syrtis solutions Tag

Syrtis Solutions

17 Apr THE IMPACT OF MEDI-CAL’S PHARMACY CARVE OUT

At the beginning of the year, California’s governor signed an executive order directing DHCS to adopt a fee-for-service model for Medi-Cal. Under the order, California would consolidate its purchasing power and leverage the state’s population size to achieve lower drug costs by purchasing in...

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Prescription Drug Costs Medicaid Syrtis Solutions Improper Payments TPL

10 Apr REDUCING MEDICAID’S PRESCRIPTION DRUG COSTS

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 prescription drug spending has increased...

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Medicaid improper payments

29 Mar Senators Question Oversight Of Medicaid Improper Payments

Medicaid has been designated a high-risk program by the GAO since 2003 due to its size, growth, diversity and oversight challenges regarding improper payments, appropriate use of program dollars, and data. In fiscal year 2018, improper payments represented about 9.8% of the programs total spending...

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cost avoidance prescription drug costs Syrtis Solutions

28 Feb STATES TAKE ACTION TO REDUCE MEDICAID PRESCRIPTION DRUG COSTS

In 2018’s legislative session, 45 laws were passed by 28 states to address the problem of prescription drug costs. Apart from these legislative efforts, administrative actions are also being taken to improve the management of Medicaid pharmacy benefits spending. Ohio, West Virginia, and California are...

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CMS

23 Jan MEDICAID IN 2019

Last year, there were multiple attempts to reform the Medicaid program. While efforts at the federal level met resistance, multiple reform initiatives took place at the state level.  These measures included legislation, program expansion, demonstration waivers, eligibility restrictions, and work requirements. Some of these changes...

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17 Jan EXECUTIVE ORDER: MEDI-CAL TO NEGOTIATE DRUG PRICES

California’s newly elected governor; Gavin Newsom (D) has recently made a legislative step to address skyrocketing drug prices. Shortly after he was sworn in last week, Newsom signed an executive order making the state responsible for negotiating drug prices directly with pharmaceutical companies. In addition,...

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Medicaid Expansion Midterm Elections

09 Nov 2018 MIDTERMS FAVOR MEDICAID EXPANSION

Medicaid expansion was an important issue in the 2018 midterm elections. Three states – Idaho, Nebraska, and Utah - successfully passed ballot initiatives to expand their Medicaid programs, while Kansas and Maine elected pro-expansion governors. As a result, almost 500,000 additional low-income citizens will be...

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Syrtis Solutions Improper Payments CMS Trump

26 Oct PREVENTING IMPROPER MEDICAID PAYMENTS

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, antiquated data systems, and methodologies...

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