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Understanding Medicaid Home Care Amid CMS Focus on Potential Fraud and Abuse | KFF
2+ hour, 21+ min ago (1410+ words) Understanding Medicaid Home Care Amid CMS Focus on Potential Fraud and Abuse'KFF Understanding Medicaid Home Care Amid CMS Focus on Potential Fraud and Abuse Potential fraud in state Medicaid programs is getting renewed attention, with a recent emphasis on home…...
TrumpRx: What's the Value for Customers? | KFF
9+ hour, 19+ min ago (431+ words) For those paying with private insurance, many of these drugs already had "copay assistance programs" to help offset some out-of-pocket costs for the commercially insured (and still do). In many cases, out-of-pocket costs could be less than the TrumpRx self-pay…...
Medicare Advantage Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans | KFF
1+ day, 2+ hour ago (686+ words) Medicare Advantage Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans'KFF Medicare Advantage Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans The Centers for Medicare & Medicaid Services (CMS) released the latest Medicare Advantage…...
Medicaid Managed Care Reporting and Transparency: Managed Care Program Annual Reports | KFF
6+ day, 6+ hour ago (1333+ words) Medicaid Managed Care Reporting and Transparency: Managed Care Program Annual Reports'KFF Medicaid Managed Care Reporting and Transparency: Managed Care Program Annual Reports Comprehensive, capitated managed care is the dominant Medicaid delivery system, accounting for about 78% of beneficiaries (over 66 million individuals…...
A Look at the Medicaid Payment Error Rate Measurement (PERM) Program and Upcoming Changes and Impacts | KFF
1+ week, 4+ day ago (1613+ words) A Look at the Medicaid Payment Error Rate Measurement (PERM) Program and Upcoming Changes and Impacts'KFF A Look at the Medicaid Payment Error Rate Measurement (PERM) Program and Upcoming Changes and Impacts Medicaid is a very complex program that involves…...
Comparing States’ Rural Health Fund Allotments to Medicaid Spending Cuts Can be Misleading | KFF
2+ week, 4+ day ago (714+ words) Comparing States" Rural Health Fund Allotments to Medicaid Spending Cuts Can be Misleading'KFF Comparing States" Rural Health Fund Allotments to Medicaid Spending Cuts Can be Misleading The 2025 reconciliation law made historic cuts to federal support for health care, including an…...
ACA Marketplace Enrollment is Down in 2026—But All of the Data Isn’t in Yet | KFF
2+ week, 5+ day ago (246+ words) 2026 marks the first year since 2020 that enrollees in the Affordable Care Act Marketplaces do not have access to enhanced premium tax credits. The effect of the expiration on how many people will use ACA Marketplace coverage remains unclear. This brief…...
A Closer Look at Nebraska, the First State Planning to Implement a Medicaid Work Requirement | KFF
3+ week, 4+ day ago (880+ words) A Closer Look at Nebraska, the First State Planning to Implement a Medicaid Work Requirement'KFF A Closer Look at Nebraska, the First State Planning to Implement a Medicaid Work Requirement In December, Nebraska was the first state to announce that…...
Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024 | KFF
3+ week, 6+ day ago (619+ words) After dropping in 2020 amid the initial phase of the COVID-19 pandemic, prior authorization requests increased steadily between 2021 and 2024 (Figure 1). The decline in 2020 was likely due to both a decline in utilization, as well as the option for insurers to temporarily…...
Our Darwinian Approach to Health Care Costs
3+ week, 6+ day ago (1205+ words) Our Darwinian Approach to Health Care Costs'KFF Our Darwinian Approach to Health Care Costs President Trump is now railing about insurance company premiums. The Ways and Means Committee and Energy and Commerce Health Subcommittee in the House just held hearings…...