Over the past three decades, Medi-Cal, California's Medicaid program, has undergone considerable changes and expansion. By 2016, the program provided coverage to more than one in three Californians, and as of January 2024, eligibility has been extended to include all residents with incomes below specific...
Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly recap concentrates on developments, research, and legislation that pertains to Medicaid integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a summary...
Proposition 35 is a ballot measure in California that seeks to enforce a long-term tax on managed care organizations (MCOs) that provide healthcare services for the Medicaid population. The measure also outlines specific ways the tax revenue must be used. Context and Background The ballot initiative comes amid recent...
Syrtis Solutions issues a monthly Medicaid news summary to help you stay up-to-date. The monthly recap highlights developments, analysis, and legislation that relates to Medicaid integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a list of...
Payment integrity programs are designed to ensure correct claims processing, adherence to contractual rates, and compliance with payment rules. These initiatives are essential for sustaining the financial stability of healthcare systems and ensuring that patients receive appropriate care. That being said, they can produce friction...
Syrtis Solutions issues a monthly Medicaid news summary to help you stay informed. The monthly summary highlights developments, analysis, and legislation that pertains to Medicaid program integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Below is a summary...
Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly recap concentrates on developments, research, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Below is a...
America's most vulnerable populations depend on Medicaid and Medicare for vital healthcare services. Sadly, these programs lose billions of dollars on a yearly basis due to improper payments. Just recently, the Subcommittee on Oversight and Investigations delved into this pressing issue in a critical hearing...
Syrtis Solutions publishes a monthly Medicaid news recap to help you stay informed. The monthly summary focuses on developments, analysis, and legislation that pertains to Medicaid program integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a...
A recent audit by the U.S. Government Accountability Office reveals that the government suffered a significant loss of $236 billion in 2023 as a result of improper payments. Medicaid and Medicare alone accounted for 43% of these payments, with Medicaid's improper payments reaching $50.3 billion....