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Medicaid coverage gap. Under the public healthcare policy of the United States, some people have incomes too high to qualify in their state of residence for Medicaid, the public health insurance plan for those with limited resources, but too low to qualify for the premium tax credits that would subsidize the purchase of private health insurance.
Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; [3] in 2019, the program paid for half of all U.S. births. [4]
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 system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care ...
e. 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]
September 18, 2024 at 7:36 PM. (This story was updated to add a photo gallery and new information.) A federal whistleblower lawsuit accuses insurance companies and hospitals of defrauding Indiana ...
Dual-eligible beneficiaries (Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. [1][2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid ...
Parents of disabled children sue Indiana over Medicaid changes addressing $1 billion shortfall. ISABELLA VOLMERT. May 17, 2024 at 1:37 PM.
Photograph by official White House photographer Michael Evans, courtesy of the Ronald Reagan Presidential Library. A Katie Beckett waiver or TEFRA waiver is a Medicaid waiver concerning the income eligibility for home-based Medicaid services for children under the age of nineteen. Prior to the Katie Beckett waiver, if a child with significant ...
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