Medicaid interacts with other payers when Medicaid beneficiaries have other sources that are legally liable for payment of their medical costs. These may include private insurance, Medicare, other public programs such as the Ryan White program, workers’ compensation, and amounts received for injuries in liability cases. The program also interacts with CHIP when states provide Medicaid coverage to beneficiaries using CHIP funds.
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Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare
Medicaid and Medicare together provide health coverage for approximately 12.2 million low-income seniors and people with disabilities who are dually eligible for both programs. The Centers for Medicare & Medicaid Services’ Medicare-Medicaid Coordination Office has implemented the Financial Alignment Initiative to improve care and reduce program costs for these beneficiaries, as well as improve coordination …
Medicaid’s Role in Health Care for American Indians and Alaska Natives
Medicaid is one of several programs that play a meaningful role in financing health services for American Indian and Alaska Native (AIAN) people: it provided health insurance coverage for more than one-third of AIAN adults in 2018. It is also an essential source of revenue for the facilities and programs that make up the Indian …
Medicaid and TRICARE Third-Party Liability Coordination
Chapter 4 addresses a continuing challenge in Medicaid: protecting the safety-net program’s statutory role as the payer of last resort. By law, all other sources of coverage must pay claims under their policies before Medicaid will pay for the care of an eligible individual. This requirement is referred to as third-party liability (TPL) because payment …