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 Daneil 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…


Whitepaper Rounds up Third Party Liability Best Practices

Posted on: December 8th, 2014 by hmshealthcare

HMS, the national leader in third party liability for Medicaid programs, recently updated one of its most downloaded whitepapers.


Not Quite RAC and Roll in Lousiana

Posted on: November 21st, 2014 by hmshealthcare

As Medicare RACs and hospitals continue to duke it out before Congressional referees, Medicaid RACs are facing their own state matches.


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 […]