Managed Care

Are Children Getting Full Medicaid Pediatric Benefits and Care?
Management & Administration Are Children Getting Full Medicaid Pediatric Benefits and Care?

Medicaid’s pediatric benefit package, known as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), is designed to provide comprehensive health coverage to over 30 million children in the United States. This program is particularly crucial for low-income families, children of color, and

December 13, 2024
Why Is Medicare Advantage Overpayment and Fraud So Hard to Stop?
Management & Administration Why Is Medicare Advantage Overpayment and Fraud So Hard to Stop?

The Medicare Advantage program, designed to provide seniors with an alternative to traditional Medicare, has faced persistent issues of overpayments and fraud for over a decade. Despite the numerous efforts by the Centers for Medicare & Medicaid Services (CMS) to address and rectify these

December 11, 2024
Can Molina Healthcare Thrive Amid Medicaid Market Challenges?
Management & Administration Can Molina Healthcare Thrive Amid Medicaid Market Challenges?

Molina Healthcare, Inc. (NYSE: MOH) has become a significant player in the Medicaid services sector, focusing primarily on low-income individuals and families. Despite many achievements in recent years, the company faces a series of challenges that could impact its future. This article dives into

October 28, 2024
How Will Proposition 35 Impact California's Medicaid Funding?
Management & Administration How Will Proposition 35 Impact California's Medicaid Funding?

California's voters will soon decide on a significant healthcare measure, Proposition 35. This proposition seeks to permanently authorize a tax on managed healthcare insurance plans, aimed at securing ongoing funding for the state's Medi-Cal program, which serves low-income residents.

October 17, 2024
How Will Medicare Changes in 2025 Affect Your Health Coverage?
Management & Administration How Will Medicare Changes in 2025 Affect Your Health Coverage?

The upcoming changes to Medicare in 2025 are set to bring significant modifications that will impact beneficiaries nationwide. With the open enrollment period from October 15 to December 7, it is crucial for those on Medicare to stay informed and review their options carefully to make the best

October 14, 2024
Why Did Huntsville Hospital and UnitedHealthcare Split After Talks?
Management & Administration Why Did Huntsville Hospital and UnitedHealthcare Split After Talks?

The recent termination of the relationship between Huntsville Hospital (HH) and UnitedHealthcare has resonated throughout the healthcare landscape, leaving many patients and stakeholders searching for answers. After extended and unproductive negotiations, this split has significant implications for

October 11, 2024
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