Medicaid: Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.Beak: In some animals, the jaws together with their horny covering. The beak usually refers to the bill of birds in which the whole varies greatly in form according of the food and habits of the bird. While the beak refers most commonly to birds, the anatomical counterpart is found also in the turtle, squid, and octopus. (From Webster, 3d ed & Storer, et al., General Zoology, 6th ed, p491, 755)Centers for Medicare and Medicaid Services (U.S.): A component of the Department of Health and Human Services to oversee and direct the Medicare and Medicaid programs and related Federal medical care quality control staffs. Name was changed effective June 14, 2001.State Health Plans: State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.United StatesPlatypus: A small aquatic oviparous mammal of the order Monotremata found in Australia and Tasmania.Eligibility Determination: Criteria to determine eligibility of patients for medical care programs and services.MonotremataManaged Care Programs: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.State Government: The level of governmental organization and function below that of the national or country-wide government.Insurance, Health, Reimbursement: Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)Fees, Medical: Amounts charged to the patient as payer for medical services.Medicare: Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)Medically Uninsured: Individuals or groups with no or inadequate health insurance coverage. Those falling into this category usually comprise three primary groups: the medically indigent (MEDICAL INDIGENCY); those whose clinical condition makes them medically uninsurable; and the working uninsured.Insurance Coverage: Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.Cost Control: The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Reimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment.Capitation Fee: A method of payment for health services in which an individual or institutional provider is paid a fixed, per capita amount without regard to the actual number or nature of services provided to each patient.Palaeognathae: A superorder of large, mostly flightless birds, named for their distinctive PALATE morphology. It includes the orders Apterygiformes, Casuriiformes, Dinornithiformes, RHEIFORMES; STRUTHIONIFORMES and Tinamiformes.Insurance Claim Review: Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.Rate Setting and Review: A method of examining and setting levels of payments.Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Child Health Services: Organized services to provide health care for children.Insurance Benefits: Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed.Saint Lucia: An independent state in the West Indies. Its capital is Castries. It was probably discovered by Columbus in 1502 and first settled by the English in 1605. Contended for by the French and English in the 17th century, it was regarded as neutral in 1748 but changed hands many times in the wars of the 19th century. It became a self-governing state in association with Great Britain in 1967 and achieved independence in 1979. Columbus named it for the day on which he discovered it, the feast of St. Lucy, a Sicilian virgin martyr. (From Webster's New Geographical Dictionary, 1988, p1051 & Room, Brewer's Dictionary of Names, 1992, p477)Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Reimbursement, Disproportionate Share: Payments that include adjustments to reflect the costs of uncompensated care and higher costs for inpatient care for certain populations receiving mandated services. MEDICARE and MEDICAID include provisions for this type of reimbursement.Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.Sulfadimethoxine: A sulfanilamide that is used as an anti-infective agent.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Legislation, Medical: Laws and regulations, pertaining to the field of medicine, proposed for enactment or enacted by a legislative body.Insurance Claim Reporting: The design, completion, and filing of forms with the insurer.Personal Health Services: Health care provided to individuals.Patient Protection and Affordable Care Act: An Act prohibiting a health plan from establishing lifetime limits or annual limits on the dollar value of benefits for any participant or beneficiary after January 1, 2014. It permits a restricted annual limit for plan years beginning prior to January 1, 2014. It provides that a health plan shall not be prevented from placing annual or lifetime per-beneficiary limits on covered benefits. The Act sets up a competitive health insurance market.CaliforniaRheiformes: An order of large, long-necked, long-legged, flightless birds, found in South America. Known as rheas, they are sometimes called American ostriches, though they are in a separate order from true OSTRICHES.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Uncompensated Care: Medical services for which no payment is received. Uncompensated care includes charity care and bad debts.Legislation as Topic: The enactment of laws and ordinances and their regulation by official organs of a nation, state, or other legislative organization. It refers also to health-related laws and regulations in general or for which there is no specific heading.National Health Insurance, United StatesPasseriformes: A widely distributed order of perching BIRDS, including more than half of all bird species.Formularies as Topic: Works about lists of drugs or collections of recipes, formulas, and prescriptions for the compounding of medicinal preparations. Formularies differ from PHARMACOPOEIAS in that they are less complete, lacking full descriptions of the drugs, their formulations, analytic composition, chemical properties, etc. In hospitals, formularies list all drugs commonly stocked in the hospital pharmacy.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)Politics: Activities concerned with governmental policies, functions, etc.Federal Government: The level of governmental organization and function at the national or country-wide level.Government Regulation: Exercise of governmental authority to control conduct.Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.Charadriiformes: An order of BIRDS including over 300 species that primarily inhabit coastal waters, beaches, and marshes. They are comprised of shorebirds, gulls, and terns.Heliconiaceae: A plant family of the order ZINGIBERALES, subclass Zingiberidae, class Liliopsida.OregonTennesseeFeathers: Flat keratinous structures found on the skin surface of birds. Feathers are made partly of a hollow shaft fringed with barbs. They constitute the plumage.FloridaBirds: Warm-blooded VERTEBRATES possessing FEATHERS and belonging to the class Aves.MarylandSongbirds: PASSERIFORMES of the suborder, Oscines, in which the flexor tendons of the toes are separate, and the lower syrinx has 4 to 9 pairs of tensor muscles inserted at both ends of the tracheal half rings. They include many commonly recognized birds such as CROWS; FINCHES; robins; SPARROWS; and SWALLOWS.Nursing Homes: Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Budgets: Detailed financial plans for carrying out specific activities for a certain period of time. They include proposed income and expenditures.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Judaism: The religion of the Jews characterized by belief in one God and in the mission of the Jews to teach the Fatherhood of God as revealed in the Hebrew Scriptures. (Webster, 3d ed)Hospital Charges: The prices a hospital sets for its services. HOSPITAL COSTS (the direct and indirect expenses incurred by the hospital in providing the services) are one factor in the determination of hospital charges. Other factors may include, for example, profits, competition, and the necessity of recouping the costs of uncompensated care.ArkansasWest VirginiaPolicy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.Patient Credit and Collection: Accounting procedures for determining credit status and methods of obtaining payment.Insurance, Pharmaceutical Services: Insurance providing for payment of services rendered by the pharmacist. Services include the preparation and distribution of medical products.Economics, Hospital: Economic aspects related to the management and operation of a hospital.New JerseyDrug Costs: The amount that a health care institution or organization pays for its drugs. It is one component of the final price that is charged to the consumer (FEES, PHARMACEUTICAL or PRESCRIPTION FEES).Mechanoreceptors: Cells specialized to transduce mechanical stimuli and relay that information centrally in the nervous system. Mechanoreceptor cells include the INNER EAR hair cells, which mediate hearing and balance, and the various somatosensory receptors, often with non-neural accessory structures.North CarolinaEuthanasia: The act or practice of killing or allowing death from natural causes, for reasons of mercy, i.e., in order to release a person from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals.New YorkDental Care for Children: The giving of attention to the special dental needs of children, including the prevention of tooth diseases and instruction in dental hygiene and dental health. The dental care may include the services provided by dental specialists.MichiganInflation, Economic: An increase in the volume of money and credit relative to available goods resulting in a substantial and continuing rise in the general price level.Geraniaceae: A plant family of the order Geraniales, subclass Rosidae, class Magnoliopsida.Medicare Assignment: Concept referring to the standardized fees for services rendered by health care providers, e.g., laboratories and physicians, and reimbursement for those services under Medicare Part B. It includes acceptance by the physician.Reimbursement, Incentive: A scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered.MaineRisk Sharing, Financial: Any system which allows payors to share some of the financial risk associated with a particular patient population with providers. Providers agree to adhere to fixed fee schedules in exchange for an increase in their payor base and a chance to benefit from cost containment measures. Common risk-sharing methods are prospective payment schedules (PROSPECTIVE PAYMENT SYSTEM), capitation (CAPITATION FEES), diagnosis-related fees (DIAGNOSIS-RELATED GROUPS), and pre-negotiated fees.Fraud: Exploitation through misrepresentation of the facts or concealment of the purposes of the exploiter.Social Welfare: Organized institutions which provide services to ameliorate conditions of need or social pathology in the community.Fees and Charges: Amounts charged to the patient as payer for health care services.Medical Assistance: Financing of medical care provided to public assistance recipients.Drug Utilization Review: Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.Health Benefit Plans, Employee: Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.Contract Services: Outside services provided to an institution under a formal financial agreement.Fee Schedules: A listing of established professional service charges, for specified dental and medical procedures.Cost Sharing: Provisions of an insurance policy that require the insured to pay some portion of covered expenses. Several forms of sharing are in use, e.g., deductibles, coinsurance, and copayments. Cost sharing does not refer to or include amounts paid in premiums for the coverage. (From Dictionary of Health Services Management, 2d ed)Finches: Common name for small PASSERIFORMES in the family Fringillidae. They have a short stout bill (BEAK) adapted for crushing SEEDS. Some species of Old World finches are called CANARIES.Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.Government Agencies: Administrative units of government responsible for policy making and management of governmental activities.OhioInsurance, Physician Services: Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense".Legislation, Hospital: Laws and regulations concerning hospitals, which are proposed for enactment or enacted by a legislative body.Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Pigmentation: Coloration or discoloration of a part by a pigment.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.KentuckyFinancing, Government: Federal, state, or local government organized methods of financial assistance.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Utilization Review: An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.Cost Allocation: The assignment, to each of several particular cost-centers, of an equitable proportion of the costs of activities that serve all of them. Cost-center usually refers to institutional departments or services.Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.South CarolinaDiagnosis-Related Groups: A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.Case Management: A traditional term for all the activities which a physician or other health care professional normally performs to insure the coordination of the medical services required by a patient. It also, when used in connection with managed care, covers all the activities of evaluating the patient, planning treatment, referral, and follow-up so that care is continuous and comprehensive and payment for the care is obtained. (From Slee & Slee, Health Care Terms, 2nd ed)Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality.Disabled Persons: Persons with physical or mental disabilities that affect or limit their activities of daily living and that may require special accommodations.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Ownership: The legal relation between an entity (individual, group, corporation, or-profit, secular, government) and an object. The object may be corporeal, such as equipment, or completely a creature of law, such as a patent; it may be movable, such as an animal, or immovable, such as a building.Models, Econometric: The application of mathematical formulas and statistical techniques to the testing and quantifying of economic theories and the solution of economic problems.MassachusettsHealthcare Disparities: Differences in access to or availability of medical facilities and services.MissouriUnited States Dept. of Health and Human Services: A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.Skilled Nursing Facilities: Extended care facilities which provide skilled nursing care or rehabilitation services for inpatients on a daily basis.Home Care Services: Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.Fees, Pharmaceutical: Amounts charged to the patient or third-party payer for medication. It includes the pharmacist's professional fee and cost of ingredients, containers, etc.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.
  • The 14 conditions in the bill include employment and job search requirements, cost-sharing by enrollees and maximized use of private insurance plans instead of the traditional Medicaid plan. (dailylocal.com)
  • The audit would evaluate the appropriateness of the lump-sum, capitated rates paid to the insurers as well as the healthcare outcomes of Medicaid enrollees who are in a managed-care plan. (modernhealthcare.com)
  • There also have been some worries Medicaid enrollees are having trouble finding specialists. (modernhealthcare.com)
  • The higher cost would also apply to current enrollees who leave Medicaid for a month or more, then seek to return when they fall on hard times. (cbpp.org)
  • The proposal would change the way the federal government currently funds Medicaid by limiting federal funding and shifting cost over time to both states and Medicaid enrollees, and their families. (aarp.org)
  • One important role for Medicaid is to provide risk protection, shielding enrollees from the financial impact of particularly adverse health events, which is the most fundamental role of an insurance product. (marginalrevolution.com)
  • One source of evidence comes from Massachusetts' low-income health insurance exchange, where researchers could observe how much charging higher premiums for Medicaid-like coverage led enrollees to drop out: at least 70 percent of enrollees valued insurance at less than their own cost of coverage. (marginalrevolution.com)
  • That could allow Trump to approve changes proposed by Republican governors that the Obama administration has rejected, including work requirements for Medicaid enrollees and monthly premiums and other cost-sharing. (governing.com)
  • Many older consumers would face huge premium hikes under the GOP bill because its tax credits are not as generous as Obamacare's subsidies for lower-income enrollees in their 50s and early 60s. (cnn.com)
  • Sen. Max Wise, a Campbellsville Republican and the sponsor of SB 5, said the efforts should provide significant help to independent pharmacists, many of whom are struggling under cuts from managed care under Medicaid, which covers about 1.3 million people in Kentucky. (usatoday.com)
  • This enhanced federal funding of state Medicaid programs is important for the prevention of additional cuts to pharmacy services and pharmacy access at the state level," National Association of Chain Drug Stores president and CEO Steve Anderson said. (drugstorenews.com)
  • The National Association of Medicaid Directors on Monday criticized the deep cuts to Medicaid proposed in the Senate's draft legislation to repeal and replace Obamacare as "unworkable. (talkingpointsmemo.com)
  • But the group blasted the cuts the draft bill would impose to Medicaid. (talkingpointsmemo.com)
  • NGA Executive Director Raymond Scheppach said that Medicaid could be a top candidate for cuts in states with budget issues if Congress allows the additional Medicaid funding to lapse in December. (californiahealthline.org)
  • That would cut federal Medicaid spending, with the cuts growing each year. (cbpp.org)
  • To compensate for these cuts, states would have to raise taxes, cut other budget areas like education, or as is far likelier, cut Medicaid spending. (cbpp.org)
  • Faced with these cuts, many states would have to cut home- and community-based services , an optional benefit in Medicaid that enables people with serious health problems (including children with disabilities) to remain in their homes instead of a nursing home by helping them with daily living activities like bathing and getting dressed. (cbpp.org)
  • Other "optional" programs that help people stay independent in their homes, such as Community First Choice, Money Follows the Person, and Medicaid "buy-in" programs would also be at risk of deep cuts. (cbpp.org)
  • Medicaid cuts would threaten key resources for students with disabilities. (cbpp.org)
  • Provides tax cuts for the wealthy - Perhaps the cruelest aspect of the Senate Republican health care bill is that it would devastate health coverage for tens of thousands of North Dakotan families - and millions of Americans nationwide - all while giving billions of dollars in tax breaks to the most affluent and special interests, like national insurance companies that pay their CEOs over $500,000 . (insurancenewsnet.com)
  • The proposed Medicaid cuts will grow deeper over time. (aarp.org)
  • These significant cuts to Medicaid will have negative impacts on older adults, adults with disabilities, and individuals and families who rely on Medicaid to meet their health care and long-term services and supports needs. (aarp.org)
  • The Republican bill to repeal and replace Obamacare narrowly passed the House of Representatives on Thursday, advancing a plan that would gut health coverage for millions of Americans while delivering tax cuts to the rich. (time.com)
  • In addition, Medicaid would see a $772 billion cut over the next decade, while wealthy Americans would receive $541 billion in tax cuts. (truthout.org)
  • WASHINGTON - Alaska doesn't fare very well under the proposed Senate health care legislation: Many Alaskans are likely to face higher premium costs or less coverage, and the state would eventually have to make deep cuts to Medicaid coverage. (adn.com)
  • Medical costs historically rise faster than inflation, so as time goes by, the Medicaid cuts "grow bigger and bigger and bigger," Greenstein said. (adn.com)
  • Either way, "states would have no alternative but to make massive cuts" to Medicaid programs, Greenstein said. (adn.com)
  • Eliminates Medicaid Disproportionate Share Hospital cuts in the current federal fiscal year and reduces and delays next year's cuts. (bricker.com)
  • Effective July 1, 2017, you must bill all Medicaid inpatient and outpatient substance use disorder claims either directly to the Michigan Department of Health and Human Services (MDHHS)/Fee For Service Medicaid, or to the local Prepaid Inpatient Health Plan (PIHP), for payment. (priorityhealth.com)
  • Any Medicaid substance use disorder inpatient claims Priority Health paid between Jan. 1, 2017 and now will be recouped, and providers will be advised to bill the proper PIHP instead. (priorityhealth.com)
  • New AARP Public Policy Institute projections find that the per enrollee cap proposal in Graham-Cassidy-Heller-Johnson will cut between $1.2 trillion and $3.2 trillion from total (federal and state) Medicaid spending over the 20-year period between 2017 and 2036 (see table 1 below). (aarp.org)
  • Transfers from the Department of Children and Families (DCF) to the AHCA the responsibility for conducting Medicaid fair hearings related to Medicaid programs administered by the AHCA, by March 1, 2017. (flsenate.gov)
  • This billing for up to 4 units per line item was acceptable until 2015- mid 2016, then late 2016-early 2017. (aapc.com)
  • Sen. Susan Collins, R-Maine, speaks amid a crush of reporters after Republicans released their long-awaited bill to scuttle much of President Barack Obama's Affordable Care Act, at the Capitol in Washington, Thursday, June 22, 2017. (timesfreepress.com)
  • All told, the AHCA would have a devastating impact on health care for over 70 million people who rely on Medicaid, including over 30 million children and millions of seniors, people with disabilities, pregnant women, and low-income adults. (cbpp.org)
  • Updates the years of audited data that AHCA uses to determine each hospital's Medicaid days and charity care for the disproportionate share hospital (DSH) programs. (flsenate.gov)
  • Effective upon the bill becoming law, authorizes the Department of Highway Safety and Motor Vehicles to allow the Agency for Health Care Administration (AHCA), via interagency agreement, to access photographic images of driver licenses for the purpose of preventing health care fraud. (flsenate.gov)
  • The bill authorizes the AHCA to contract with a private entity to carry out duties relating to health care fraud prevention under specified safeguards and parameters. (flsenate.gov)
  • Deletes the requirement in current law for the AHCA to limit payment for hospital emergency department visits for non-pregnant Medicaid recipients 21 years of age or older to six visits per fiscal year. (flsenate.gov)
  • Can States Survive the Per Capita Medicaid Caps in the AHCA? (american.edu)
  • For example, beginning in 2020, the bill would subject the traditional Medicaid eligibility groups- aged, disabled, and children to mandatory caps on a per-person basis. (aarp.org)
  • Another significant issue facing lawmakers this year comes on the question of whether to expand Medicaid this year. (fosters.com)
  • But the nonpartisan Congressional Budget Office (CBO) has not yet scored the revised bill, so lawmakers voted without key projections on how the legislation would affect the number of insured, premium costs, the federal budget, and other measures. (time.com)
  • The bill lawmakers eventually approved spares retired teachers and makes only one major change for existing teachers. (kentucky.com)
  • But Dollar said Cohen shouldn't be involved in Cooper's attempt to expand Medicaid, which GOP lawmakers think would be illegal. (newsobserver.com)
  • But Alaska's Republican lawmakers have repeatedly cited its previous data on health care costs, particularly an analysis of the recent U.S. House health care bill. (adn.com)
  • Arizona Gov. Jan Brewer is planning to attend a rally at the Capitol this week designed to pressure lawmakers into approving her plan to expand Medicaid. (azcapitoltimes.com)
  • This is a bill that really focuses on trying to help children and encouraging better teachers," Gov. Charlie Crist said hours after the Senate took what Republican lawmakers called a historic vote for education reform. (bradenton.com)
  • The original bill, called the American Health Care Act, had a lot of critics -- ranging from conservative lawmakers to moderate ones to insurers to the AARP. (cnn.com)
  • The cap would equal federal Medicaid spending per beneficiary in 2016, rising each year by a slower rate than the Congressional Budget Office's (CBO) current projection for Medicaid per beneficiary spending. (cbpp.org)
  • Sex education stressing abstinence, Kentucky bourbon and wine, improvements to adoption and foster care and help for pharmacists squeezed by Medicaid payments were among bills that won final passage Monday as the 2018 legislative session wound down. (usatoday.com)
  • BOSTON - United States Attorney Carmen M. Ortiz announced today that Boston Medical Center (BMC) and two of its physician practice organizations have agreed to pay $1.1 million to resolve allegations that BMC improperly billed Medicare and Medicaid. (justice.gov)
  • Proponents, including House Speaker Paul Ryan, say the bill will restore choice to consumers and lower premiums that spiraled out of control under Obamacare. (time.com)
  • Beyond that, the bill would restructure all of Medicaid, not just the parts that Obamacare touched. (time.com)
  • Conservatives complained that the bill does not fully repeal Obamacare and that many provisions are too similar to the health reform law. (cnn.com)
  • In February, JAMA published a study that estimated costs of billing and insurance-related activities in an academic health system ranging from $20 for a primary care visit to $215 for an inpatient surgical procedure. (medscape.com)
  • States would also have the option of converting Medicaid to a block grant for children, adults (other than seniors and people with disabilities), or both. (cbpp.org)
  • Under H.B. 2138, healthy adults on Medicaid must have at least a part-time job, complete 20 weeks or more of job training or complete 12 job training-related activities in a month. (triblive.com)
  • Obama law: States have the option to expand Medicaid to cover more low-income adults. (timesfreepress.com)
  • House GOP bill: Loosens the age restriction so insurers can charge older adults up to 5 times more. (timesfreepress.com)
  • When Masonicare realized in 2009 it had improperly coded its Lupron injections and had been overpaid, Fein said the health care facility never self-disclosed its improper billing to the government or made any attempt to pay the money back. (nhregister.com)
  • The White House praised Alaska Gov. Bill Walker for opting to expand Medicaid Tuesday under President Obama's health care law, balancing out their praise with thinly veiled criticism for about 20 states that have refused to expand their own programs, leaving millions "needlessly uninsured. (washingtontimes.com)
  • The American Health Care Act, as the bill is called, had been tweaked in several ways since it was pulled from a House vote in March after failing to garner enough support. (time.com)
  • Scott made his suggestion at the end of a topsy-turvy day that witnessed GOP leaders in the Florida House and Senate remaining firm in their positions regarding health care funding and whether to expand Medicaid. (washingtontimes.com)
  • The Oregon Experiment found that gaining Medicaid uniformly increased health care use: including hospitalizations (by 30 percent), emergency room use (by 40 percent), physician office visits (by 50 percent), and prescription drugs (by 15 percent). (marginalrevolution.com)
  • As it stands now, though, the low reimbursement rates of Medicaid already lead to long lines, or an inability to find a good doctor altogether, while the higher reimbursement rates of Medicare and private insurance keep health care costs high. (marginalrevolution.com)
  • No longer will the federal government pay a proportion (usually 50 percent) of the Medicaid health care costs. (adn.com)
  • Since the Affordable Health Care Act passed, many states have overhauled their Medicaid requirements, covering more people than ever before. (reference.com)
  • Today, states confront the dilemma of having to choose between joining Medicaid or being forced to sacrifice any health care "safety net" for their indigent populations. (hawaiireporter.com)
  • What's inside the Republican health care bill? (cnn.com)
  • WASHINGTON (AP) - The Senate Republican health care bill would guarantee immediate assistance for insurance markets that are struggling in many states. (timesfreepress.com)
  • New Hampshire Congresswoman Annie Kuster is calling on Republican House leaders to withdraw their health care reform bill. (nhpr.org)
  • The lawsuit, which was filed under the qui tam provision of the False Claims Act in 2015 and made public Thursday, alleges Epic's billing software's default protocol is to charge for both the applicable base units for anesthesia provided on a procedure as well as the actual time taken for the procedure. (beckershospitalreview.com)
  • I was a bit unsure whether this provision had made it into the final bill, but the CBO score (Title I, Subtitle B, Sec 1202 for those keeping track at home) seems to imply that it did. (medpagetoday.com)
  • The extenders bill originally included a provision to extend federal Medicaid assistance through mid-2011. (californiahealthline.org)
  • A recession produces huge shortfalls in revenue for the states, creating pressure to cut spending, while, at the exact same time, there are more unemployed and otherwise impoverished people signing up for Medicaid and increasing the costs. (medpagetoday.com)
  • Medicaid provides supports that help people with disabilities remain independent in their homes and communities. (cbpp.org)
  • Medicaid can also help people with disabilities find and hold jobs. (cbpp.org)
  • But opponents argued that the people targeted by the bill were probably already looking for jobs. (apnews.com)
  • Reports are coming in from across the country of people facing bills of nearly $35,000 or up to nearly $90,000 if ventilator support is needed. (whittierdailynews.com)
  • Its prime sponsor, Fayette County Republican Matthew Dowling, touted the bill as a way "to help people out of poverty and reliance on the government for aid. (triblive.com)
  • Second, many of the benefits of Medicaid go to medical providers who would otherwise provide uncompensated or unpaid care to the same people. (marginalrevolution.com)
  • A significant influx of people into Medicaid, under current institutions, will lead to more queuing. (marginalrevolution.com)
  • To interpret CPT medical billing codes, people outside the medical profession can consult the American Medical Association's official website, suggests Abo. (reference.com)
  • Medicaid covers only specific group of people regardless of income. (medicalbillingcodings.org)
  • If we do not have fewer people in Medicaid in four years, then we have not reformed health policy in a good direction," he said. (governing.com)
  • The MRT set aside five minutes for Eddie Rodriguez, president of District Council 37, speaking on behalf of Local 1549's New York City clerical workers who help enroll people in Medicaid, and Anthony Wells from DC 37's Social Service Employees Union Local 371, which represents 17,000 workers employed by New York City in social service professions. (crainsnewyork.com)
  • Senate staffers said they were continuing to look for a way to alter the bill - within procedural rules - that would keep people from "gaming the system. (adn.com)
  • The Congressional Budget Office found that 24 million fewer people would be insured by 2026 under the GOP bill. (cnn.com)
  • Medicaid covers some 70 million people, from newborns to elderly nursing home residents. (timesfreepress.com)
  • Senate GOP bill: Premium subsidies are keyed to income, age and geography, and are more tightly focused on lower-income people. (timesfreepress.com)
  • The nonpartisan Congressional Budget Office estimates the bill would increase the number of people without insurance by 14 million in the first year, and 24 million by 2026. (nhpr.org)
  • The sale of a life insurance policy can keep people off Medicaid. (wikipedia.org)
  • Mr. President, according to CBO - and that report just came out a few hours ago - this bill would throw 22 million Americans off of health insurance, cut Medicaid by over $770 billion, defund Planned Parenthood and substantially increase premiums for older Americans. (truthout.org)
  • In addition to advocating on the bill's FMAP provisions, the NACDS also lobbied on behalf of pharmacies on the bill's alteration of the definition of "average manufacturer price," inserted into the bill to help pay for it. (drugstorenews.com)
  • The House, which approved the extenders bill last week, excluded several key health-related provisions as part of efforts to alleviate members' concerns over the bill's cost and to secure enough votes for its passage. (californiahealthline.org)
  • The bill's other Medicaid changes would cut another $19 billion over ten years. (cbpp.org)
  • If it passes the Senate, President Donald Trump is expected to sign the bill into law. (time.com)
  • Last month, the Trump administration issued guidance that, for the first time in the program's history , it would consider allowing states to enact work or community service requirements to qualify for Medicaid. (latimes.com)
  • Trump could also end some waivers that expanded Medicaid and sent billions in new federal funding to some states that transformed care. (governing.com)
  • Women On $20s announced this week that its voters had selected Harriet Tubman as the woman it will encourage President Obama to swap in for Andrew Jackson on the $20 bill. (sheknows.com)
  • Barbie Hays, the coding and compliance strategist for the American Academy of Family Physicians, said her long experience with medical billing makes her doubt a conclusion that the researchers suggested in the paper. (medscape.com)
  • Where can you find medical billing codes? (reference.com)
  • A free resource for medical billing codes is ICD9Data.com, which provides a database of the current ICD-9-CM and HCPCS medical billing codes. (reference.com)
  • How do you look up medical billing codes? (reference.com)
  • Our medical billing specialists can help resolve claims that were denied due to pre-authorization issues. (patientadvocate.org)
  • Anesthesia Medical billing Guidelines and procedure codes. (anesthesiabilling.org)