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Alaska Medicaid now has a simplified application process, with a relatively short application and no interview requirement. However, according to William Streur, deputy commissioner of the Alaska Department of Health and Social Services (DHSS), the impact of these recent changes is not yet clear.
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The Centers for Medicare & Medicaid Services (CMS) is failing to ensure that rates paid to managed care organizations serving Medicaid clients aren't too high or too low, according to an August 2010 report from the U.S. Government Accountability Office (GAO).
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While some Medicaid programs have taken steps to streamline the enrollment process in recent years, the "No Wrong Door" system required by health care reform is a very different challenge.
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While some states are expecting a high-cost expansion population with complex needs in 2014, the Oklahoma Health Care Authority (OHCA), Oklahoma's Medicaid agency, expects its new enrollees may be fairly healthy. In addition, the state is seeing an uptick in revenue, which may mean that additional cuts to provider rates can be avoided.
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The Oklahoma Health Care Authority has just gone live with a new enrollment system, which has laid the groundwork for the Health Insurance Exchanges (HIEs) that need to be in place by 2014.
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Many state Medicaid programs have made impressive headway in streamlining enrollment for children. Now, health care reform is causing them to turn their attention to the adult population.
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Marc S. Gold, director of the Promoting Independence Initiative in the Texas Department of Aging and Disability Services, says that the state has made "huge strides in attendant services" since the 1980s.
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Mental health services are not typically included in patient-centered medical homes, and lack of reimbursement is one reason. In most states and in most private insurance plans, mental health specialists cannot be reimbursed for care provided in primary care settings. In addition, if a primary care provider sees a patient solely for a mental health condition, there is no reimbursement for that care.
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Chronic pain sufferers want relief. To achieve their goal, they may misuse pain medication.