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BadgerCare Plus, known informally as BadgerCare, is a public healthcare coverage program for low-income Wisconsin residents created by former governor Tommy Thompson and modified by former governor Jim Doyle. The Wisconsin Department of Health Services oversees the program's implementation.
In addition, dual-eligibles may choose a type of MA plan called a dual-eligible special needs plan (D-SNP), which is designed to target the needs of this population. For Medicaid benefits, beneficiaries generally enroll in their state's Medicaid FFS program or a Medicaid managed care plan administered by an MCO under contract with the state.
Wisconsin is one of 10 states that has not expanded Medicaid eligibility under the Affordable Care Act, also known as Obamacare, to provide health coverage to adults with incomes up to 138% of the ...
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. In 1991, 2.7 million beneficiaries were enrolled in some form of managed care. Currently, managed care is the most common health care delivery ...
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
The FQHC designation also introduced "Health Center Program look-alikes," which meet all HRSA funding requirements under Section 330 of the Public Health Service Act but do not receive direct HRSA funding. These look-alikes are eligible for FQHC reimbursement rates and other benefits available to HRSA-funded centers. [4]
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 ...
Since 1956, WPS has continually served the Military Health System as a claims administrator. WPS managed the first regional plan for Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). WPS MVH provides claims administration, customer service, and related activities for the TRICARE Overseas Program and TRICARE For Life Program.