Insurance Providers - Health Care Chief

Allegations of overcharging Medi-Cal settled by Centene for $215 million

Insurance Providers

Allegations of overcharging Medi-Cal settled by Centene for $215 million

Editorial Team

February 14, 2023
3 min read

Medicare Advantage

Insurance Providers

CMS proposes over 1% hike in Part D and Medicare Advantage for 2024 amid risk adjustments

Editorial Team

February 7, 2023
3 min read

genetic testing labs found guilty in $463M fraud case

Insurance Providers

Owner of genetic testing labs found guilty in $463M fraud case

Editorial Team

December 20, 2022
3 min read

Payers And Provider

Insurance Providers

Payers And Provider Groups Laud CMS’ New Authorization Rule

Editorial Team

December 15, 2022
3 min read

There are a few states namely Missouri, Montana, Mississippi, and Montana whose lawmakers are expected to propose legislation that would facilitate pregnant mothers enrolled in Medicaid with an entire year of funded healthcare. Throughout the COVID-19 public health emergency, continuous postpartum coverage for Medicaid-enrolled patients is assured. But, support for governments extending the standard 60-day mandatory coverage duration until the emergency's ultimate termination has been growing. As per records, Medicaid covers more than 40% of births nationally. The agency’s main aim is to ensure that pregnant women get uninterrupted medical treatment and increase postpartum coverage attempts to lower the risk of pregnancy-related diseases and deaths. The Washington district and thirty-five states have previously extended, or are in the process of extending, postpartum eligibility in their Medicaid programs. Texas and Wisconsin are included in the total number of states; however, they still need to adopt the American Rescue Plan Act clause and have instead suggested shorter extensions of 180 days and 90 days. Republican Governor Greg Gianforte of Montana and Charlie Brereton, director of the department of public health and human services, introduced 12-month postpartum eligibility in this year’s budget proposal. According to the plan, it would cost over nine million dollars in federal and state money over the following two years, with the federal government covering approximately 70%. A study from the U.S. Department of Health and Human Services from 2021 predicted that the move would help approximately 2,000 women in Montana. According to state health department representative Jon Ebelt, the state official’s estimate is half that amount. The reason for the variation is still not clear. He terms the expansion move as a pro-life, pro-family initiative. To make this a binding law, the plan needs to be approved by state legislators once the legislative session starts in January. At the Children's Legislative Forum on November 30 in Helena, state Representative Mary Caferro emphasized the significance of women's continued eligibility. State Representative Bob Keenan said, he hasn't reviewed the budget proposal but intends to take an opinion from his fellow lawmakers and medical professionals over the postpartum extension. Federal health officials report that one in three pregnancy-related fatalities occur between a week and a year post-birth of the child, and more than one in five moms lose their insurance within a period of 180 days of giving birth nationwide. A Commonwealth Fund survey gathered data for 2020 indicating that the U.S. had the highest maternal mortality rate among developed countries, with 24 deaths per 100,000 births. The rate for Black women in the U.S. is much higher, with 55 fatalities per 100,000 births. The research suggests that high death rates are due to a lack of treatment opportunities. Annie Glover a senior research scientist for the University of Montana stated: “Governor’s proposal to extend postpartum Medicaid coverage could make a significant difference in improving overall maternal health in Montana. The university was awarded a federal grant this year for such efforts, particularly to lower the mortality rate among Native Americans. This state measure could further reduce rates. The reason has to do with maintaining access to care during this very critical period.”

Insurance Providers

More states to consider postpartum coverage beyond two months

Editorial Team

December 15, 2022
3 min read

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