Professional Documents
Culture Documents
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MEDICAID FUNDING FOR
HEALTHCARE PROVIDERS
Because the program is supposed to improve
access to health and medical services, we
should see marked improvement in this
area. However, the court case Armstrong v.
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PHYSICIANS DONT ALWAYS
ACCEPT MEDICAID PATIENTS
For individuals who are Medicaid eligible
and require care, it can be very frustrating
to obtain treatment. Why? Decreasing
reimbursement
causes
physicians
to
opt-out example, this patients plight from a
miscellaneous post online:
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PHYSICIAN REIMBURSEMENT
Medicaid pays, in some cases, pennies on the
dollar for healthcare services. While this
may sound very socially lovely and altruistic
it cannot support the provider delivering the
care. I have personally been amazed at
the rates in the past, wondering how any
hospital or physician can possibly afford
to have a high number of indigent patients
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A TOOTH FAIRY
Most children raised in America are given
some small monetary token when they lose
their baby teeth. The tooth fairy comes
to visit while theyre sleeping and leaves a
coin or bill under their pillow. Then, the next
morning the child is amazed and once again
ready to go buy candy to lose more teeth. In
essence, the tooth fairy is a positive idea
that can inadvertently cause negative
consequences. In a way, like Medicaid when
it comes to dental care.
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MEDICAID COVERAGE AND
REGULATIONS VARY BY STATE
Medicaid does not provide healthcare directly.
Instead, it pays hospitals, physicians, nursing
homes, managed care plans, and other
healthcare providers for covered services
that they deliver to eligible patients. Hospitals,
physicians, and other healthcare providers
are not required to participate in Medicaid,
and not all do.
About two-thirds of all Medicaid spending
on services pays for acute-care services
such as hospital care, physician services,
and prescription drugs; another 30% pays
for nursing home and other long-term care
services and supports. Medicaid covers more
than 60% of all nursing home residents, and
it pays 40% of the nations total costs for
long-term care services and supports.
Medicaid also reimburses certain hospitals
for the uncompensated costs they incur when
they care for low-income uninsured patients.
These payments, known as Disproportionate
Share Hospital (DSH) payments, account
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CALIFORNIA MEDI-CAL
The state of California, like a country itself,
has a Medicaid program called Medi-Cal.
And of course it is vastly different from any
other state program with its own unique rules
and regulations, manuals, and way of doing
business. For many years the physicians
associated with the program were not
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AUTHOR BIO