Latest Headlines

Latest Headlines

Some Louisiana hospital execs balk over Medicaid projections

One of the first acts of Louisiana's recently elected Democratic governor was to expand Medicaid eligibility under the Affordable Care Act.

CMS' hands off approach to MU and HIE in Medicaid managed care rule may backfire

Many people have been focused on what the Centers for Medicare & Medicaid Services' new sweeping Medicaid and CHIP managed care rule does. The long-awaited rule, unveiled earlier this week, overhauls and modernizes how Medicare managed care works, bringing much of it into the 21 st  century.

AHA: Limited coverage, geographic restrictions pose major barriers to telehealth adoption

The Centers for Medicare & Medicaid Services must include telehealth in value-based payment models and lift geographic restrictions on its use, a new brief published by the American Hospital Association argues.

Medicaid managed care rule creates rating system

The federal government on Monday issued a long-awaited final rule for Medicaid managed care plans, which creates a quality-rating system, allows states to set standards for network adequacy and limits how much money insurers can put toward administrative costs.

CMS takes hands off approach to HIE, MU in new Medicaid managed care rule

The new final Medicaid and CHIP managed care rule does not change Meaningful Use, data exchange and health IT requirements, despite commenters' requests to do so.

OIG: Failure to implement Medicaid claims safeguards leads to improper payments

Most states have not complied with the Affordable Care Act's requirement to implement automated claims safeguards known as coding edits, leaving Medicaid susceptible to billions in improper payments, according to the Office of Inspector General.  

Medicaid expansion leads to greater use of healthcare services

Low-income adults in states that have expanded Medicaid feel as though their health insurance options have improved, and their use of healthcare services has also increased, according to new research discussed in an editorial published in the  Annals of Internal Medicine.  

Medi-Cal ditches $179M IT modernization project

California has decided to scrap a $179 million computer modernization project for its Medi-Cal program and start over, reports  California Healthline.

Texas officials struggle to prove orthodontists committed fraud

A recent court ruling in favor of a Texas orthodontics provider adds to the state's longstanding inability to prove claims that dental providers overbilled Medicaid tens of millions of dollars, according to the  Austin American-Statesman.  

OIG says lack of clear rules caused states to overdraw $130M in Medicaid funds

A combination of out-of-date regulations and confusion over a lack of guidance from federal officials led two states to overdraw more than $130 million in Medicaid funds and another to use Medicaid funds for unrelated expenditures, according to a new report from the Office of Inspector General.