Medicaid’s new e-signature capability and its portal for verifying patients’ Medicaid eligibility and accessing their available health information are two ways to help cut down on the busywork in your office.
The beginning of President Donald Trump's administration brings with it the prospect of repealing and replacing the Affordable Care Act and, with that, a potential overhaul of Medicaid. Tom Price, MD, the nation's new secretary of Health and Human Services, proposed turning Medicaid into a block grant program two years ago in his role as chair of the House Budget Committee, and talk of a block-grant system is picking up steam both in Washington and at the state level.
Achieving the cost-savings we mutually envision will require more than just innovative and clinically sound health care policies. It also will require bold action by the legislature to rebuild theMedicaid physician network, which has steadily eroded over the 16 years largely for one reason:unreasonably low payment rates. Medicaid physician payments average 73 percent of Medicare and 50 percent of commercial payments.
Medicaid is a state- and federally funded health care program that provides low-income patients access to essential health care services. Without Medicaid, millions more Texans would be uninsured: As of June 2014, Medicaid covered nearly 3.8 million Texans. To qualify, patients must have a low income, but being poor doesn’t always mean a patient will qualify for the program. For example, low-income childless adults are not eligible in Texas even if their income meets the state’s Medicaid income requirements. Most Medicaid recipients in Texas are children, pregnant women, or disabled.
If you participate in Medicaid, don't forget about the implementation of the STAR Kids managed care program on Nov. 1. The legislature directed the Texas Health and Human Services Commission (HHSC) to develop the managed care program specifically designed for children aged 20 and younger who have disabilities.
When San Antonio pulmonologist John Holcomb, MD, treats patients enrolled in both Medicare and Medicaid, he knows he's dealing with a particularly fragile population that has little to no income and is elderly or has a disability. Neither these so-called "dual-eligible" patients nor the physicians treating them have it easy.
Apparently, the state got the message loud and clear: Physicians and patients are overly frustrated with the myriad administrative roadblocks that came along with the expansion of Medicaid managed care in Texas. Thanks to TMA's advocacy during the 2013 legislative session and the successful passage of Senate Bill 1150, relief from Medicaid red tape may finally be in sight.
Got Medicaid or CHIP questions? Call or email the Knowledge Center.
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