Medicaid
publication date
Finance
Hospital Finances Broke Even in April Amid Medicaid Disenrollment, End of PHE
Kaufman Hall finds inflation and high expenses continue to hinder hospitals' bottom line.
Payer
Financial Burden of Dual-Eligible Beneficiaries Split Evenly on Medicare, Medicaid
Research into utilization and spending for need-based subgroups suggests integration of the two programs could better serve enrollees.
Revenue Cycle
NW Arkansas Hospitals Will Pay $1.1M to Settle Medicaid False Claims Allegations
The health system denies intentionally filing false billings, and has worked with regualtors to resolve the case.
Payer
Roundup: Updates from the National Association of Medicaid Directors
Redeterminations are among the many significant changes and challenges that State Medicaid agencies are facing.
Clinical Care
Federal Study Calls U.S. Stillbirth Rate 'Unacceptably High' and Recommends Action
An NIH report decried stillbirths as a 'major public health concern' and said the nation needed to do more to...
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.