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Small Change, Big Consequences — Partial Medicaid Expansions Under The Aca, Adrianna Mcintyre, Allan M. Joseph, Nicholas Bagley Sep 2017

Small Change, Big Consequences — Partial Medicaid Expansions Under The Aca, Adrianna Mcintyre, Allan M. Joseph, Nicholas Bagley

Articles

Though congressional efforts to repeal and replace the Affordable Care Act (ACA) seem to have stalled, the Trump administration retains broad executive authority to reshape the health care landscape. Perhaps the most consequential choices that the administration will make pertain to Medicaid, which today covers more than 1 in 5 Americans. Much has been made of proposals to introduce work requirements or cost sharing to the program. But another decision of arguably greater long-term significance has been overlooked: whether to allow “partial expansions” pursuant to a state Medicaid waiver. Arkansas has already submitted a waiver request for a partial expansion ...


Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman Aug 2017

Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman

Commonwealth Medicine Publications

This poster highlights the results of a UMass Medical School partnership with MassHealth, the Massachusetts Medicaid program, to integrate third party liability (TPL) activities across all aspects of the Medicaid program. By embedding TPL at all stages of Medicaid operations and interfacing with all Medicaid systems, the partners optimized identification of and access to TPL sources for all Medicaid members.

The TPL activities include eligibility coordination, coverage coordination, payment coordination and recovery coordination. The partnership has achieved over $40 million in cost avoidance through the identification of missed Medicare benefits, over $64 million in cost avoidance over enhanced coordination of ...


Early Effects Of The Affordable Care Act On Health Care Access, Risky Health Behaviors, And Self-Assessed Health, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata Aug 2017

Early Effects Of The Affordable Care Act On Health Care Access, Risky Health Behaviors, And Self-Assessed Health, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata

Institute for the Study of Free Enterprise Working Papers

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both ...


Supporting Mothers With Mental Illness: Postpartum Mental Health Service Linkage As A Matter Of Public Health And Child Welfare Policy, Jesse Krohn, Msed, Jd, Meredith Matone, Drph, Mhs Jul 2017

Supporting Mothers With Mental Illness: Postpartum Mental Health Service Linkage As A Matter Of Public Health And Child Welfare Policy, Jesse Krohn, Msed, Jd, Meredith Matone, Drph, Mhs

Journal of Law and Health

Through our work in youth advocacy as, respectively, legal and public health professionals, we are all too aware of the high levels of health care fragmentation experienced during pregnancy and postpartum by poor, young mothers of color. Meredith Matone’s research highlights the heightened risk of fragmentation for girls with histories of child welfare involvement. For example, she found that 66.7% of young mothers who had resided in out-of-home placements and who had taken antipsychotic medication prior to becoming pregnant failed to fill prescriptions for antipsychotics in their first postpartum year. Put another way, two-thirds of these vulnerable young ...


Covering The Care: Health Insurance Coverage In New Hampshire, Jo Porter, Lucy Hodder Jun 2017

Covering The Care: Health Insurance Coverage In New Hampshire, Jo Porter, Lucy Hodder

Law Faculty Scholarship

the first in a series of data and policy briefs that seek to inform the current conversations about health reform happening across the state. The first brief uses data from the American Community Survey to provide information about the health insurance coverage landscape in NH.


Wrongly “Identified”: Why An Actual Knowledge Standard Should Govern Health Care Providers’ False Claims Act Obligations To Report And Return Medicare And Medicaid Overpayments, Nicholas J. Goldin Jan 2017

Wrongly “Identified”: Why An Actual Knowledge Standard Should Govern Health Care Providers’ False Claims Act Obligations To Report And Return Medicare And Medicaid Overpayments, Nicholas J. Goldin

Washington University Law Review

In 2015, Medicare spent $632 billion on health care for America’s elderly (and other covered groups). Medicaid spent another $554 billion to provide health care to America’s needy. The government estimates that improper payments account for as much as 10% of Medicare and Medicaid spending. Given the vast amount of money at stake, and the fact that there is bipartisan support for recovering taxpayer dollars, it is no surprise the federal government has made it a priority to recoup the money lost to health care fraud each year. The results are noticeable: annual recoveries for health care fraud ...


Managing Medicaid, Isaac D. Buck Jan 2017

Managing Medicaid, Isaac D. Buck

Saint Louis University Journal of Health Law & Policy

In a steady but rapid march, managed care has come to Medicaid. Privatization has undoubtedly rebuilt the Medicaid landscape across America over the last three decades. Now, as managed care programs administer health care to three-in-four Medicaid beneficiaries nationwide, whether or not managed care is adequately managing America’s largest public insurance program has become an increasingly important question.

Of particular note have been states’ difficulties in constructing and organizing the bidding and selection processes of the private companies tasked with overseeing the administration of private Medicaid plans. Legal challenges to various states’ bid procurement processes have been well documented ...


N.C. Medicaid Reform: A Bipartisan Path Forward, Barak D. Richman, Allison Rice Jan 2017

N.C. Medicaid Reform: A Bipartisan Path Forward, Barak D. Richman, Allison Rice

Faculty Scholarship

The North Carolina Medicaid program currently constitutes 32% of the state budget and provides insurance coverage to 18% of the state’s population. At the same time, 13% of North Carolinians remain uninsured, and even among the insured, significant health disparities persist across income, geography, education, and race.

The Duke University Bass Connections Medicaid Reform project gathered to consider how North Carolina could use its limited Medicaid dollars more effectively to reduce the incidence of poor health, improve access to healthcare, and reduce budgetary pressures on the state’s taxpayers.

This report is submitted to North Carolina’s policymakers and ...


Implementing Medicaid Health Homes To Provide Medication Assisted Treatment To Opioid Dependent Medicaid Beneficiaries, Page M. Smith Jan 2017

Implementing Medicaid Health Homes To Provide Medication Assisted Treatment To Opioid Dependent Medicaid Beneficiaries, Page M. Smith

Kentucky Law Journal

No abstract provided.


Health Information Equity, Craig Konnoth Jan 2017

Health Information Equity, Craig Konnoth

Articles

In the last few years, numerous Americans’ health information has been collected and used for follow-on, secondary research. This research studies correlations between medical conditions, genetic or behavioral profiles, and treatments, to customize medical care to specific individuals. Recent federal legislation and regulations make it easier to collect and use the data of the low-income, unwell, and elderly for this purpose. This would impose disproportionate security and autonomy burdens on these individuals. Those who are well-off and pay out of pocket could effectively exempt their data from the publicly available information pot. This presents a problem which modern research ethics ...