To reign in prescription drug costs and increase Medicaid program transparency, New York’s Governor, Kathy Hochul, and the New York Medicaid Redesign Team announced earlier this year that the state would carve-out the prescription drug benefit from the Medicaid program. After being delayed for two...
In March 2020, under former Governor Andrew Cuomo’s administration, the New York Medicaid Redesign Team recommended that the state carve-out pharmacy benefits from the Medicaid program due to concerns regarding pharmacy spend and provider transparency. The reform essentially transitions prescription drug reimbursement from a managed care model to...
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...
Medicaid currently fails at providing a system that efficiently and accurately stores and utilizes member data. As Medicaid is a joint state and federally run program, there are many problems with coordinating data platforms. Different states have their own unique data processing and storing, and...
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...
Over the last three years, the Coronavirus public health emergency was extended several times. The PHE and the Families First Coronavirus Response Act altered Medicaid eligibility, and as a result, Medicaid enrollment surged during the pandemic. Between February 2020 and July 2022, 82 million people...
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 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...
Changes in how pharmacy benefits are delivered under New York’s Medicaid program are coming. Earlier this year, the state announced that to reduce prescription drug costs, it would carve out its Medicaid pharmacy benefits and transition to a fee for service delivery model. Beginning April...