The majority of Medicaid improper payments occur because of antiquated data systems that result in eligibility errors. As the Medicaid program has grown, determining primary commercial coverage, also referred to as Third Party Liability (TPL), has become significantly more complicated and challenging. By law, Medicaid...
Dependence on the Medicaid program has increased exponentially over time. Currently, it is the single largest insurer in the United States, and in 2019, it accounted for more than half of all federal funds distributed to states. Regrettably, as the safety net program has grown,...
Medicaid currently fails at providing a system that efficiently and accurately saves and utilizes member data. As Medicaid is a joint state and federally managed program, there are many issues with coordinating data platforms. Different states have their own unique data processing and storing, and...
Syrtis Solutions publishes an annual Medicaid review to help you stay informed. The yearly recap concentrates on highlights, research, and legislation that relates to Medicaid integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Below is a summary of...
Syrtis Solutions publishes a monthly Medicaid news summary to help you stay informed. The monthly recap concentrates on developments, analysis, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a...
Over the last three years, the Coronavirus public health emergency was extended a number of times. The PHE and the Families First Coronavirus Response Act adjusted Medicaid eligibility, and consequently, Medicaid enrollment surged throughout the pandemic. Between February 2020 and July 2022, 82 million people...
Syrtis Solutions sends out a monthly Medicaid news summary to help you stay informed. The monthly recap highlights developments, research, and legislation that pertains to Medicaid program integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a...
Syrtis Solutions sends out a monthly Medicaid news roundup to help you stay informed. The monthly summary concentrates on developments, analysis, and legislation that relates to Medicaid integrity, cost avoidance, coordination of benefits, third party liability, improper payments, fraud, waste, and abuse. Here is a...
Changes in how pharmacy benefits are supplied under New York's Medicaid program are coming. Earlier this year, the state reported that to lower prescription drug costs, it would carve out its Medicaid pharmacy benefits and transition to a fee for service delivery model. Starting April...
Syrtis Solutions shares a monthly Medicaid news summary to help you stay informed. The monthly recap highlights developments, research, and legislation that pertains to Medicaid integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a recap of last month's notable...