The Association for Community Affiliated Plans (ACAP) has launched a massive advertising campaign imploring Republican senators from Medicaid expansion states to oppose any Medicaid cuts. The message from ACAP: Medicaid is economically critical because it supports workers. "Medicaid cuts will put millions of jobs at risk," the...
The newly released Senate health care plan, if passed, would drastically scale back Medicaid funding. This would decimate the program that provides healthcare to a large portion of the population. Reforming the program is vital; however, the recent proposal has brought the health insurance industry...
The AHCA , which narrowly passed in the House of Representatives, aims to cap federal Medicaid funding. The drastic reduction in funding could potentially put an end to Medicaid Managed Care as we know it. Converting the open-ended entitlement program to a system of per capita caps...
H.R. 938, the Medicaid Third Party Liability Act, was recently introduced by Rep. Michael Burgess (R-Texas) to help Medicaid save money. As legislators return to Washington this week, health care remains at the top of their agenda. The main issue amongst Republicans is how to handle the...
Medicaid could receive funding cuts due to Trump’s 2018 budget proposal and this may fundamentally change how the Medicaid program operates. The proposals aim is to give individual states flexibility. According to the budget, states will have a choice between receiving a block grant in...
For the fourth straight year, the federal government increased the amount of money described as improper payments. The Government Accountability Office is reporting that agencies exceeded $144 billion in improper payments in fiscal 2016, up from $137 billion in 2015. This increase translates to a higher...
The CMS has witnessed a dramatic surge in improper Medicaid payments and says the Affordable Care Act could be the cause. The Medicaid improper payment rate has jumped from 5.8% or $14.4 billion in fiscal 2013 to 9.78% or $29.12 billion in fiscal 2015, according...
Last month Congress held a hearing concerning the escalating number of improper payments in Medicare and Medicaid. The House oversight panel reviewed concerns regarding escalating improper payment rates discovered by federal oversight groups which include the Government Accountability Office (GAO) and the Health and Human Services...
When ProTPL discovers other health insurance, you can reverse the latest claim and ensure that future claims, whether pharmacy or medical, aren’t paid in error. Discovering other health insurance fast, triggered by Pharmacy claims, allows you to intercept the medical claims, such as office or...
Federal agencies issued an assessed $136.7 billion in incorrect payments during fiscal year 2015, the greatest yearly tally since 2004 when agencies first began reporting data on the subject. As in past years, the Medicare and Medicaid programs accounted for the majority of the overall total...
