medicaid Tag

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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COB MEDICAID TPL OHI SYRTIS SOLUTIONS

27 Oct IDENTIFYING TPL IN THE MEDICAID PROGRAM

The vast majority of Medicaid improper payments occur due to antiquated data systems that result in eligibility errors. As the program has grown, identifying primary commercial coverage, also known as Third Party Liability (TPL), has become increasingly more complex and challenging. By law, Medicaid plans...

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MEDICAID NEWS SEPTEMBER 2021 SYRTIS SOLUTIONS

30 Sep MEDICAID NEWS RECAP – SEPTEMBER 2021

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...

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MEDICAID NEWS SEPTEMBER 2021 SYRTIS SOLUTIONS

02 Sep MEDICAID NEWS RECAP – AUGUST 2021

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...

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MEDICAID TPL AND IMPROPER PAYMENTS LEGISLATION SYRTIS SOLUTIONS

30 Aug MEDICAID TPL AND IMPROPER PAYMENTS LEGISLATION

Over the last 56 years, Medicaid has helped provide health services to the most vulnerable populations in the United States. As member enrollment surges, Medicaid TPL and fiscal responsibility have been problematic. To resolve these issues, several legislative efforts have occurred to curb fraud, waste,...

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MEDICAID NEWS SEPTEMBER 2021 SYRTIS SOLUTIONS

04 Aug MEDICAID NEWS RECAP – JULY 2021

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...

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MEDICAID PHARMACY CARVE-OUT SYRTIS SOLUTIONS PROTPL

29 Jul MEDICAID PHARMACY CARVE-OUTS

    Wisconsin Pharmacy Carve-Out Last year, the Wisconsin Department of Health Services carved out prescription drugs from the Family Care Partnership Program and transitioned to a Fee-for-Service (FFS) delivery model. The carve-out ensured compliance with the 2020 Medicaid and CHIP Managed Care Final Rule and eliminated the...

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MEDICAID NEWS SEPTEMBER 2021 SYRTIS SOLUTIONS

02 Jul MEDICAID NEWS RECAP – JUNE 2021

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...

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SYRTIS SOLUTIONS PAYMENT INTEGRITY SOLUTIONS FOR MEDICAID PAYERS

30 Jun MEDICAID CAN SAVE MILLIONS WITH E-PRESCRIBING

Medicaid payers of last resort face the challenging task of recovering claims payments made in error when program beneficiaries fail to report primary coverage information at the time services are provided. Plan members do not share other coverage information for a multitude of reasons, but...

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