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MEDICAID IMPROPER PAYMENTS $50.3 BILLION SYRTIS SOLUTIONS CMS FACT SHEET

29 Nov MEDICAID IMPROPER PAYMENTS TOTAL $50.3 BILLION

Medicaid improper payments have caused the healthcare program to be on the Government Accountability Office's High-Risk List since 2003. The GAO's list identifies government-funded programs that involve substantial resources and provide critical services to the public that are vulnerable to fraud, waste, abuse, and mismanagement....

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MEDICAID IMPROPER PAYMENTS 2021 $98.72 BILLION SYRTIS SOLUTIONS

29 Nov $98.72 BILLION IN MEDICAID IMPROPER PAYMENTS

Medicaid has been designated a high-risk program by the Government Accountability Office (GAO) since 2003 because of improper payments, poor quality data, and oversight challenges. Earlier this month the Department of Health and Human Services (DHHS) released its Agency Financial Report. In FY 2021 Medicaid’s...

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House Energy and Commerce Committee Investigate MEDICAID IMPROPER PAYMENTS Syrtis Solutions

28 Oct MEDICAID IMPROPER PAYMENTS CAUSE CONCERN

Under the Payment Integrity Information Act of 2019, the Centers for Medicare & Medicaid Services (CMS) was required to review federal programs at risk of improper payments. The bill tasked CMS to assess what programs are at risk, estimate the number of improper payments, and report...

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MEDICAID IMPROPER PAYMENTS SYRTIS SOLUTIONS CMS FY 2020

18 Dec $86.49 BILLION IN MEDICAID IMPROPER PAYMENTS

Medicaid is the single largest payer of health care in the United States. As the program has grown in size and scope, it has struggled with fraud, waste, abuse, and improper payments. Over the years, there have been a number of federal initiatives to rein...

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2020 Medicaid Managed Care Final Rule CMS2408F Syrtis Solutions

01 Dec Medicaid Managed Care Final Rule – CMS-2408-F

The Medicaid Managed Care Final Rule, CMS-2408-F, was finalized this November. The new rule implements proposals from the Notice of Proposed Rule Making from last year. Provisions from the rule will begin taking effect as early as December 14, 2020.   According to Medicaid enrollment data from 2018, 66...

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30 Mar SECTION 1135 WAIVERS AID STATES AMID COVID-19

After COVID-19 was declared a national emergency on March 13th, the Centers for Medicare and Medicaid Services (CMS) was able to waive stipulations in federally funded programs to help States respond to the pandemic. To date, CMS has approved Medicaid Section 1135 Waivers for 23...

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16 Dec DISCORD AT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Government healthcare reforms along with reducing prescription drug prices have been at the top of President Donald Trump’s agenda. A feud between the top health officials at HHS is delaying the administration’s healthcare initiatives. Over the past year, tensions have been building between HHS Secretary Alex...

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20 Sep Medicaid Third Party Liability Report From GAO

Identifying third party liability continues to be a challenge under the coordination of benefits for Medicaid plans. By law, plans are payers of last resort so whenever beneficiaries have other active coverage (OHI), those third parties should pay first. Currently, Medicaid plans are required to...

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30 Jul COST AVOIDANCE TECHNOLOGY SOLUTIONS FOR MEDICAID

In addition to rising health care costs and increased spending from the program’s expansion, Medicaid is losing billions of dollars a year from improper payments. Protecting the integrity of the Medicaid program has become a top priority for the Centers for Medicare and Medicaid Services...

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23 Jul MEDICAID COSTS PUT EMPHASIS ON RECOVERY EFFORTS

In 1965, Title XIX of the Social Security Act established the Medicaid program to provide health care coverage to low-income individuals. Over time it has developed into one of the nation's largest payers for health care, covering one out of five Americans. In FY 2017,...

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