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 274

Medicaid Medicare 274

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 260

Medicaid 260

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 313

Medicaid 313

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 284

Medicaid 284

Fierce Healthcare

MAY 10, 2024

This month, Iowa signed into a law a postpartum Medicaid expansion, L.A. Below is a roundup of payer-centric news headlines you may have missed during the month of May 2024. Care Health commited $3 million to providers, Aetna settled a lawsuit alleging fertility discrimination, a former NBA champion was sentenced to prison and more.

Medicaid 274

Medicaid 274

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 255

Medicaid Medicare 255

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 293

Medicaid 293

Fierce Healthcare

APRIL 10, 2024

Almost all community health centers (95%) are reporting Medicaid disenrollment, influencing the level of care provided to individuals that rely on these locations. States have handled the Medicaid redetermination process with varying degrees of success. A new study looks at how community health centers have been impacted.

Medicaid 246

Medicaid 246

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 292

Medicaid 292

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 301

Medicaid 301

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 258

Medicaid Hospitals Medicare 258

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 313

Medicaid 313

Health Care Dive

APRIL 2, 2024

Threats of fines, procedural errors and 19 million Americans disenrolled: Here are the major headlines from the past year of states unwinding Medicaid.

Medicaid 278

Medicaid 278

Health Care Dive

MAY 30, 2024

Worries about higher-than-expected medical spending have reached Medicaid, as redeterminations spark turbulence in the program.

Medicaid 247

Medicaid Medicare 247

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 329

Medicaid Medicare 329

Fierce Healthcare

JULY 2, 2024

The Department of Health and Human Services (HHS) is helping incarcerated adults and children obtain access to Medicaid or Children’s Health Insurance Program (CHIP) coverage before they leave a pr | HHS is extending Medicaid and CHIP coverage to incarcerated individuals that are soon to be released in five states.

130

130

Health Care Dive

MAY 29, 2024

The ban initially only affects UnitedHealthcare, which is the sole for-profit managed care organization with a Medicaid contract in the state.

Medicaid 195

Medicaid 195

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 291

Medicaid Medicare 291

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 322

Medicaid Healthcare 322

Health Care Dive

MARCH 1, 2024

It’s the second recent Medicaid state loss for Molina, despite executives expressing confidence about the insurer’s ability to retain contracts.

Medicaid 264

Medicaid 264

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 340

Medicaid 340

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 284

Medicaid 284

Fierce Healthcare

DECEMBER 15, 2023

The Centers for Medicare & Medicaid Services is rolling out a new payment model that aims to support state Medicaid agencies in offering whole-person maternal care. |

Medicaid 259

Medicaid Medicare 259

Health Care Dive

FEBRUARY 21, 2024

Under the new definition, hospitals can only receive disproportionate share hospital Medicaid reimbursements for beneficiaries who are primarily insured by the safety-net program.

Medicaid 254

Medicaid Hospitals 254

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 306

Medicaid Hospitals 306

Health Care Dive

SEPTEMBER 22, 2023

Nearly 500,000 people will regain Medicaid or Children’s Health Insurance Program coverage after being improperly removed from the rolls during redeterminations, according to the HHS.

Medicaid 306

Medicaid 306

Health Care Dive

JANUARY 19, 2024

It’s not yet clear how much the new Medicaid managed care contract is worth. The state’s previous contract with insurers, including Centene, allocated $6 billion in funds over five years.

Medicaid 173

Medicaid 173

Fierce Healthcare

MARCH 29, 2024

As public health officials nationwide sound the alarm on a “tripledemic”—the emergence of the respiratory syncytial virus (RSV), the influenza virus and the COVID-19 virus simultaneously—pregnant w | Given that Medicaid and CHIP cover a significant portion of all pregnancies in America—especially for historically disadvantaged groups—policy actions (..)

Medicaid 284

Medicaid 284

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 328

Medicaid 328

Health Care Dive

APRIL 23, 2024

In two final rules issued Monday, the CMS also moved to crack down on financing gimmicks used by states and hospitals to increase federal Medicaid funding — though not until 2028.

Medicaid 162

Medicaid Hospitals 162

Health Care Dive

APRIL 10, 2024

The number of people enrolled in Medicaid soared over the pandemic, but many enrollees may not have known their coverage had continued, new research suggests.

Medicaid 162

Medicaid 162

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 321

Medicaid 321

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 306

Medicaid 306

Health Care Dive

NOVEMBER 29, 2023

Medicaid enrollees are more likely to understand and be satisfied with their plans, despite reporting poorer health outcomes, according to a new report from KFF.

Medicaid 262

Medicaid 262

Fierce Healthcare

APRIL 4, 2024

Centene appears to be crying foul to Texas over the state's scoring of its Medicaid proposal. Centene feels they have received unfair treatment from the state of Texas over how the state scored its Medicaid bid.

Medicaid 157

Medicaid 157

Fierce Healthcare

SEPTEMBER 27, 2023

The expansion of Medicaid coverage under the Affordable Care Act helped address the problem to some extent, but not all states elected to take advantage of that opportunity. Structural racism encompassing groups, not bigotry targeting individuals, drives much of the healthcare inequity in the U.S., according to a study in Health Affairs. |

Medicaid 300

Medicaid Healthcare 300

Fierce Healthcare

NOVEMBER 28, 2023

Patients have to navigate too many hurdles when enrolling for and managing their Medicaid coverage. Fortuna Health launched earlier this year to simplify Medicaid navigation. The startup picked up $4 million in seeding funding to accelerate state expansion.

Medicaid 274

Medicaid 274