The state agency that provides Medicaid coverage to more than 840,000 Missourians does not have proper oversight over contractors in charge of certain aspects of payment processing, according to an audit released Monday of MO HealthNet.
On Saturday, open enrollment season for Healthcare.gov begins. For the second time around, public health organizations and insurance "navigators" are holding outreach events, running ads, and looking for the remaining uninsured Missouri residents.
But who are those uninsured Missourians? And how have the changes implemented through the Affordable Care Act affected the state?
Hundreds of thousands of people in Missouri are uninsured. Who are they?
The state of Missouri may be required to repay $11.5 million to the federal government, after miscalculating Medicaid payment rates for some case management services to people with developmental disabilities. The findings were published last week in an audit by the Office of the Inspector General.
The Department of Justice is charging 14 people with Medicaid fraud in Illinois.
The U.S. attorney for the Southern District of Illinois, Stephen Wigginton, said over the past few years, dozens of people have fleeced a Medicaid program that pays personal assistants to help disabled or sick Medicaid recipients live at home. The intention is to save the state money by keeping people in their homes and out of costly institutions such as hospitals or nursing homes.
Missouri’s business community is getting more vocal in pushing the state’s legislators to expand Medicaid.
The St. Louis Regional Chamber held a panel Friday with business leaders who expressed frustration that the state is not capturing federal dollars to provide Medicaid coverage to more low-income residents.
This year, the state will pass up $2 billion dollars in federal funds.
After the panel discussion, St. Louis Regional Chamber President and CEO Joe Reagan said that Jefferson City needs to get the message.
For years in most states, Medicaid eligibility had been limited to disabled adults, seniors needing long-term care and very low-income parents with their children.
Then along came the Affordable Care Act. It was designed to grow health insurance coverage across the board. One of its tenets was to expand Medicaid coverage beyond the extremely poor and disabled to include all adults earning up to 138 percent of federal poverty levels.
But in 2012, the Supreme Court gave states the chance to opt out Medicaid expansion.