Results for “Medicaid” — Page 3

PubMed1992

Medicaid program; coordination of Medicaid with Special Supplemental Food program for Women, Infants, and Children (WIC)--HCFA. Final regulations.

This rule requires State Medicaid agencies to coordinate the operation of the Medicaid program with the State's operation of the Special Supplemental Food Program for Women, Infants, and Children (WIC) under section 17 of the Child Nutrition Act of 1966. State Medicaid agencies also are required to notify certain individuals of WIC benefits and refer them to the local WIC agencies. This requirement ensures that all Medicaid-eligible individuals who might be WIC-eligible are aware of WIC benefits and how to obtain them. The rule implements section 6406 of the Omnibus Budget Reconciliation Act of 1989.

Adult↗

PubMed1985

Medicare and Medicaid program; withholding the federal share of payments to recover Medicare or Medicaid overpayments--HCFA. Final rule.

These final regulations facilitate HCFA's recovery of Medicare and Medicaid overpayments. Some institutions or persons that participate (or have participated) in both programs have received a Medicare or Medicaid overpayment which cannot be recovered under that program. Under expanded statutory authority (Section 905 of Pub. L. 96-499 and section 2104 of Pub. L. 97-35), HCFA has authority to withhold the Federal share of Medicaid payments in order to recover Medicare overpayments and to withhold Medicare payments to recover Medicaid overpayments.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1988

Medicare and Medicaid programs; Medicare, Medicaid, and Clinical Laboratories Improvement Act (CLIA) patient confidentiality rules--PHS and HCFA. Final rule.

This final rule eliminates the requirement that a laboratory maintain the name and other identification of individuals undergoing testing to determine the presence of the Human Immunodeficiency Virus (HIV) antibody or causative agent, if the laboratory is not seeking Medicare or Medicaid payment for these tests. However, it will not excuse a laboratory from maintaining such information if it is required to do so by State law. Those laboratories or entities seeking payment from the Medicare or Medicaid programs for HIV testing must continue to provide the name and other identification of persons tested to assure proper payment of claims. However, State Medicaid programs may choose to approve the use of alternative identifiers in place of the patient's name for HIV testing of Medicaid recipients. Also, laboratories licensed under CLIA will not be required to maintain the names and other identification of individuals being tested to determine the presence of the HIV antibody or causative agent. The intent of this change is to add further protection of confidentiality of HIV test results and to encourage voluntary testing.

AIDS Serodiagnosis↗

PubMed2002

Medicaid matters: children's health and Medicaid eligibility expansions.

In the late 1980s, a series of federal laws were enacted which expanded Medicaid eligibility to more of the nation's children. States had a great amount of discretion in how fast and how far these expansions were implemented. As a result, there was great variation among the states in defining who was eligible for the program. This variation provides a rare opportunity to disentangle the effect of Medicaid from a child's socioeconomic status. Using data from the National Health Interview Survey, we address whether the Medicaid expansions improved the health and functional status of children. Econometric models were developed using fixed-effects regressions, and were estimated separately for white, black, and Hispanic children. White children experienced statistically significant reductions in acute health conditions and functional limitations. Black and Hispanic children showed some evidence of improved health conditions and functional status, but this evidence is inconclusive in the study sample. This may be due to differences in their access to appropriate health services or to the smaller sample size of minorities in each geographic area. The findings are also relevant to the implementation of the Children' Health Insurance Program (CHIP), the latest federal effort to expand access to health care to poor and near poor children. In many states, CHIP is being implemented in whole or in part through further Medicaid expansions.

Black or African American↗

PubMed1995

Medicaid matching formula, federal subsidies, and Medicaid payments.

The federal government uses the Medicaid matching formula to distribute federal funds to states to finance various social welfare programs involving billions of dollars. How does the formula affect the distribution of federal money? How would that distribution change if a revised formula were used? This article presents the results of a regression analysis on Medicaid payments in the states and the federal subsidies for states to finance Medicaid. The findings indicate that under the current Medicaid matching formula, fewer federal subsidy dollars per poor person go to states with lower per capita incomes and to states with a higher percentage of African Americans than to states with the opposite characteristics. Even under the revised formula, states with lower per capita incomes would receive the same amount of federal matching dollars per poor person as would states with higher per capita incomes. The implications for policy are discussed.

Data Collection↗

PubMed1975

Optometric prescribing patterns: a quality comparison of Medicaid and non-Medicaid practitioners.

This study analyzes five variables related to quality and utilization of optometric prescribing of eyeglasses. The practices of optometrists participating in the New York City Medicaid Program were compared with those not participating. The variables chosen for this study can be analyzed by computer and seem to have wide applicability for monitoring of optometry services. Significant differences were found in four of the five variables under review. Overall, non-Medicaid patients appear to be receiving higher quality optometric care and less unnecessary care. Many of these differences, however, depend on the setting of the practice-whether solo, group, or corporate. Of additional note, wide variations occurred in the patterns of practice for non-Medicaid, as well as Medicaid, optometrists.

Eyeglasses↗

PubMed1991

A comparison of Medicaid and non-Medicaid obstetrical care in California.

The use of prenatal care and rates of low birth weight were examined among four groups of women who delivered in California in October 1983. Medicaid paid for the deliveries of two groups, and two groups were not so covered. The analyses suggest that longer Medicaid enrollment improved the use of prenatal care. The association between prenatal care and birth weight was less clear. For women under Medicaid, measures of infant and maternal morbidity, hospital characteristics, and Medicaid eligibility were all statistically related to charges, payments, and length of stay for the delivery hospitalization.

Adolescent↗

PubMed1990

Medicaid mysteries: transitional benefits, Medicaid coverage, and welfare exits.

The links between Medicaid and welfare exits are examined using longitudinal Medicaid program data. Few people who leave welfare get any sort of ongoing or transitional Medicaid protection. Moreover, it appears that many who are eligible for transitional benefits are not getting them. Finally, people with high expected medical costs appear to be less likely to leave welfare. The loss of Medicaid associated with leaving welfare probably does have an important deterrent effect on welfare exists.

Adult↗

PubMed1996

Medicaid eligibility policy and the crowding-out effect: did women and children drop private health insurance to enroll in Medicaid.

In the late 1980s and early 1990s, the federal government expanded Medicaid eligibility for children and pregnant women. By 1992, nearly a third of all children in the United States were eligible for Medicaid, and between 40 and 50 percent of women of childbearing age were eligible for Medicaid coverage for pregnancy-related services. During this period, the number of persons with employment-based insurance coverage declined, leading researchers to investigate whether Medicaid expansions have contributed to this decline--a so-called crowding-out effect. This Issue Brief discusses research findings and the health policy implications of the crowding-out effect.

Child↗

PubMed2000

Medicaid-eligible children who don't enroll: health status, access to care, and implications for Medicaid enrollment.

We estimate that 17% of Medicaid-eligible children in the United States are uninsured, with 27% covered by private insurance. Uninsured children have become a target for state outreach and enrollment efforts. However, the effort may not be a worthwhile use of resources if these children have sufficient access to primary care and are able to enroll in Medicaid should serious health problems arise. This analysis of health status, access to care, and use of preventive and other services suggests otherwise. Although the uninsured Medicaid-eligible children are slightly healthier than their enrolled counterparts, they face reduced access to care and lower rates of service use. After controlling for health status and other characteristics, we find that being uninsured increases the likelihood of being without a usual source of care by eight percentage points, and increases reporting of unmet needs by seven percentage points. Being uninsured also decreases by nine percentage points the proportion of children with any health provider visits, and increases by 12 percentage points the proportion with family out-of-pocket expenses exceeding $500. These findings lend support to the hypothesis that the enrollment process is onerous for some families. Targeted efforts to enroll uninsured Medicaid-eligible children could help in reducing the effect of barriers and reducing differences in access to care.

Adolescent↗

PubMed2000

Medicaid and indigent care issue brief: Medicaid: services covered.

Medicaid provides health care insurance for low-income children, some parents who meet income thresholds, pregnant women, the elderly and the disabled. In order to receive federal funds for Medicaid, each state must offer coverage for the following health care services: inpatient and outpatient hospital services; physician services; medical and surgical dental services; nursing facility services; home health care services; family planning services; rural health clinic services; laboratory and x-ray services; pediatric and family nurse practitioner services; federally qualified health center services; nurse-midwife services; and early and periodic screening, diagnosis and treatment (EPSDT) services for individuals under age 21. States can also choose to cover certain additional services under their Medicaid plans, and these often include prescription drugs, dental services (nonmedical or surgical), clinic services, and vision and hearing services. It is up to each state to decide what optional services to include with the mandated services to create their Medicaid benefit package.

Delivery of Health Care↗

PubMed2000

Medicaid and indigent care issue brief: Medicaid: managed care.

In an effort to reduce the high cost of fee-for-service health care, many states have implemented managed care into their Medicaid programs. Managed care has many forms, but the most traditional measures states adopt are fully capitated, partially capitated, or primary care case management (PCCM) programs. According to the Kaiser Commission on the Future of Medicaid, enrollment in Medicaid managed care has grown dramatically from 2.7 million beneficiaries in 1991 to 16.6 million in 1998. Over half (53.6 percent) of Medicaid beneficiaries, predominately poor children and their parents, are enrolled in some form of managed care.

Humans↗

PubMed2000

Medicaid and indigent care issue brief: Medicaid: services covered.

Medicaid provides health care insurance for low-income children, some parents who meet income thresholds, pregnant women, the elderly and the disabled. In order to receive federal funds for Medicaid, each state must offer coverage for the following health care services: inpatient and outpatient hospital services; physician services; medical and surgical dental services; nursing facility services; home health care services; family planning services; rural health clinic services; laboratory and x-ray services; pediatric and family nurse practitioner services; federally qualified health center services; nurse-midwife services; and early and periodic screening, diagnosis and treatment (EPSDT) services for individuals under age 21. States can also choose to cover certain additional services under their Medicaid plans, and these often include prescription drugs, dental services (nonmedical or surgical), clinic services, and vision and hearing services. It is up to each state to decide what optional services to include with the mandated services to create their Medicaid benefit package.

Forecasting↗

PubMed2002

Medicaid and indigent care issue brief: Medicaid: services covered: year end report-2002.

Medicaid provides health care insurance for low-income children, some parents who meet income thresholds, pregnant women, the elderly and the disabled. In order to receive federal funds for Medicaid, each state must offer coverage for the following health care services: inpatient and outpatient hospital services; physician services; medical and surgical dental services; nursing facility services; home health care services; family planning services; rural health clinic services; laboratory and x-ray services; pediatric and family nurse practitioner services; federally qualified health center services; nurse-midwife services; and early and periodic screening, diagnosis and treatment (EPSDT) services for individuals under age 21. States can also choose to cover certain additional services under their Medicaid plans, and these often include prescription drugs, dental services (nonmedical or surgical), clinic services, and vision and hearing services. It is up to each state to decide what optional services to include with the mandated services to create their Medicaid benefit package.

Adult↗

PubMed2003

Medicaid and indigent care issue brief: Medicaid: benefits and services: year end report-2003.

Medicaid provides health care insurance for low-income children, some parents who meet income thresholds, pregnant women, the elderly and the disabled. In order to receive federal funds for Medicaid, each state must offer coverage for the following health care services: inpatient and outpatient hospital services; physician services; medical and surgical dental services; nursing facility services; home health care services; family planning services; rural health clinic services; laboratory and x-ray services; pediatric and family nurse practitioner services; federally qualified health center services; nurse-midwife services; and early and periodic screening, diagnosis and treatment (EPSDT) services for individuals under age 21. States can also choose to cover certain additional services under their Medicaid plans, and these often include prescription drugs, dental services (nonmedical or surgical), clinic services, and vision and hearing services. It is up to each state to decide what optional services to include with the mandated services to create their Medicaid benefit package.

Forecasting↗

PubMed1991

Medical malpractice claims filed by Medicaid and non-Medicaid recipients in Maryland.

Several databases available in Maryland are used to investigate whether Medicaid recipients are more likely than other persons to engage in medical malpractice litigation. All malpractice claims filed during 1985 and 1986 (N = 1037) were updated for outcomes through 1989 and described with regard to the payer status of claimants. The proportion of claims filed by persons enrolled in Medicaid before and/or during the alleged malpractice incident was lower than the proportion of state residents enrolled in Medicaid. In addition, the proportion of obstetric claims filed by Medicaid recipients was identical to their proportion of hospital discharges for obstetric services during the period in which the incidents occurred.

Attitude to Health↗

PubMed1990

Medicaid program; Medicaid eligibility quality control (MEQC) program requirements--HCFA. Final rule with comment period.

This rule revises the regulations governing the Medicaid eligibility quality control (MEQC) program to include more specific program requirements and to establish new timeframes for completing and reporting MEQC case findings to HCFA. The rule also establishes a performance-based threshold for States to meet before HCFA will consider good faith waiver requests of disallowance of Federal financial participation (FEP) in erroneous Medicaid payments and provides more definitive criteria for evaluating States' good faith efforts to meet the national standard error rate. In addition, the rule makes several technical changes and provides that a State may rebut its projected error rate only when it can present evidence that its projected error rate was based on erroneous data. These revisions will strengthen the basic MEQC program and provide flexibility and incentives to States to produce accurate Medicaid eligibility determinations.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1992

Patching the patchwork quilt: "reforming" the Medicaid program--the Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991.

Congress modified the Medicaid program by restricting states' sources of funding, capping payments to certain hospitals, and altering the relationship between the states and the federal government. While the legislation puts to rest an ongoing dispute between the state and federal governments, it does not improve access to or quality of care nor address fundamental problems with the Medicaid program; it is simply another patch to the patch-work quilt called Medicaid.

Centers for Medicare and Medicaid Services, U.S.↗