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Montana, one of about a dozen states still managing its own Medicaid programs, has a new Medicaid director who championed handing the management of the program to private companies in Iowa and Kansas.
El estado impuso una multa de $55 millones a L.A. Care por múltiples violaciones en sus procesos de asistencia médica.
California regulators issued record fines against L.A. Care, the state’s largest Medi-Cal managed-care plan, for providing inadequate care to its enrollees. But whether the penalties are a sign that the state will make a more forceful effort to improve Medi-Cal’s overall quality of care remains to be seen.
Georgia lawmakers unveiled a mental health bill that would limit the profits of the managed-care companies that serve Medicaid patients. KHN previously reported that Georgia, unlike most states, does not set a medical loss ratio for the companies’ spending on medical care and quality improvements.
The nine commercial insurers in Medi-Cal must reapply by submitting bids for new contracts. The state hopes the process will improve care for low-income residents and tighten accountability, something critics say has been missing.
Illinois is moving thousands of children into its Medicaid managed-care program. Proponents say the approach can cut costs while increasing access to care. But after a phase-one rollout of the new health plans caused thousands to temporarily lose coverage, some question whether it’s the right move.
Entrevistas con docenas de terapeutas, pacientes y expertos pintan un cuadro de mejoras superficiales, pero que no se traducen en una atención más efectiva y accesible.
Interviews with dozens of Kaiser Permanente therapists, patients and industry experts reveal superficial changes that look good on paper but do not translate into more effective and accessible care.
Dozens of frail nursing home residents have been informed by their Medi-Cal managed care plans that they are no longer eligible for long-term care. Some health care advocates and legal aid attorneys fear that such terminations will increase as the state implements mandatory managed care for nursing home residents.
Facing GOP pressure to install work requirements for adults getting Medicaid coverage, some states seek instead to offer more opportunities for job training.
Psychiatric treatment for children in Medicaid managed-care plans in Missouri has declined and suicide risks are up, reveals a study sponsored by the state hospital association.
Managed-care plans, which reap billions in taxpayer dollars to coordinate care for low-income Americans on Medicaid, outsource crucial treatment decisions to subcontractors that aren’t directly accountable to the government. In California, health officials say one firm improperly withheld or delayed care for hundreds of people.
The money was paid on behalf of more than 400,000 people who may have been ineligible for the public program, a state audit found. One had been dead for four years before payments stopped.
Norma Díaz y su esposo, Joseph García, han dedicado sus carreras a administrar una aseguradora de salud sin fines de lucro que cubre a residentes carenciados de California. Y en el proceso, han ganado millones de dólares.
How a California health plan’s CEO and her husband, an executive consultant, got rich off the taxpayer-funded program for the poor. Critics see a conflict of interest, the plan doesn’t, and the state has no rules either way.
State regulators and insurers are looking into SynerMed, which medical groups depend upon to handle their finances and business operations. The groups, serving 1 million patients, fear a messy fallout.
Complaints are rising against for-profit insurance companies that manage Medicaid for about 600,000 Iowans. The privatization of Medicaid is a national trend affecting more than half of the 74 million Americans who get their health care through the state-federal program.
Advocates say California’s Medicaid program is violating its own rules by overturning decisions that would allow seriously ill patients to stay out of managed care and keep their doctors.
LogistiCare often shows up late, if at all, and compromises patient safety, according to a public interest firm’s lawsuit. The company says the allegations are inaccurate.
The California Nurses Association, representing some 100,000 registered nurses, is regarded statewide and nationally as a progressive political powerhouse. “Politicians are afraid” of the activists they turn out, said one critic.