Medicaid programs mull dropping insurers
Various state Medicaid programs are considering replacing outside managed care plans with in-house management. Such a reversal of the multi-decade trend to outsourcing overall management of Medicaid plans to various insurers and reverting to fee-for-service (FFS) Medicaid could have major ramifications for hospitals and health systems. Bruce Greenstein, secretary of the Louisiana Department of Health…
Hospitals see danger to SDPs in fraud fight
Hospitals are worried that a coming Trump administration fraud-fighting effort will go after Medicaid state-directed payments (SDPs). The concern was raised by various hospital advocates responding to the administration’s solicitation for targets in its coming anti-fraud regulations, called the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). That request for information (RFI) specifically asked about fraud-fighting…
Medicaid taxes target of coming regulations
The White House is reviewing a proposed rule to change Medicaid taxes, potentially cutting federal spending by $48 billion to $630 billion over 10 years, and could impact the funding for state-directed payments (SDPs) and designated state health programs (DSHPs).