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The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
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 ...
In the 1980s, as Medicaid managed care expanded across the county, safety net providers, such as Community Health Centers (CHCs) and public hospitals, feared that managed care would reduce reimbursements for Medicaid-eligible services, making it more difficult for them to provide care to the un- and under-insured, and result in a loss of Medicaid volume, as beneficiaries would choose to see ...
After the passage of the ACA, 32 states used the funding of the ACA to expand their state's low-income insurance programs, such as Medi-Cal, and 19 states opted out. The 19 states, as of 2014, had a 15% higher poverty rate than the 32 states that chose to expand their services. California was one of the states to expand its Medicaid program. [6]
The Hospital Value-Based Purchasing Program in Medicaid has also shown the potential to improve health outcomes, with early studies reporting positive and significant effects on total patient experience score, 30-day readmission rates, incidences of pneumonia and pressure ulcers, and 30-day mortality rates for pneumonia. [285]
A review by Pennsylvania's elected financial watchdog concluded there were shortcomings in a state agency's oversight of fees paid to pharmacy benefit managers in the Medicaid program, but the ...
State governments use FMAP percentages to determine the federal government's contribution to specific state administered programs and assess their related budgetary outlays. For example, the general 2006-2007 FMAP rate for California was 50% meaning that for every dollar that California contributed to an eligible social or medical program ...
As initially passed, the ACA was designed to provide universal health care in the U.S.: those with employer-sponsored health insurance would keep their plans, those with middle-income and lacking employer-sponsored health insurance could purchase subsidized insurance via newly established health insurance marketplaces, and those with low-income would be covered by the expansion of Medicaid.