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Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states.

UPMC for You honored by MHPA Institute for Medicaid Innovation

UPMC for You, the Medical Assistance program of UPMC Health Plan, was honored by the Medicaid Health Plans of America Institute for Medicaid Innovation for demonstrating innovative and effective approaches to providing services that have improved the health of Medicaid enrollees, at MHPA's annual Best Practices Awards program held in Washington, D.C., earlier this month.

19 Nov 2015

Nearly 50% of Medicaid patients infected with hepatitis C denied coverage for life-saving antiviral drugs

Nearly 50 percent of Medicaid patients infected with chronic hepatitis C whose doctors had prescribed newer, life-saving antiviral drugs were denied coverage to the therapies because they weren't considered "a medical necessity" or because the patients tested positive for alcohol/drugs, among other reasons, according to new Penn Medicine research.

17 Nov 2015

Study: Safe spaces may play critical role in community-based HIV prevention efforts

The creation and sustainment of "safe spaces" may play a critical role in community-based HIV prevention efforts by providing social support and reducing environmental barriers for vulnerable populations, a new study from an Oregon State University researcher has found.

17 Nov 2015

Children in low-income families have greater access to preventive care under Medicaid, CHIP

Researchers have found that children in low-income families experience greater access to preventive medical and dental care under Medicaid or the Children's Health Insurance Program (CHIP) than children covered by private insurance. However, for all types of insurance coverage, access to pediatric specialty care was a challenge.

17 Nov 2015

Study explores diabetes screening for patients with severe mental illness

A study just published in the Journal of the American Medical Association Internal Medicine examines diabetes screening for patients with severe mental illness, who are two to three times more likely to have type 2 diabetes than the general population. More than seven million Americans in the United States have severe mental illness, and there are many factors contributing to their increased risk of getting diabetes, including treatment with antipsychotic medication.

13 Nov 2015

Obesity groups take aim at states that deny coverage of obesity treatment under affordable care act

The American Society for Metabolic and Bariatric Surgery (ASMBS) and groups including The Obesity Society (TOS) and Academy for Nutrition and Dietetics (AND), filed a complaint this month with U.S. Health and Human Services (HHS) claiming the 27 states that deny coverage for bariatric surgery are in non-compliance with the Affordable Care Act (ACA) and that their failure to comply is discriminatory against women and people with disabilities, and violates the ban against denying coverage based on health status or a pre-existing condition.

10 Nov 2015

Major US healthcare database has missing pieces

A major source of American health information data contains a handful of glaring flaws related to health risks, say Johns Hopkins researchers in a study published online Wednesday in the journal PLOS ONE.

9 Nov 2015

Main barriers to health coverage lie in perceived cost and knowledge gap, U-M study finds

If you need health care in rural Michigan, and you don't have insurance or money, you can turn to a free clinic -- like the one University of Michigan medical students run each Saturday in the tiny town of Pinckney. Fewer people need this kind of help these days, because of new insurance options made possible by the Affordable Care Act.

6 Nov 2015

New study compares effectiveness of clozapine with standard antipsychotics in adults with schizophrenia

In real-world settings, patients with schizophrenia whose symptoms do not respond to standard antipsychotic medications have better outcomes if they are switched to clozapine instead of another standard antipsychotic. They have fewer hospitalizations, stay on the new medication longer, and are less likely to need to use additional antipsychotics.

6 Nov 2015

Most states do not cover bariatric surgery under ACA despite minimal impact on monthly insurance premiums

Most states do not cover bariatric surgery under the Affordable Care Act (ACA) despite the need for effective treatments for obesity and the minimal impact it has on monthly premiums, according to new research presented here at ObesityWeek 2015, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity.

5 Nov 2015

Three out of four consumers not covered for evidence-based obesity treatment services

In one of the largest studies ever conducted to better understand insurance coverage of obesity treatments, researchers found that three out of four consumers report that they are not covered for necessary, evidence-based obesity treatment services, including access to a registered dietician (72% not covered), medical weight management (77% not covered), bariatric surgery (76% not covered) or FDA-approved obesity drugs (84% not covered).

5 Nov 2015

EndoGastric Solutions announces assignment of relative value units for new CPT code covering TIF procedure

EndoGastric Solutions® (EGS), a leader in incisionless procedural therapy for gastroesophageal reflux disease (GERD), today announced the Federal Register has posted coding and payment information specific to the new Current Procedural Terminology (CPT)® code covering the Transoral Incisionless Fundoplication (TIF®) procedure.

4 Nov 2015

Voluntary Advance Care Planning to become recognized, reimbursable benefit for Medicare recipients

Reflecting recommendations from the American Geriatrics Society and 65 other partner organizations, the Centers for Medicare and Medicaid Services announced that voluntary Advance Care Planning (ACP)--a comprehensive, ongoing, person-centered approach to communication about future healthcare choices--will for the first time become a recognized, reimbursable benefit for Medicare recipients.

4 Nov 2015

Medigus announces CMS’ publication of fee schedules for endoscopic fundoplication procedures under CPT code 43210 effective January 2016

Medigus Ltd., a medical device company developing minimally invasive endosurgical tools and a leader in direct visualization technology, today announced that following the American Medical Association’s (AMA) decision earlier this year to create a new Category I Current Procedural Terminology (CPT®) code for esophagogastric fundoplast...

3 Nov 2015

Researchers find strong associations between hunger and poor health

It may come as a surprise that, even after the Great Recession ended in 2009, almost 50 million people in the United States are food insecure -- that is, they lack access to adequate food because of limited money or other resources. University of Illinois economist Craig Gundersen and University of Kentucky's James Ziliak examined recent research on food insecurity and its association with poor health and offer suggestions, including that doctors screen for hunger.

3 Nov 2015

Researchers find rise in state-level obesity-related health care costs

Nearly 11 percent or $8 billion of the cost to treat severe obesity was paid for by Medicaid in 2013, ranging from a low of $5 million in Wyoming to $1.3 billion in California. Research led by Y. Claire Wang, ScD, associate professor of Health Policy and Management at Columbia University's Mailman School of Public Health, predicts these costs will only grow as Medicaid eligibility is extended to more people following the implementation of the Affordable Care Act's Medicaid expansion.

3 Nov 2015

WSU researcher to lead $2.5 million study on impact of Affordable Care Act in people with disabilities

A Washington State University researcher will lead a $2.5 million examination of the federal Affordable Care Act's impact on what may be the largest group in need of its services: people with disabilities.

3 Nov 2015

New across-the-board Medicare cuts may place many patients and providers at risk

The Partnership for Quality Home Healthcare – a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation's seniors – today warned that additional across-the-board cuts by the Centers for Medicare & Medicaid Services made in the Final Home Health Prospective Payment System Rule for calendar year 2016 could threaten access to patient preferred, cost effective and clinically advanced care for America's home health patients, whom data show are already at significant risk.

31 Oct 2015

CarePoint Health – Bayonne Medical Center named ACR-designated center for lung cancer screening

CarePoint Health, a fully integrated healthcare system that provides quality, patient-focused healthcare to residents of the Hudson County region, today announced that CarePoint Health – Bayonne Medical Center has been named an American College of Radiology designated center for lung cancer screening, making it the second facility in Hudson County (after CarePoint Health – Christ Hospital) to receive this designation.

31 Oct 2015

Cologuard stool DNA test: An accurate screening option for Alaska Native people with colorectal cancer

Cologuard stool DNA testing for colorectal cancer was found to be an accurate noninvasive screening option for Alaska Native people, a population with one of world's highest rates of colorectal cancer, concluded researchers from the Alaska Native Tribal Health Consortium and Mayo Clinic.

31 Oct 2015

Medicaid News and Research

UPMC for You honored by MHPA Institute for Medicaid Innovation

Nearly 50% of Medicaid patients infected with hepatitis C denied coverage for life-saving antiviral drugs

Study: Safe spaces may play critical role in community-based HIV prevention efforts

Children in low-income families have greater access to preventive care under Medicaid, CHIP

Study explores diabetes screening for patients with severe mental illness

Obesity groups take aim at states that deny coverage of obesity treatment under affordable care act

Major US healthcare database has missing pieces

Main barriers to health coverage lie in perceived cost and knowledge gap, U-M study finds

New study compares effectiveness of clozapine with standard antipsychotics in adults with schizophrenia

Most states do not cover bariatric surgery under ACA despite minimal impact on monthly insurance premiums

Three out of four consumers not covered for evidence-based obesity treatment services

EndoGastric Solutions announces assignment of relative value units for new CPT code covering TIF procedure

Voluntary Advance Care Planning to become recognized, reimbursable benefit for Medicare recipients

Medigus announces CMS’ publication of fee schedules for endoscopic fundoplication procedures under CPT code 43210 effective January 2016

Researchers find strong associations between hunger and poor health

Researchers find rise in state-level obesity-related health care costs

WSU researcher to lead $2.5 million study on impact of Affordable Care Act in people with disabilities

New across-the-board Medicare cuts may place many patients and providers at risk

CarePoint Health – Bayonne Medical Center named ACR-designated center for lung cancer screening

Cologuard stool DNA test: An accurate screening option for Alaska Native people with colorectal cancer

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