MassHealth and Medicaid

Selected news for the payer organization - MassHealth, and the healthcare topic - Medicaid. We have 165 shared news items for this connection to-date.

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Selected Headlines

Date Headline (link) Source Relevant Snippet
12/7/2021 Health Care Entities May Challenge MassHealth Financial Withholdings | State AG Insights ... has issued an important ruling for health care entities who are being investigated by the Massachusetts Attorney General‚Aos Office Medicaid Fraud Division and facing financial withholding, often without recourse while the AGO takes its ... request. Two years later, while the investigation was still pending, MassHealth notified Rizkallah that it was withholding payments with respect to the billing code applicable to athletic mouthguards as a result of the investigation. MassHealth ...
12/4/2021 State Sponsors "Drive for Good!" Program - BartDay ... MassHealth reimbursements just didn‚Aot cover the costs associated with wheelchair van transportation. Cataldo is one of the few resources still operating the service. We have been absorbing the losses in order to continue to provide the critical services needed by this vulnerable population.‚Au An upcoming increase in the Medicaid reimbursement rates for medically necessary wheelchair transportation should contribute to a longer-term solution supporting residents in skilled nursing ...
12/4/2021 State Sponsors "Drive for Good!" Program - BartDay ... MassHealth reimbursements just didn‚Aot cover the costs associated with wheelchair van transportation. Cataldo is one of the few resources still operating the service. We have been absorbing the losses in order to continue to provide the critical services needed by this vulnerable population.‚Au An upcoming increase in the Medicaid reimbursement rates for medically necessary wheelchair transportation should contribute to a longer-term solution supporting residents in skilled nursing ...
12/3/2021 State Sponsors "Drive for Good!" Program PR Newswire ... MassHealth reimbursements just didn't cover the costs associated with wheelchair van transportation. Cataldo is one of the few resources still operating the service. We have been absorbing the losses in order to continue to provide the critical services needed by this vulnerable population." An upcoming increase in the Medicaid reimbursement rates for medically necessary wheelchair transportation should contribute to a longer-term solution supporting residents in skilled nursing facilities across ...
12/3/2021 State Sponsors "Drive for Good!" Program PR Newswire ... MassHealth reimbursements just didn't cover the costs associated with wheelchair van transportation. Cataldo is one of the few resources still operating the service. We have been absorbing the losses in order to continue to provide the critical services needed by this vulnerable population." An upcoming increase in the Medicaid reimbursement rates for medically necessary wheelchair transportation should contribute to a longer-term solution supporting residents in skilled nursing facilities across ...
12/3/2021 State Sponsors "Drive for Good!" Program ... MassHealth reimbursements just didn't cover the costs associated with wheelchair van transportation. Cataldo is one of the few resources still operating the service. We have been absorbing the losses in order to continue to provide the critical services needed by this vulnerable population." An upcoming increase in the Medicaid reimbursement rates for medically necessary wheelchair transportation should contribute to a longer-term solution supporting residents in skilled nursing facilities across ...
10/16/2021 MassHealth expands long-term care to thousands of immigrants wbur] Advertisement Thousands of immigrants will become eligible for long-term care coverage under MassHealth, the state's Medicaid program, thanks to a policy change that takes effect Nov. 1. The MassHealth members that fall under the new policy are currently prohibited from long-term care coverage due to their immigration status, though their medical care is covered by the program. One of those immigrants is Nora Ketter, about whom WBUR ...
10/16/2021 MassHealth expands long-term care to thousands of immigrants - NewsBreak Thousands of immigrants will become eligible for long-term care coverage under MassHealth, the state's Medicaid program, thanks to a policy change that takes effect Nov. 1. The MassHealth members that fall under the new policy are currently prohibited from long-term care coverage due to their immigration status, though their medical care is covered by the program ...
10/16/2021 MassHealth expands long-term care to thousands of immigrants - WBUR siminkabarin.blogspot.comThousands of immigrants will become eligible for long-term care coverage under MassHealth, the state's Medicaid program, thanks to a policy change that takes effect Nov. 1.The MassHealth members that fall under the new policy are currently prohibited from long-term care coverage due to their immigration status, though their medical care is covered by the program.One of those immigrants is Nora Ketter, about whom WBUR reported ...
9/22/2021 Massachusetts dental office manager pleads guilty to Medicare fraud scheme Robin Cronin of Worcester, Mass., pleaded guilty Sept. 21 to participating in a scheme to defraud the state's Medicaid program, MassHealth. Ms. Cronin, 58, pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of healthcare fraud. In January 2020, Ms. Cronin; Anthony DiStefano III, DDS; and Scott Cale, DDS, were all indicted for their alleged roles in the scheme. According to the indictment, dental services ...
4/22/2021 Report: Taxpayers left to pay hefty charges to MassHealth by pharmacy benefit managers Boston Herald ... new report claims that Massachusetts taxpayers are footing the bill for $25 million in inflated charges to the state‚Aos Medicaid program by pharmacy benefit managers and the insurers that hire them.The report, commissioned ... Health and Human Services said that Massachusetts‚Ao Medicaid program, MassHealth, does not contract with PBMs but does have contracts with managed-care plans that use PBMs for pharmacy claims management for both their Medicaid ...
4/7/2021 Three Years or You‚Äôre Out: SJC Limits MassHealth Estate Recovery Claims ... from Omar: The Case for Public Funding of Postconviction Innocence Defense ‚Ui Three Years or You‚Aore Out: SJC Limits MassHealth Estate Recovery Claims by Meredith A. Fine Case FocusIn In the Matter of ... the Division of Medical Assistance (the ‚AuDivision‚Au), the state Medicaid agency that administers the MassHealth program. MassHealth notified counsel for the probate petitioner it would file a notice of claim in the estate. The ...
4/1/2021 Fallon Health to exit commercial insurance business, stick to government Becker's Hospital Review Fallon Health to exit commercial insurance business, stick to government Morgan Haefner - Print EmailMassachusetts insurer Fallon Health is backing away from the commercial insurance business.The nonprofit health insurer will instead focus solely on government plans, according to a March 31 news release . The change will take place April 1.Fallon will narrow its strategy to offerings like Medicare Advantage and MassHealth Medicaid services, a change that has been ...
3/28/2021 This Moment in Corruption: AG Settles False, Inflated Billing Cases Since 2016, the office of Attorney General Maura Healey has successfully prosecuted three home health agencies and their owners for defrauding MassHealth, the state's Medicaid program, and has settled civil actions against nine home health agencies similarly accused of improper billing.During federal fiscal year 2020 alone, AG Healey's Medicaid Fraud Division recovered more than $45 million from companies and individuals participating in the MassHealth system, which provides health care ...
3/22/2021 AG Healey Secures $1.25 Million From Lawrence Home Health Care Company That Falsely Billed MassHealth | Mass.gov In ongoing efforts to combat fraud in the home health industry, Attorney General Maura Healey announced today that her office reached a $1.25 million settlement witha Lawrence-based home health care company and its owner to resolve allegations that they falsely billed the state‚Aos Medicaid Program (MassHealth) for services that were not properly authorized by a physician.Pursuant to a settlement agreement with the AG‚Aos Office, Lifod Home ...
3/16/2021 MassHealth sleep studies under scrutiny MassHealth sleep studies under scrutiny By Christian M. Wade Statehouse Reporter Mar 16, 2021 2 hrs agoBOSTON ‚Ai The state‚Aos Medicaid program is paying tens of millions of dollars on sleep studies, according to a new report by the inspector general that suggests providers may be fleecing the state and federal government.The report released Friday by Inspector General Glenn Cunha‚Aos office said nearly 58,000 claims were ...
3/15/2021 Rewarding ACOs that Manage Complex Patients 1 Comment Health insurers often pay health plans to manage the care of their members. Good care can help prevent emergencies, such as avoidable trips to a hospital emergency department (ED). Medically complex patients, such as those with behavioral health problems or substance use disorders, tend to have a lot of ED visits. Social determinants of health (SDH) also affect outcomes for complex patients. MassHealth , the Massachusetts Medicaid program, launched ...
3/12/2021 Massachusetts Fosters Partnerships Between Medicaid Accountable Care and Community Organizations to Improve Health Outcomes Massachusetts Fosters Partnerships Between Medicaid Accountable Care and Community Organizations to Improve Health Outcomes Since 2018, three Massachusetts state agencies have incentivized Medicaid accountable care organizations (ACOs) to forge partnerships with community-based organizations and ... key roles in fostering partnerships between Medicaid ACOs and CBOs. MassHealth (Massachusetts‚Ao Medicaid agency) oversees Medicaid ACOs and the Department of Public Health (DPH) has helped CBOs build their capacity to form these unique ...
3/9/2021 Why Massachusetts' reimbursement per vaccination is 2x the national Medicare rate Becker's Hospital Review ... Medicaid beneficiaries COVID-19 vaccines, and is requiring private health plans to do the same for their members, according to The Boston Globe .Under the requirement, providers will be reimbursed at least $90 for giving two doses of the Moderna or Pfizer-BioNTech vaccine to members of MassHealth ‚Ai the name of the state's Medicaid program ‚Ai or private health plans. The rate for Johnson & Johnson's vaccine hasn't been set ...
3/9/2021 Massachusetts sets COVID-19 vaccine reimbursement rates twice as high | Boston.com ... Medicaid program, MassHealth, or by private insurance. That‚Aos compared to the $45 rate set by the federal Medicare program and the vast majority of other states.The move was first announced in a bulletin to providers in January .State officials say the increased rates are part of the administration‚Aos plan to ‚Auvaccinate as many residents as possible in the most efficient and equitable manner.‚Au‚AuReimbursement rates to ...
3/3/2021 Mass. Orthodontist Accused Of Fraud Says He Won‚Äôt Be ‚ÄòBullied‚Äô CBS Local Filed Under: AG Maura Healey , Bill Shields , Dr. Mouhab RizkallahBOSTON (CBS) ‚Ai Dr. Mouhab Rizkallah is the President of Medicaid Orthodontists of Massachusetts, but Attorney General Maura Healey says he was abusing the MassHealth insurance system and using kids and braces to do it.‚AuBasically what he was doing was using these poor children who are on MassHealth as a way to bill MassHealth for services,‚Au Healey said ...
3/2/2021 Massachusetts orthodontist allegedly kept kids in braces longer than needed, defrauding MassHealth of millions Print Massachusetts orthodontist allegedly kept kids in braces longer than needed, defrauding MassHealth of millionsAn orthodontist is being accused of fraudulently submitting millions of dollars in false claims to Massachusetts' Medicaid program, MassHealth, according to a March 1 news release from Massachusetts Attorney General Maura Healey.The attorney general has filed a lawsuit against Mouhab Rizkallah, DDS, and two companies ‚Ai Dr. Mouhab Z. Rizkallah, DDS, MSD, PC and ...
3/2/2021 Lawsuit claims orthodontist overcharged state by millions Mar. 2-An orthodontist with a Lawrence practice is being sued by the attorney general for fraudulently billing Medicaid for millions of dollars, including keeping children in braces for too long and deceptively overbilling for ... a series of illegal practices with the intent to defraud MassHealth."For years, this orthodontist used his young patients as pawns to steal millions of dollars from the state," Healey stated. "This illegal behavior harmed ...
3/2/2021 Lawsuit claims orthodontist overcharged state by millions ... 2021 17 hrs agoAn orthodontist with a Lawrence practice is being sued by the attorney general for fraudulently billing Medicaid for millions of dollars, including keeping children in braces for too long and deceptively ... a series of illegal practices with the intent to defraud MassHealth.‚AuFor years, this orthodontist used his young patients as pawns to steal millions of dollars from the state,‚Au Healey stated. ‚AuThis illegal behavior ...
3/1/2021 AG Healey sues orthodontist for keeping kids in braces longer than needed | Boston.com ... MassHealth, according to a lawsuit filed by Attorney General Maura Healey Monday.The defendant, Dr. Mouhab Rizkallah, runs six practices under the name ‚AuThe Braces Place,‚Au which has locations in Boston, Somerville, Lawrence, Lowell, Framingham, and Lynn. The attorney general‚Aos complaint alleges that Rizkallah has intended to defraud the state‚Aos Medicaid program since November 2013.‚AuFor years, this orthodontist used his young patients as pawns to steal ...