Another way of committing fraud is to impersonate a licensed provider. For example, in 2022, a Texas woman was accused of using her ex-husband’s provider number to submit fraudulent claims to Medicaid for counseling services that were never provided, receiving more than $600,000 in fraudulent ...
Independent Choicesoffers great flexibility in allowing the beneficiary to determine their own care needs andClient-Employed Providerallows participants to hire their own service providers with the state managing the administrative tasks. The newerK Planunder the Community First Choice option also helps. ...
These patients are the latest Medicaid recipients to find their coverage threatened amid the state's redetermination process, which began in April 2023. Florida's Medicaid rolls swelled by 1.7 million people during the pandemic, when thefederal governmentgave states additional funding to keep people ...
An individual or group plan provides, or pays the cost of, medical care. A health plan combines health insurance coverage benefits under a product with a specific cost-sharing structure and provider network, within a geographic area. There are various types of health plans. 50...
Conclusions Higher provider continuity was associated with a lower risk of SCD-related hospitalization in the Florida Medicaid SCD population, but did not affect the rate of 30-day re-hospitalization. Policies that improve and maintain continuity between SCD patients and a single provider may lead ...
doi:urn:uuid:3629c75d24d9b410VgnVCM100000d7c1a8c0RCRDAnthem has closed its purchase of Florida Medicaid managed care provider Simply Healthcare Holdings Inc., as the nation's second-largest health insurer continues to expand its government business.Fox Business...
We examine parental reports and ratings of care to explore whether and how patient and parent experiences vary by child health status and managed care plan type, including provider-sponsored specialized plans serving only children. Parents of children in a Florida Medicaid demonstration project in two...
Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors. J Am Coll Surg. 2013;216(3):482-492.e12. doi:10.1016/j.jamcollsurg.2012.11.014 PubMedGoogle ScholarCrossref 48. Valenzuela F, Romero ...
For 2012, we considered data from 39 states, excluding Arizona, California, Florida, Hawaii, Idaho, Michigan, Missouri, North Dakota, Pennsylvania, South Carolina, and South Dakota. The primary exclusion criterion was insufficient provider-level data in the Medicaid Service provider identification and...
legislative budget requests for submission to the Florida legislature in 1999 and 2001 seeking a specific appropriation to implement an enhanced rate. Provider groups (FAHA, FHCA and the FHA) expressed support for some form of enhanced reimbursement for NFs serving individuals who are ventilator-depen...