As of March 18th, Medicaid Managed Care Organizations are confronting significant challenges due to proposed federal budget cuts totaling $880 billion over the next decade. These reductions threaten to reshape Medicaid funding, potentially leading to coverage losses and stricter eligibility requirements. Consequently, MCOs may experience...
As previously discussed, potential federal budget cuts pose significant threats to Medicaid, impacting millions who rely on this essential program. Recent developments across various states highlight the urgency for proactive measures to mitigate these challenges. California's Financial Measures California has borrowed $3.4 billion from its general fund...
Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly roundup focuses on developments, research, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a summary of last...
The latest House budget proposal presents serious threats to Medicaid funding, potentially cutting billions from state programs. With these looming reductions, Medicaid agencies and Managed Care Organizations (MCOs) must take immediate action to maximize every dollar spent. One of the most effective ways to achieve...
With the passing of the recent budget proposal in Congress, Medicaid remains a prime target for potential budget cuts. If funding reductions move forward, states will be left scrambling to fill gaps, likely leading to fewer benefits, stricter eligibility requirements, and financial strain on healthcare...
Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly roundup focuses on developments, research, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a summary of last...
Syrtis Solutions publishes an annual Medicaid review to help you stay informed. The annual recap focuses on developments, research, and legislation that relates to Medicaid integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a summary of...
Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly roundup focuses on developments, research, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a summary of last...
A recent audit by the Washington State Auditor’s Office revealed that Washington state is overspending on Medicaid premiums—an estimated $8.6 million annually—due to individuals being enrolled in Medicaid programs in multiple states. The audit focused on seven states but suggested that the financial impact from...
The reported government-wide improper payment rate of 3.97% in 2024 marks the lowest level in over a decade. But beneath the surface lies a complex reality that reveals systemic flaws in how improper payments are calculated and managed. These numbers, far from representing genuine progress,...