The GAO reported this week that The Centers for Medicare & Medicaid Services must create a much more robust risk-based anti-fraud strategy for the Medicare and Medicaid programs. Improper payments within both programs amounted to about $95 billion in fiscal

The federal government must quickly move away from the "Pay and Chase" model where Medicaid routinely makes improper claims payments (those that were the liability of primary insurance plans), then retrospectively identifies the claims with third party liability. To make

While the Senate considers the Obamacare Repeal Reconciliation Act of 2017, the Kaiser Family Foundation recently reported on the main provisions that would effect Medicaid; they are, the removal of statutory authority to cover childless adults up to 138% FPL

Enrollment surveys have shown that healthcare options under Medicaid programs are acceptable to enrollees. Enrollees have reported in a nationwide survey that the healthcare they receive under Medicaid is more than adequate. Researchers at Harvard T.H. Chan School of Public

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

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

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

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

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

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.