Medicaid third-party liability : savings issues and efforts / Donald Murphy, editor.

Format:

Book

Contributor:

Murphy, Donald, editor.

Series:

Health care in transition series.

Health Care in Transition

Language:

English

Subjects (All):

Medicaid--Claims administration--United States.

Medicaid.

United States.

Physical Description:

1 online resource (111 p.)

Place of Publication:

New York, [New York] : Nova Publishers, 2015.

Language Note:

English

Summary:

In fiscal year 2013, Medicaid-jointly financed by states and the federal government-provided health care coverage to over 70 million individuals at a total cost of about 460 billion. Congress generally established Medicaid as the health care payer of last resort, meaning that if enrollees have another source of health care coverage-such as private insurance-that source should pay, to the extent of its liability, before Medicaid does. This is referred to as third-party liability (TPL). There are known challenges to ensuring that Medicaid is the payer of last resort. This book examines the exten

Contents:

MEDICAID THIRD-PARTY LIABILITY:SAVINGS ISSUES AND EFFORTS; MEDICAID THIRD-PARTY LIABILITY:SAVINGS ISSUES AND EFFORTS; Library of Congress Cataloging-in-Publication Data; CONTENTS; PREFACE; Chapter 1: MEDICAID: ADDITIONAL FEDERAL ACTION NEEDED TO FURTHER IMPROVE THIRD-PARTY LIABILITY EFFORTS; ABBREVIATIONS; WHY GAO DID THIS STUDY; WHAT GAO RECOMMENDS; WHAT GAO FOUND; BACKGROUND; AN ESTIMATED 7.6 MILLION MEDICAID ENROLLEES HAD PRIVATE INSURANCE IN 2012 AND THIS NUMBER IS EXPECTED TO INCREASE WITH THE MEDICAID EXPANSION

SELECTED STATES REPORTED SOME SUCCESS ADDRESSING CHALLENGES TO THEIR TPL EFFORTS AND ADDITIONAL CMS ACTION COULD IMPROVE SUCH EFFORTS NATIONWIDE CONCLUSION; RECOMMENDATIONS; APPENDIX I: SCOPE AND METHODOLOGY OF THE AMERICAN COMMUNITY SURVEY (ACS) ANALYSIS; AGENCY COMMENTS; KEY ANALYSIS VARIABLES; METHODOLOGY; APPENDIX II: DETAILED ESTIMATES OF MEDICAIDENROLLEES WITH OTHER SOURCESOF HEALTH COVERAGE; Chapter 2:MEDICAID THIRD-PARTY LIABILITYSAVINGS INCREASED, BUT CHALLENGES REMAIN; EXECUTIVE SUMMARY:MEDICAID THIRD-PARTY LIABILITY SAVINGS INCREASED, BUT CHALLENGES REMAIN OEI-05-11-00130; OBJECTIVES

BACKGROUND METHODOLOGY; FINDINGS; STATES REPORTED THAT IMPROVEMENTS TO THEIR PROCESSES FACILITATED TPL SAVINGS, BUT CHALLENGES REMAIN; CONCLUSION AND RECOMMENDATIONS; AGENCY COMMENTS AND OFFICE OF INSPECTORGENERAL RESPONSE; APPENDIX A. CHALLENGES BY STATE; Chapter 3:COORDINATION OF BENEFITS AND THIRD PARTY LIABILITY (COB/TPL) IN THE MEDICAID PROGRAM: A GUIDE TO EFFECTIVE STATE AGENCY PRACTICES; INTRODUCTION; EFFECTIVE STATE PRACTICES, BY TOPIC AND SUBMITTING STATES; Blank Page; INDEX

Notes:

Includes index.

Description based on online resource; title from PDF title page (ebrary, viewed August 19, 2015).

ISBN:

1-63483-050-4