Report Considers the Impact of Medicaid and CHIP and their Future under the ACA

Posted on: April 10th, 2014 by hmshealthcare

Medicaid and the Children’s Health Insurance Program (CHIP) provide health insurance coverage to more than one in three children. According to a Kaiser study, these two programs provided coverage to 33.7 million children as of June 2013. A new brief from the Kaiser Family Foundation examines the availability of coverage for children in the years […]


Report Examines High-Expenditure Medicaid-Only Beneficiaries

Posted on: March 6th, 2014 by hmshealthcare

The Government Accountability Office (GAO) has released a report examining the characteristics of high-expenditure Medicaid-only beneficiaries and their impact on state Medicaid spending. According to the GAO, far less attention has been given to high-expenditure Medicaid-only beneficiaries than to the dual-eligible population (individuals who qualify for both Medicare and Medicaid), even though states’ spending habits […]


Mental Health Parity and the Affordable Care Act

Posted on: February 13th, 2014 by hmshealthcare

Before the Mental Health Parity Act of 1996, health insurance coverage for mental health conditions was commonly less generous than coverage for other physical illnesses. Mental health parity legislation was a response to this insurance coverage discrepancy. It essentially requires that health insurance coverage for mental health and substance use disorder services be offered at […]


Clearer Reporting of Medicaid Improper Payments Needed, Says GAO

Posted on: January 14th, 2014 by hmshealthcare

States and the federal government have historically played key roles in identifying Medicaid improper payments. However, the Deficit Reduction Act of 2005 increased the Centers for Medicare and Medicaid Services’ (CMS’) Medicaid program integrity responsibilities. As a result, CMS formed the National Medicaid Audit Program (NMAP), a program that uses federal contractors to audit state […]


Initial Medicaid Enrollment Numbers Exceed Expectations

Posted on: December 17th, 2013 by hmshealthcare

At least 1.5 million new individuals have enrolled in or been pre-qualified for expanded Medicaid coverage since health insurance Marketplace open enrollment began, according to a recent survey. Medicaid enrollment has greatly exceeded enrollment in private coverage since October 1, and the initial Medicaid enrollment numbers are also exceeding expectations. Reasons for High Initial Medicaid […]


Popularity of Medicaid Managed Care Expected to Grow

Posted on: December 10th, 2013 by hmshealthcare

Managed care is the future of Medicaid, according to Dr. Vern Smith, PhD, former Medicaid Director and current managing principle at Health Management Associates. Today, nearly half of Medicaid recipients are enrolled in managed care and approximately 78% of reimbursements come from fee-for-service. But those numbers are likely to change in a big way in […]


Arkansas Expands Medicaid through Premium Assistance

Posted on: November 20th, 2013 by hmshealthcare

Health insurance and how individuals obtain coverage has been a hot topic as of late for most Americans. For residents of Arkansas who are newly eligible for Medicaid as a result of the Affordable Care Act (ACA), something brand new is on the horizon. They will experience Medicaid in a different way, through a plan […]


North Carolina Medicaid Mulls Moving to Managed Care

Posted on: October 23rd, 2013 by hmshealthcare

As budgetary pressures and healthcare costs continue to rise, more and more states have begun shifting portions of their Medicaid populations to managed care in an effort to better predict costs and improve health outcomes. In early 2013, North Carolina began debating whether it should become the next state to privatize its Medicaid program. State […]


Federal Marketplace and Medicaid Aren’t on the Same Page (Yet)

Posted on: October 22nd, 2013 by hmshealthcare

Health insurance Marketplaces (or “Exchanges”) are designed to be a one-stop shop for individuals in need of insurance coverage. Private plans are available at a variety of price points, and if the individual qualifies for Medicaid, he or she can enroll online, on the spot. But that simple shopping experience is not quite ready for […]


Medicaid Expansion Opt-out Will Impact More Americans than Expected

Posted on: October 17th, 2013 by hmshealthcare

As written, the Affordable Care Act (ACA) would have required all states to expand their Medicaid programs to individuals earning up to 133% of the federal poverty level. However, the 2012 Supreme Court ruling on the healthcare law made Medicaid expansion optional for states. As of today, only about 50% of states will expand their […]