Jukebox Health’s Post

This report hits the nail on the head, specifically chapter 2 on Medicaid Managed Care appeals and denials. Medicaid families are at an enormous disadvantage with lack of oversight on the appeals processes. There are VAST discrepancies across MCOs (even within the same state) in ability to access adequate, effective care, that is consistent with the generally accepted standards of care in the relevant medical community. Imagine that it’s your child… and you are not able to access the level of care that your child needs, while other children in your state are able to, just because of your MCO interpreting the states policy in a different, more restrictive way. It’s not equal and it’s not consistent. I have the pleasure of serving families navigating the Medicaid fair hearing process across many states for ABA therapy, and in short, there is so much work that needs to be done to ensure a “full and fair” review, which is the entire intent of the appeal and hearing process for Medicaid. States have nearly full oversight to their Medicaid processes, which is problematic when there is no oversight to ensure the state is not disadvantaging the families for their own financial benefit. Autism deserves equal coverage, that abides by state and federal laws to the full extent. Period. #autismawareness #mentalhealth #parity #appliedbehavioranalysis #abatherapy

One of my favorite events: One of, if not THE, most impactful events hosted by the Iowa Pharmacy Association Nearly 150 pharmacy professionals will advocate together this week at the state capitol. AND - if you’re unable to join us in Des Moines - join the many members that will contact their state senator and representative to AMPLIFY our voice. Details on both ⬇️ #advocacy #advocacyinaction #oneprofessiononevoice #pharmacy #paymentreform

Last week, Nebraska introduced L.B. 1278 to cover #doula services under #Medicaid by 2026 and launch a stakeholder workgroup to develop an implementation plan. Read more about the impact of community-based doulas in our Roadmap: https://t.co/3tfzyO4MFX

We're Heading to the #RISE Part D Masterclass Conference Soon! Come say hello to Asaf Kleinbort & David Burianek, and discover how to boost your medication adherence star score by up to 5%! #MedOrion #QualityLeadership #Stars #Behavioralscience #medicareadvantage #healthplans #medicaid #Behavioralhealthmanagment

Streamlining healthcare finances with precision and care! Our medical billing services ensure seamless reimbursement, so you can focus on patient well-being. . . . #financialfreedom #dentaleducation #patientcare #medicaid #expertise #hipaa #rcm #financialmanagement #ushealthcare #medicalbillingservices #patientsfirst #microcredentials1

New from our blog: State #Medicaid Programs Retake Pharmacy Controls State Medicaid programs’ relationships with managed care organizations that serve Medicaid recipients continue to evolve. Just when it appears that trends are slowing or stabilizing, a new method is introduced. The latest development could overlap existing state controls to bring even more pharmacy control back to state management. Read more here: https://lnkd.in/ebx38HTS

ICYMI: MACPAC recently published an updated issue brief on the types of #Medicaid hospital payments, the goals of these payments, and how the use of these payments varies by state. Learn more!  https://lnkd.in/eMSF3yn6

This is what every provider waits for , Credentialing/ Provider Enrollment Approvals and that is where our expertise lies. Get you credentialing done. #credentialing #providerenrollment #medicaid #rcm #medicalbilling