89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Cod
doi:10.1001/jamanetworkopen.2024.55461 Key Points Question For people who have dual eligibility for Medicare and Medicaid, does new enrollment in Dual-Eligible Special Needs Plans (D-SNPs) vs other Medicare Advantage (MA) change North Carolina Medicaid fee-for-service spending? Findings ...
With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in ...
A proportion of these adults are likely Medicare enrolled without dual Medicaid eligibility because they are older than 65 years or have a parent who meets Medicare eligibility.33 Only a small proportion of adults with Down syndrome have full-time employment that provides employer-subsidized health ...
If a test was completed after PAR denial, the patient or family elected to pay for the test out of pocket without insurance or with financial support from a third party. We did not track PAR appeals, therefore some patients may have also successfully appealed and overturned a PAR denial ...
With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in ...
In analyzing the eligibility pathways into Medicaid for children who qualify for IDEA services, it is importantto consider Medicaid eligibility groups that specifically target the disabled living in 20 HCFA Medicaid Guide, p. 10. 21 With respect to financial eligibility criteria for Medicaid, both ea...
Medicaid financial eligibility guidelines are based on both income and asset limits. Income limits are guided by Federal Poverty Level Standards as defined by the Department of Health and Human Services, and asset limits are derived from federal Medicare Low-Income Subsidy asset limits. These numbers...
13 We also found that despite more generous eligibility for pediatric patients younger than 1 year, children and adolescents had lower disenrollment than newborns and infants. While our models adjusted for the number of visits prior to becoming uninsured, given that our ability to measure ...
doi:10.1001/jamanetworkopen.2024.55461 Key Points Question For people who have dual eligibility for Medicare and Medicaid, does new enrollment in Dual-Eligible Special Needs Plans (D-SNPs) vs other Medicare Advantage (MA) change North Carolina Medicaid fee-for-service spending? Findings ...