Medicaid COB has never been more critical as states confront mounting fiscal pressure and federal funding cuts. Many states have already begun reducing their Medicaid budgets — even before the most significant federal reductions take effect. According to the Medicare
With the passing of the Trump administration’s spending bill in the House, Medicaid is at the center of the healthcare policy conversation. The program now consumes roughly one-third of most state budgets, placing enormous strain on state finances. Medicaid expansion and pandemic-era
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
Syrtis Solutions, a leading provider of real-time Other Health Insurance (OHI) coverage information for payers of last resort, recently achieved a significant milestone by being named a preferred vendor for the Association for Community Affiliated Plans (ACAP). This designation is
Medicaid has evolved to become an integral safety net program that provides access to health care for millions of Americans. Payment for this health care is either delegated to Medicaid or other third party insurance coverage. In 2012, 7.6 million
The Coronavirus pandemic and the consequential economic recession accentuated the importance of the Medicaid program last year. By February, the Medicaid enrollment rate increased to 7.4 percent, and 76.5 million people were enrolled in the jointly funded program. In 2021,
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
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
Since state Medicaid programs are responsible for the healthcare of several populations, skyrocketing prescription drug costs have become a major budgetary concern. Currently, health care spending is dominating many of their budgets and on a per capita basis, inflation-adjusted retail
Of the $4 trillion spent by the government in 2017, nearly $141 billion were improper payments. These are payments made in error either to the wrong recipient, in the incorrect amount, or for a service that is not legitimate. Fraud,
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