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In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
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 expenditures. [3] Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. [4]
Maximus Inc. is an American government services company, [1] with operations in countries including the United States, Canada, and the United Kingdom. [2] Maximus provides administration and other services for Medicaid, Medicare, health care reform, welfare-to-work, and student loan servicing, among other government programs.
The Centers for Medicaid and Medicare Services also hasn’t heeded calls by the inspector general that watches over Medicare to increase the frequency of hospice inspections. A HuffPost analysis of Medicare survey data found that the average hospice hasn’t undergone a full certification inspection in 3 ½ years.
Molina Healthcare, a major Medicaid provider, said that it was considering exiting some markets in 2018, citing "too many unknowns with the marketplace program." Molina lost $110 million in 2016 due to having to contribute $325 million more than expected to the ACA "risk transfer" fund that compensated insurers with unprofitable risk pools.
Enrollment in the marketplaces started on October 1, 2013, and continued for six months. As of April 19, 2014, 8.02 million people had signed up through the health insurance marketplaces. An additional 4.8 million joined Medicaid. [3] Enrollment for 2015 began on November 15, 2014, and ended on December 15, 2014. [4]
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The operator then pays for their medical expenses. Traditional Medicare directly compensates providers on a fee-for-service basis. [1] Plans are offered by integrated health delivery systems, labor unions, non profit charities, and health insurance companies, which may limit enrollment to specific groups of people (such as union members).