Meridian of Illinois’ Post

Illinois Medicaid providers—revalidation is underway. Revalidation must be timely or providers risk removal from Medicaid without the ability to bill for services. Because revalidation notices are only sent via email, you should log into IMPACT to ensure ALL email addresses listed under the “Basic Information” page are accurate for your organization. Know when to expect your notice: Look for your “Revalidation Period” on the “Basic Information” page in IMPACT. Don’t attempt to revalidate until you receive your email notice. Organizations with multiple service locations and/or NPI numbers must revalidate each service location and/or NPI number separately. Never ignore a revalidation notice from HFS, even if you think you have already completed the process. Get full details in our provider notice: https://bit.ly/4fUqe1q

why dies it take medicaid managed care 3 months to verify credentials and restrict access when it only took 2-3 weeks 30 yrs ago. private credentialing can be done in weeks but medicaid carriers hurt practices with their absurd policies that only hurt patients. there is no plausible explanation for this delay except to prove their total disregard for private entities and to further restrict patient access. I have a 2 yr lapse in participation with no complaints, no malpractice claims, no criminal issues, and after 3 months have not been vetted by a single medicaid managed care company as competent enough to care for their patients. This must be stopped to restore proper access to medicaid recipients and improve access to care

📊 Essential Tool: The Medicaid Waiver Tracker Keeping up with the constantly evolving landscape of Medicaid waivers is crucial for healthcare professionals. The KFF’s Medicaid Waiver Tracker offers a comprehensive look at approved and pending Section 1115 waivers by state. This tool is indispensable for anyone involved in policy planning or administration, providing the latest updates and resources needed to stay informed and proactive. 🔗 https://lnkd.in/evWGZ9F #MedicaidPlanning #HealthPolicy #HealthcareAdministration #StateHealthcare

States are stepping up to adjust Medicaid rates, aiming to align payments with members' healthcare needs. Centene reports a promising 52% earnings increase, while emphasizing the ongoing work needed to secure adequate reimbursement. As the landscape evolves, Centene’s approach highlights data-driven collaboration with state partners to drive sustainable growth and meet the rising demand for healthcare support. https://lnkd.in/erst7XBe

What did the five largest publicly traded companies operating Medicaid managed care plans experience during the unwinding? Our new analysis takes a look ⤵️ • From March 2023 to December 2023, Medicaid enrollment declined by nearly 10% across the five firms, tracking the rate of decline seen nationally. • Although firms saw a 10% decline in Medicaid enrollment as of the end of 2023, the firms that report Medicaid-specific revenue information reported year-over-year (2023 over 2022) growth in Medicaid revenue ranging from 3% to 18%. • In earnings calls, firms have discussed the impacts of unwinding, including high procedural disenrollment rates of 70% or above and gaps in member coverage that can extend for several months.

Friday was a major milestone for North Carolina, with 503,967 individuals who now have benefits/coverage through Medicaid expansion. This means that more people than ever before have access to high-quality affordable healthcare. At UnitedHealthcare Community & State, we remain committed to sharing this vital information because we know that if someone is eligible for Medicaid, having that continuous health coverage allows individuals to have access to critical medical care and preventative services. #uhc #medicaidexpansion #healthcare #healthcarecoverage https://lnkd.in/eimqprBs

In 2022, we spent $8,813 on average per Medicaid recipient. 🏥Medicaid recipients are 4x more likely than commercial insurance patients to use the Emergency Department - one of the most expensive forms of care. 💰 Imagine if we paid for direct primary care memberships 👩🏽⚕️instead for each Medicaid patient using only a fraction of that spend (appx $1200/year) - we could deliver better care and potentially lower cost overall! We are long overdue for a primary care investment.🩺 We already spending the money, let’s spend it more efficiently. Looking forward to the passage of this bipartisan legislation. https://lnkd.in/gxvKCSxg ================================ If you find this content valuable, then you’ll LOVE the Building DPC newsletter!! Subscribe Today - link in comments

🔎📰 The latest report by GAO on Medicaid eligibility and enrollment highlighted the pressing need for streamlined processes to ensure eligible individuals can access vital healthcare services. Our Key Takeaways from the Report: 1️⃣ Identification of Barriers: The GAO report highlights barriers hindering eligible individuals from enrolling in Medicaid, underscoring the importance of efficient enrollment processes. 2️⃣ Streamlining Processes: Streamlining eligibility determination and enrollment procedures is crucial to enhancing access to healthcare for vulnerable populations. 3️⃣ Importance of Partnerships: Collaborative efforts between government agencies, healthcare providers, and enrollment assistance organizations are vital for overcoming enrollment challenges. At #HospitalReferralServices, we're committed to driving positive change in Medicaid eligibility and enrollment. By leveraging technology and expertise, we empower individuals to navigate the enrollment process seamlessly. Read the full report here: https://hubs.ly/Q02qYKWL0 #Medicaid #HealthcareAccess #EnrollmentSolutions

It's truly astonishing how the lack of oversight in today’s technologically advanced world can lead to such significant errors. I recall a pro-bono medical lien case that involved a township and a historic home, which had recently been bequeathed by the family of a Medicaid recipient. A thorough review of the data revealed that an estimated $250,000 was overpaid for personal care services due to non-adherence to the applicable fee schedule. Despite this, the lien filed was for $300,000. This kind of oversight is mind-boggling and highlights the critical need for better monitoring and transparency in our systems. In this case the comptroller’s audit found Medicaid paid out: $14.5 billion in personal care claims for 82 million services (44%) with no matching electronic visit verification record. $97.6 million in home health care claims reflecting 400,557 services (89%) with no matching electronic visit verification records. $11.6 million in claims for visits that lasted less than eight minutes, which is too short to be billable under Medicaid rules. $9.7 million for home services provided when the patient was hospitalized, and home visits should have been suspended.h https://lnkd.in/gTU_zjUF

The Centers for Medicare & Medicaid Services (CMS) has once again extended waivers for the Medicaid unwinding process. Here’s what you need to know: - Extended Timeline: States can now use waivers through June 30, 2025, extending the previously set deadlines. - Continuous Coverage: This extension aims to help more Americans maintain their Medicaid coverage during the unwinding process. - State Flexibility: States are empowered to update their verification plans and make temporary amendments to Medicaid and CHIP state plans. - Reuse of Waivers: Specific waivers can be used multiple times under certain conditions to ensure continuous eligibility. - Support for States: CMS is committed to supporting state efforts to renew and maintain coverage without needing to contact CMS for extensions. - Streamlining Processes: Some waivers may become long-standing, streamlining eligibility determinations and renewal processes. - Innovative Approaches: States can incorporate tools like SNAP benefits to confirm Medicaid eligibility during renewals. - Special Enrollment Periods: There are additional opportunities for enrollment during this extended period. #MedicaidUnwinding #HealthcareAccess #CMSUpdates #MedicaidCoverage #StateFlexibility #CHIP #HealthPolicy #PublicHealth #MedicaidExtension #HealthcareReform Let’s ensure everyone who needs it maintains access to essential health coverage! 🌍💚