During the 2016 Presidential campaign and shortly after assuming office, President Trump was adamant about repealing the ACA's provisions for Medicaid expansion. In fact, President Trump and the administrator of The Centers for Medicare and Medicaid Services (CMS), Seema Verma, are now considering waivers to...
Last month, President Trump delayed presenting his plan to address the soaring costs of prescription drugs. Despite the delay, New York’s Medicaid Drug Utilization Review Board (DURB) took it upon themselves to negotiate with drug manufacturers. DURB voted in favor of lowering the price its...
Lawmakers in Virginia were unable to approve the Commonwealth’s biennial spending plan earlier this year; which included provisions for Medicaid Expansion. Due to a divide in Republican support within the House and Senate, the legislators agreed to reconvene for a special session, which took place...
The future of rural hospitals in Virginia hangs in the balance in the upcoming debate over Medicaid expansion. Due to the large population of uninsured and low-income citizens in Virginia's countryside, rural hospitals rely heavily on the Medicaid program for financial assistance. If Virginia legislators...
Last month, Virginia’s work on the Commonwealth’s biennial spending plan budget came to an abrupt halt due to the inclusion of provisions for Medicaid expansion. In short, the Republican House supports expanding Medicaid whereas the Republican Senate does not. As a result of the split...
Over the past year, the Trump administration and the GOP had a strong push to repeal the ACA along with reforming Medicaid. With the New Year underway, it is clear that the uncertainty in Medicaid's future is a cause for concern amongst Medicaid managed care...
Just under 60% of Utah residents support the expansion of Medicaid under the ACA in order to cover a greater number of low-income adults, according to a recent poll. A strong majority of Utahns back a full Medicaid expansion, according to the poll conducted by Dan Jones and...
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 2016. The Government Accountability Office, in...
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 this change, the government must...
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 ($16,643 for an individual in...
