Medicaid could receive funding cuts due to Trump’s 2018 budget proposal and this may fundamentally change how the Medicaid program operates. The proposals aim is to give individual states flexibility. According to the budget, states will have a choice between receiving a block grant in...
For the fourth straight year, the federal government increased the amount of money described as improper payments. The Government Accountability Office is reporting that agencies exceeded $144 billion in improper payments in fiscal 2016, up from $137 billion in 2015. This increase translates to a higher...
Last month Congress held a hearing concerning the escalating number of improper payments in Medicare and Medicaid. The House oversight panel reviewed concerns regarding escalating improper payment rates discovered by federal oversight groups which include the Government Accountability Office (GAO) and the Health and Human Services...
When ProTPL discovers other health insurance, you can reverse the latest claim and ensure that future claims, whether pharmacy or medical, aren’t paid in error. Discovering other health insurance fast, triggered by Pharmacy claims, allows you to intercept the medical claims, such as office or...
Federal agencies issued an assessed $136.7 billion in incorrect payments during fiscal year 2015, the greatest yearly tally since 2004 when agencies first began reporting data on the subject. As in past years, the Medicare and Medicaid programs accounted for the majority of the overall total...
Government expenditures for Medicaid managed care embodied more than one-third of the total government Medicaid spending in 2014, according to a government report (GAO-16-77) released Jan. 19 that highlights exactly how states are increasingly relying on managed care as they expand Medicaid coverage within the...
In September, The Globe Gazette reported that Iowa representatives have turned in waiver requests with the federal government as a part of Gov. Terry Branstad's strategy to switch Medicaid to a privately run managed care system effective Jan. 1 - a shift they anticipate will deliver...
Why GAO Did This Study During fiscal year 2013, Medicaid - collectively funded by states and the federal government - delivered health care insurance coverage to over 70 million people at an overall cost of about $460 billion. Our lawmakers generally established Medicaid as the health...
Recently, I got into a discussion with a state Medicaid TPL director about RFPs for third party liability cost avoidance work. I feel that our cost avoidance solution would greatly benefit state-run plans, but RFPs are nearly always written for a single vendor to handle an assortment of...
E-Perscribing: What it is, how it works, and how it can help Medicaid save millions of dollars Payer of last resort providers face the difficult task of recovering payments when the recipient does not present primary coverage information at the time services are rendered. For a...
