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On March 26, 1998, US Attorney Mike Skinner announced that Acadian Ambulance had agreed to pay the federal government $1.9 million to settle a lawsuit that charged the Lafayette company with overbilling the Medicare and Medicaid programs from 1990 to 1994 by offering a greater discount to members than allowed by law. The Company did not incur ...
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Medicaid is a government program in the United States 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 significant ...
Durable medical equipment (DME) is a category of medical devices designed to assist individuals with disabilities, injuries, or chronic health conditions. [1] These devices are prescribed by healthcare professionals and intended for repeated use over an extended period.
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It is often referred to as "durable" medical equipment (DME) as it is intended to withstand repeated use by non-professionals or the patient, and is appropriate for use in the home. Medical supplies of an expendable nature, such as bandages, rubber gloves and irrigating kits are not considered by Medicare to be DME.
An additional 4.8 million joined Medicaid. [3] Enrollment for 2015 began on November 15, 2014, and ended on December 15, 2014. [4] As of April 14, 2020, 11.41 million people had signed up through the health insurance marketplaces. [5] Private non-ACA health care exchanges also exist in many states, responsible for enrolling 3 million people. [6]
In response, states like Ohio, West Virginia, and Louisiana have taken action to regulate PBMs within their Medicaid programs. For instance, they have created new contracts that require all discounts and rebates to be reported to the states. In return, Medicaid pays PBMs a flat administrative fee. [19]