Here are seven Medicaid updates Becker’s has reported since Oct. 31.
- It’s been more than seven months since the first states began the process of unwinding the continuous Medicaid enrollment period in place for three years during the pandemic, resulting in state agencies and beneficiaries reporting major operational challenges and exacerbated care access issues. Here are five key redeterminations updates.
- New York fined five Medicaid managed care plans a total of $2.6 million following an examination of their reimbursement of behavioral health claims that found “repeatedly and inappropriately denied claims” or failure to pay for services at rates required by law.
- New York spends the most on its Medicaid managed care program every year, according to data published by KFF in November. Here are states ranked by annual Medicaid managed care spend.
- CVS Health named Mark Santos as president of Aetna Medicaid.
- More than 10 million people have been disenrolled from Medicaid since continuous coverage requirements ended in April, according to KFF. Of those disenrolled, 71 percent had their coverage terminated for procedural reasons, rather than being determined no longer eligible for the program.
- Concord (N.H.) Hospital is suing a number of medical authorities, including CMS, regarding $8 million in alleged overpayment of Medicaid uncompensated care funds.
- Medicaid expansion in Montana is set to sunset in 2025, and removing that coverage could limit affordable healthcare in the state, Logan Health President and CEO Craig Lambrecht, MD, said.
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