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Eligibility for Medicaid coverage is based on income, family size, disability status and age, and can vary from state to state. The expansion of Medicaid through the Affordable Care Act made ...
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. [2] There are two main forms of Medicaid managed care, "risk-based MCOs" and "primary care case management (PCCM)." [3] Managed care delivery systems grew rapidly in the Medicaid program during the 1990s.
The Health Insurance Premium Payment Program (HIPP) is a Medicaid program that allows a recipient to receive free private health insurance paid for entirely by their state's Medicaid program. A Medicaid recipient must be deemed 'cost effective' by the HIPP program of their state. Ultimately, the program was made optional, and its use is minimal ...
The contract is not usually exclusive so individual doctors or the group may sign contracts with multiple HMOs. Physicians who participate in IPAs usually also serve fee-for-service patients not associated with managed care. IPAs usually have a governing board to determine the best forms of practices.
Last fall, the U.S. Centers for Medicare and Medicaid Services approved a test program that allowed Arkansas to spend up to $85 million in federal and state funds on health-related needs.
The guidelines for calculating the FMAP are outlined in the Social Security Act and they exclusively determine the ratio of matching funds for each state's Medicaid program. Section 2105(b)of the Act stipulate that "Enhanced Federal Medical Assistance Percentages," or Enhanced FMAPs, will be calculated at the same time as the FMAPs.
The history of Medicaid suggests the expansion would continue to spread if the Affordable Care Act were left in place. When the program launched more than 50 years ago, just over half the states signed up in the first two years. The last state to join, Arizona, didn’t begin participating until 1982.