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As of June 1, 2015, the Texas Health and Human Services Commission mandates that electronic visit verification be used for all home healthcare visits billed to the state. [3] The state of Ohio began the process of implementing an electronic verification system that would be used starting in 2016. [ 7 ]
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]
A variety of different types of health plans serve Medicaid managed care programs, including for-profit and not-for-profit, Medicaid-focused and commercial, independent and owned by health care providers such as community health centers. In 2007, 350 health plans offered Medicaid coverage.
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Conflicting information, computer systems not working, denials before verification and more problems come to the surface from whistleblowers, advocacy groups.
President Barack Obama signed the Affordable Care Act (ACA) into law on March 23, 2010, in the East Room before a select audience of nearly 300 people. He stated that the health reform effort, designed after a long and acrimonious debate facing fierce opposition in the Congress to expand health insurance coverage, was based on "the core principle that everybody should have some basic security ...
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WellCare began operations in 1985 in Tampa, Florida as a Medicaid provider for the State of Florida. [5] In 1992, Kiran Patel, a cardiologist and entrepreneur, purchased the company. [6] [7] In 2002, Patel sold it to a New York investment group led by George Soros and Todd Farha. [7] Also in 2002, Todd Farha joined the company as CEO. [8] [9]