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Dual-eligible beneficiaries (Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. [1] [2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid ...
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity.
It does not apply to beneficiaries who are eligible designated beneficiaries (EDBs), meaning spouses and minor children, as well as those who are not more than 10 years younger than the deceased ...
Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former president Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [7]
The Patient Protection and Affordable Care Act (PPCA) aims to reduce: . Funding for the Medicaid DSH program by $17.1 billion between 2014 and 2020; [3] Aggregate Medicaid DSH allotments by $0.5 billion in 2014, $0.6 billion in 2015, $0.6 billion in 2016, $1.8 billion in 2017, $5 billion in 2018, $5.6 billion in 2019, and $4 billion in 2020; and
The approval would potentially allow just over a quarter of the 13.7 million Medicare beneficiaries diagnosed with heart disease and obesity to use Wegovy, the KFF study showed.
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
For example, in cases of divorce where minor children are involved, a court may require an ex-spouse to be named as an irrevocable beneficiary to ensure the children’s financial protection ...