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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 ...
Top Dollar Program (TOP$)SM is the State Medicaid Pharmaceutical Purchasing Pool started by Provider Synergies, for Louisiana and Maryland in 2005. Delaware, Idaho, Nebraska, Pennsylvania and Wisconsin joined more recently for a total of seven participants as of April 2009.
Medicaid is the largest revenue source for FQHCs, but Medicare offers financial incentives, such as higher per-visit fees compared to non-FQHC providers, making FQHC status attractive. Under the Affordable Care Act, Medicare transitioned to a Prospective Payment System (PPS) in 2014, offering additional payments for preventive services and new ...
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Medicaid expansion has provided nearly 480,000 previously uninsured residents with coverage, dropping the state's uninsured rate to 8.4% in 2017 [9] LDH also includes the Bureau of Community Partnerships & Health Equity, which is responsible for operationalizing community engagement and health equity best practices and standards agency wide ...
MMS has Medicaid Management Information Systems (MMIS) contracts with Idaho, Louisiana, Maine, New Jersey, West Virginia and the U.S. Virgin Islands. In Autumn 2018, Molina Healthcare, Inc. sold its Medicaid management information systems business, Molina Medicaid Solutions (MMS), to DXC Technology. MMS was a wholly owned subsidiary of Molina ...
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Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
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