Fierce Healthcare

SEPTEMBER 4, 2024

Centene’s business is still impacted by Medicaid redeterminations, a process that began in early 2023, the company said during the Wells Fargo Healthcare Conference. Centene's stock sunk Wednesday after the company highlighted issues it faces surrounding Medicaid redeterminations.

Medicaid 284

Medicaid Healthcare 284

Fierce Healthcare

SEPTEMBER 23, 2021

CMS official says Medicaid must cover Aduhelm as industry awaits national coverage decision. Thu, 09/23/2021 - 10:54.

Medicaid 362

Medicaid 362

Healthcare It News

MARCH 18, 2022

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. What's happening in this area of digital health?

Medicaid 332

Medicaid Telemedicine Hospitals Clinical Practice 332

Fierce Healthcare

AUGUST 27, 2024

TennCare, the state of Tennessee’s Medicaid program, intentionally prevented families from receiving healthcare coverage and benefits, a federal district judge determined Aug.

Medicaid 291

Medicaid Healthcare Prevention 291

Fierce Healthcare

NOVEMBER 14, 2023

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 297

Medicaid 297

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 317

Medicaid Medicare 317

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 333

Medicaid 333

Fierce Healthcare

SEPTEMBER 27, 2024

Many counties do not have medication for opioid use disorder (MOUD) services available through providers and treatment programs, and even in counties that do, Medicare and Medicaid beneficiaries of | A new report from HHS OIG looked at access to medication for opioid use disorder services and found many high need counties do not have specialized providers. (..)

Medicaid 307

Medicaid Medicare 307

Fierce Healthcare

MARCH 27, 2024

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 263

Medicaid Medicare 263

Health Care Dive

JUNE 21, 2024

Medicaid unwinding has been less than perfect. However, the process has helped states expand Medicaid eligibility to more people and streamline enrollment and outreach, according to a new survey.

Medicaid 259

Medicaid 259

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 308

Medicaid Healthcare 308

Health Care Dive

OCTOBER 26, 2024

Like other payers, Centene flagged a mismatch between patient acuity and payment rates in Medicaid. But the insurer said a diversified portfolio helped it navigate challenges in the third quarter.

Medicaid 262

Medicaid 262

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 277

Medicaid 277

Health Care Dive

JULY 3, 2024

The survey, which included low-income people in Arkansas, Kentucky, Louisiana and Texas, found about half of those who were no longer enrolled in Medicaid became uninsured.

Medicaid 303

Medicaid 303

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 249

Medicaid Medicare 249

Health Care Dive

AUGUST 15, 2024

Despite challenges in Medicaid and MA, major insurers still posted large earnings in the second quarter — many helped by growing health services divisions.

Medicaid 280

Medicaid Medicare 280

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 283

Medicaid Hospitals 283

Health Care Dive

APRIL 26, 2024

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 241

Medicaid 241

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 297

Medicaid 297

Fierce Healthcare

MARCH 20, 2024

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 271

Medicaid 271

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 296

Medicaid 296

Fierce Healthcare

MARCH 20, 2024

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 285

Medicaid 285

Health Care Dive

APRIL 19, 2022

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.

Medicaid 322

Medicaid 322

Fierce Healthcare

JULY 12, 2024

Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S. Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S.

Medicaid 278

Medicaid 278

Fierce Healthcare

APRIL 15, 2024

Insurers Humana, Centene and Elevance Health were selected as the three statewide Medicaid contract awardees in Florida on April 12. Just three insurers earned statewide contracts for Florida's state-run managed care program, but UnitedHealth, Aetna and Molina were not selected.

Medicaid 278

Medicaid 278

Fierce Healthcare

AUGUST 9, 2024

Medicare Advantage and Medicaid woes continued to plague some major payers in the second quarter, with UnitedHealth Group regaining its crown as the most profitable company in the industry for Q2.<

Medicaid 284

Medicaid Medicare 284

Health Care Dive

OCTOBER 24, 2024

The presidential election, loss of higher federal funding, inflationary pressures and other challenges are leaving state regulators uncertain about Medicaid’s “new normal.”

Medicaid 250

Medicaid Regulations 250

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 252

Medicaid Hospitals Medicare 252

Fierce Healthcare

SEPTEMBER 6, 2024

Two years after Mississippi awarded Medicaid contracts to three insurers, the state is finally moving forward with its decision following challenges from UnitedHealthcare and Elevance Health.

Medicaid 261

Medicaid 261

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 276

Medicaid Medicare 276

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 281

Medicaid 281

Fierce Healthcare

MAY 30, 2023

Medicaid work requirements dropped in debt ceiling deal pminemyer Tue, 05/30/2023 - 12:20

Medicaid 271

Medicaid 271

Fierce Healthcare

MAY 2, 2024

Two new studies released Thursday shed new light on how states are handling the Medicaid unwinding process for adults and children. Analyses out of Georgetown University and the Urban Institute show just how dire the Medicaid redetermination crisis is in some states.

Medicaid 254

Medicaid 254

Fierce Healthcare

MAY 16, 2024

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 234

Medicaid 234

Fierce Healthcare

DECEMBER 21, 2021

CMS: Medicaid, CHIP enrollment increases by 433K in June and 17% since start of pandemic. Tue, 12/21/2021 - 12:36.

Medicaid 317

Medicaid 317

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 291

Medicaid 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 271

Medicaid 271