cms
Every record this desk has filed under cms, newest first, each with the number of sources it can still show you.
Medicaid states must show that their fixes for eligibility errors will not wrongly deny coverage. GAO found that check missing from all 14 plans it reviewed, and in one state more than 30 percent of sampled denials were errors.
When a state's Medicaid eligibility reviews find errors, it must send CMS a corrective action plan, and each plan must evaluate whether the fixes could lead to more improper denials. GAO's report released September 17 reviewed the plans of seven states and found that evaluation missing from all 14 plans, while CMS accepted them anyway. It also found CMS does not analyse errors and fixes across states, so one state's lesson does not reach the other 50. The stakes run both ways: GAO counted 2,789 eligibility errors in states' reviews since 2019, most from caseworkers and missing documents, and a separate sample of denials found error rates of 12 percent or more in five of the seven states in at least one year, above 30 percent in one. GAO made two recommendations. HHS agreed with one and said the other was already done; GAO disagreed.
Also filed undergaomedicaidhealth-coverageeligibilityoversight
About 4.4 million people with ACA marketplace coverage are in plans that cover abortions beyond the federal exceptions, GAO counted. The law requires a separate $1-a-month charge for that coverage, and GAO found two of 13 insurers it checked were not billing it the ways CMS allows.
GAO's September 15 report, requested by members of Congress, counts which 2026 ACA marketplace plans cover abortion services beyond the cases where federal funding is allowed, and checks how insurers keep that money separate as the law requires. In the 50 states and D.C., 1,719 of 6,655 plans (26 percent) covered them, in 19 jurisdictions, and about 4.4 million enrollees (about 24 percent) were in such plans in June. No plan in the 25 states that restrict this coverage offered it. All 15 insurers GAO surveyed charge the required minimum of $1 per enrollee per month, and those that shared estimates put the actual cost below 50 cents. Two of 13 insurers that bill enrollees directly did not use one of the billing methods CMS regulations allow, and one insurer had no required segregation plan for one state. CMS told GAO it does not collect those plans because the law does not require it to. GAO made no recommendations and does not find that federal funds paid for abortions.
Also filed undergaohealth-insuranceacamarketplaceabortion-coverage
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