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Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [ 1 ] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
L.A. Care Health Plan (Local Initiative Health Authority for Los Angeles County) was created in 1997 by the State of California to provide health care services for Medi-Cal managed care beneficiaries, uninsured children and other vulnerable populations in Los Angeles County. [3]
Proposition 35 would permanently impose a tax on health insurance providers like Anthem Blue Cross and L.A. Care, known as managed care organizations, that provide or arrange services for a ...
California was slated to give a long-awaited raise to health facilities that help quadriplegics and others with serious medical needs, but the passage of Prop. 35 unraveled those plans.
The report released Wednesday by Auditor General Tim DeFoor said the Department of Human Services allowed $7 million in improper “spread pricing” in the Medicaid program in 2022.
For example, the general 2006-2007 FMAP rate for California was 50% meaning that for every dollar that California contributed to an eligible social or medical program between 2006 and 2007, the federal government also contributed one dollar. [4] Within Medicaid, the FMAP can vary.
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