Medicaid Active Case Analysis

Throughout the past decade restrictions on eligibility for taxpayer-subsidized medical care has risen at both the state and national level. Some of these restrictions are based on laws and reform acts that have been

Any decision naturally means there must be at least two options from which to choose. The decisions made concerning the Affordable Care Act (ACA) are certainly no exception. Certainly politics enters into the mix, as does associated costs, availability of medical care, quality of care and numerous other factors. While the idea medical care for all seems quite simple on the surface, the devil is in the details. My father, Dudley Plaisance, worked in healthcare for many years, even co-founding a company whose role was to find sources of funding for patients without resources to pay medical

The Affordable Care Act promotes Medicaid expansion. Medicaid expansion is needed in North Carolina to insure the disabled and those that live below the poverty level receive adequate healthcare coverage. The resistance of North Carolina legislature in the promotion of Medicaid reform has retarded Medicaid expansion to its uninsured residents. The cooperation of the North Carolina legislature and its support of the Affordable Care Act is necessary for successful Medicaid reform. This paper reviews the impact of the Affordable Care Act 's lack of implementation in North Carolina.

The Medicaid program has impacted our hospitals and the economy of the state of South Carolina. There are a lot of pressures for most of the hospitals in the state dealing with bad credit, pay cuts, and financial pressure. According to U.S. News (2012), "the Supreme Court upheld the President, Patient Protection, and Affordable Care Act because it was the big key to a health care law expansion of Medicaid." This program is based on lower-income individuals and children that are below

Prior to 2014, NC’s uninsured and uninsurable populations were staggeringly high. Medicaid and the NC Healthy Choice (NCHC) safety net programs are state-run plans with their own unique coverage laws. NCHC is not considered an entitlement program so children could be placed on a wait list until additional funds were found for this program. This left many children without healthcare coverage. In 2009, NC’s Medicaid and NCHC program laws made it impossible

On Tuesday July 7, 2015, at approximately 3:01 PM, Kiana Beekman, (MFCU Investigator) (Beekman) received a call on the state office telephone from HILL, Lucy (Service Facilitator of Lucy Hill Services (LHS). During the conversation, Beekman asked HILL to clarify her role and responsibilities as a service facilitator, in addition to the role and responsibilities of HARRIS, LaFrance as the Employer of Records (EOR) for Medicaid Recipient DANIEL, Rose and MCGHEE, Inocencia as DANIEL’s aide. She was also asked to provide any documentation of training on timesheet submission and approvals that she provided HARRIS and MCGHEE under the Department of Medicaid Services (DMAS) Consumer-Directed care aide program.

Housing Update: client NY NY I, II was approved. Client is waiting for DHS manifest to tour apartment. Another alternative housing is MRT once client SSI is approved. Client also mentioned she signed up with Brightpoint Health Home Health Services since 5/9/2015, Client report she will like to sign up with CAMBA/Home Health and she provided BrightPoint Home Health approval letter for CM to submit to CAMBA/Home Health Coordinator. Client is waiting for her coordinator at Brightpoint to return from vacation to close her case, so that she can sign up with CAMBA/Home Health

Seven of the thirty-three states that adopted Medicaid expansion obtained section 1115 Medicaid demonstration waivers. These waivers allow states flexibility in operating state-specific Medicaid programs beyond what is available under current law. Indiana is among the seven states that are using a Federal waiver to continue its seven-year-old Healthy Indiana Plan instead of implementing the traditional Medicaid expansion offered by the ACA. The Healthy Indiana Plan, also known as HIP 2.0 since 2015, is a health insurance program for uninsured adults with income at or below 138 percent of the Federal poverty level.1 Indiana Medicaid has three programs for patients with serious mental illness, emotional disturbances, and substance use

In the state of Texas Medicaid is funded by state and federal programs. Those eligible to receive Medicare benefit is the low income individuals, families, children, pregnant women, elderly and individuals who suffer with disabilities (Hegar). The Texas Health and Human Service commission (HHSC) distributes the Medicaid (Hegar). Those receiving Medicaid benefits in the fiscal year of 2010 were found to be 55 percent female and 77 percent under the age of 21 (Hegar). Children accounted for 66 percent of all Texas Medicaid recipients in that year; however, 32 percent of those children actually received health care (Hegar).

Following the death of a Medicaid recipient, the program not only can but must attempt to recover costs from the estate of the deceased. Medicaid's official site says:

Dual eligible beneficiaries are among the poorest and sickest of those covered by either Medicare or Medicaid and, subsequently, they account for a disproportionate share of spending in both programs. Yet unfortunately their care is disjointed, with little to no coordination. State and federal agencies, managed care organizations and advocates all agree that the misalignment between Medicare and Medicaid must be addressed. The varying rules, overlapping benefits and conflicting financial incentives between the two programs greatly affect the nearly 10 million beneficiaries nationwide who are dually eligible for both programs.

Michigan expansion. The “Healthy Michigan Plan” is the Section 1115 waiver that was approved by CMS in December 2013 for Michigan to implement the ACA’s Medicaid expansion. This plan uses Medicaid funds to provide coverage for all newly eligible adults with income up to 138% of the FPL (Norris, 2017).

In order to qualify for Healthier Mississippi Waiver (HMW) coverage before the age of sixty-five, an individual must be determined to be disabled. 42 C.F.R. § 435.540 specifies that DOM must use the same definition of disability as is used under the Supplemental Security Income (SSI) program, which is administered through the Social Security Administration (SSA). In addition, 42 C.F.R. § 435.541 specifies that the SSA disability determination is binding on the Medicaid agency until the determination is changed by the SSA.

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

A suit has been filed by the New Hampshire Hospital Association, along with several other NH hospitals against CMS over the treatment of dual eligibles in the calculation of uncompensated care for purposes of the DSH program. An initial hearing related to the suit is scheduled for early December. This hearing could potentially put the 2011 DSH recoupments on hold pending further proceedings. Similar suits have already been filed by other States/organizations and the outcome of these proceedings could eventually affect the