Utah’s Dueling Medicaid Expansions

Posted on: May 5th, 2015 by Jeremy Gorenstein

The Utah legislature is expected to call a special session before the July 31 deadline to approve a Medicaid expansion package.

The Feds Weigh in on the Future of Medicaid TPL

Posted on: April 13th, 2015 by Brett Logan

The Government Accountability Office recommends more CMS guidance on state oversight of TPL in Medicaid managed care plans.

Medicaid Innovations: Three Ways to Cover Childless Adults

Posted on: March 17th, 2015 by Daniel Sorrells

One of the most important opportunities for states by the ACA is the opportunity to add adult populations to their Medicaid programs.

HMS Breaks Down the PRIME Act

Posted on: February 12th, 2015 by Jaimie Vickery

Recently, Reps. Peter Roskam (R-IL) and John Carney (D-DE) introduced HR 818, the Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act.

Court Strikes Blow Against Medicaid “Balance Billing”

Posted on: January 14th, 2015 by Jon Hutcheson

The Abbott decision aligns Arizona with the majority of other state court decisions related to the practice of balance billing…

Dually Eligible, Dually Complex and Duly Noted

Posted on: January 13th, 2015 by hmshealthcare

In 2011, CMS created the Financial Alignment Demonstration for those dually eligible for Medicaid and Medicare…

How Utilization Can Make a Difference

Posted on: January 9th, 2015 by Daniel Sorrells

HMS highlights one major way that utilization review management can not only save money, but also save lives.

Two Steps Forward, Two Steps Back; Medicaid Expansion in 2015

Posted on: January 5th, 2015 by hmshealthcare

The partisan divide on Medicaid expansion may be becoming increasingly narrow, as more Republican governors choose to embrace expansion.

Legislative Trends in Utilization Review (UR)

Posted on: December 22nd, 2014 by hmshealthcare

UR is designed to create standardization, administrative efficiency, and patient protections. However,
the legislation we are beginning to see presents challenges to Medicaid and Medicare.

In CA, A New Waiver 1115 Aims to Broaden the Scope of Care

Posted on: December 10th, 2014 by hmshealthcare

The new Medicaid Waiver proposal set to be submitted in February 2015, will focus on…