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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 ...
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.
As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. [2] 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.
Among the touted benefits of the two new Medicaid contracts, scheduled to start on July 1, 2025, according to the McKee administration. Reducing unnecessary prior authorizations (PAs ...
The gist: By March 1, 2025, dental insurance carriers will be required to submit to the state's health insurance commissioner, "an actuarial memorandum disclosing its incurred claims and earned ...
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The guidelines for calculating the FMAP are outlined in the Social Security Act and they exclusively determine the ratio of matching funds for each state's Medicaid program. Section 2105(b)of the Act stipulate that "Enhanced Federal Medical Assistance Percentages," or Enhanced FMAPs, will be calculated at the same time as the FMAPs.
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.