Payer Systems

Medicare Savings Programs: Vital Support Faces Barriers
Management & Administration Medicare Savings Programs: Vital Support Faces Barriers

Imagine a senior citizen, after decades of hard work, facing the daunting reality of choosing between paying for life-saving medications and covering basic living expenses like rent or groceries, a scenario that is not a distant fear but a daily struggle for millions of low-income Medicare

State Ballot Measures Push for Universal Health Care Reform
Management & Administration State Ballot Measures Push for Universal Health Care Reform

In a striking response to the persistent shortcomings of the federal health care system, a groundbreaking movement is taking shape across the United States, driven by the advocacy group One Payer States, which seeks to revolutionize access to medical coverage through state-level ballot measures.

How Can Smart IT Fix Duplicate Medicaid Enrollments?
Management & Administration How Can Smart IT Fix Duplicate Medicaid Enrollments?

The challenge of duplicate enrollments in Medicaid and the Children’s Health Insurance Program (CHIP) has quietly siphoned off billions of taxpayer dollars for years, creating a financial burden that undermines the efficiency of these critical healthcare programs. This issue arises when

How Will CMS Updates Boost IPF Payments for FY 2026?
Management & Administration How Will CMS Updates Boost IPF Payments for FY 2026?

In a significant move for mental health care providers, the Centers for Medicare and Medicaid Services (CMS) has rolled out a series of updates to the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS) for fiscal year 2026. These changes, detailed in a recent final rule,

Why Is CareOregon Limiting Out-of-Network Mental Health Care?
Management & Administration Why Is CareOregon Limiting Out-of-Network Mental Health Care?

In a healthcare landscape increasingly defined by rising costs and funding uncertainties, a significant policy shift by CareOregon, a Portland, Oregon-based nonprofit managed care organization, has sparked attention and concern among its members and industry observers. This nonprofit, the largest

CMS Partners with Tech Firms for New Health Data Ecosystem
Management & Administration CMS Partners with Tech Firms for New Health Data Ecosystem

In a landmark effort to transform the landscape of healthcare data management, the U.S. Centers for Medicare & Medicaid Services (CMS) has launched an innovative federal Health Technology Ecosystem, as announced by President Donald Trump at the White House. This bold initiative seeks to overhaul

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