Minnesota AG charges personal care agency in $10M fraud scheme
By
Adam Healy
Sep 05, 2023
The Minnesota attorney general recently charged five individuals for Medicaid fraud totaling about $9.5 million.
CMS instructs states to review Medicaid auto-renewal process to improve wrongful terminations
By
Adam Healy
Sep 01, 2023
The CMS is addressing the “operational issues” that are kicking people off state Medicaid plans during the federal unwinding period.
OIG releases strategic plan to oversee managed care integrity, efficiency
By
Adam Healy
Sep 01, 2023
As concerns about fraud and abuse continue to trail Medicare Advantage and Medicaid managed care, the U.S. Office of Inspector General this week disclosed its new oversight strategy for monitoring the...
Numbers of Medicaid terminations of older, disabled growing by the week
By
Liza Berger
Aug 25, 2023
I don’t envy state Medicaid workers at the moment. They are in the midst of what one expert has called one of the greatest challenges to the program in its history.
Older adults, people with disabilities a casualty of Medicaid unwinding, analysis says
By
Liza Berger
Aug 17, 2023
The Medicaid unwinding, which began April 1, has affected an estimated 76,630 older adults and people with disabilities in 22 states. This equates to approximately 5% of total disenrollments in those states,...
In terms of prior authorization denials, MA has nothing on Medicaid MCOs
By
Liza Berger
Jul 21, 2023
Move over Medicare Advantage. It turns out that there might be an even more troublesome creature than you. The new problem child? Medicaid managed care organizations (MCOs).
Home care groups detail criticism of Medicaid HCBS worker wage proposal
By
Liza Berger
Jul 10, 2023
The home care community generally approves of the Ensuring Access to Medicaid Services (Access NPRM) rule, which the Centers for Medicare & Medicaid Services proposed in April. However, it is unequivocally...
Independent living program to aid hundreds of aging, disabled adults
By
Adam Healy
Jul 10, 2023
A pilot program in Wisconsin will help individuals age comfortably in their homes, rather than enter a long-term care facility through Medicaid.
Study finds link between Medicaid expansion, palliative care utilization
By
Adam Healy
Jul 07, 2023
Medicaid expansion has led to increased usage of palliative care services among late-stage cancer patients, according to research from the American Cancer Society.
New study finds lower nursing home use, savings for states that expand Medicaid HCBS
By
Liza Berger
Jun 29, 2023
A new study dispels the notion of the “woodwork effect” — that states that expand access to Medicaid home- and community-based services (HCBS) experience new Medicaid enrollees who just want to access...