, payers dominating both Medicaid and the Exchanges will continue to win...
Post-Acute
4 Questions With OSF HealthCare Executives on Home Care Services
According to Lena Nilsson, vice president of clinical operations for OSF HealthCare Home Care Services, the home setting is the...