How Medicaid billing failures harm clinics and patients

Considering how to safeguard assets while planning for potential long-term care needs? A Medicaid asset protection trust enables individuals to transfer assets into a trust, designating a trusted advisor as trustee. This strategy aims to facilitate Medicaid eligibility while shielding assets. By strategically placing assets, such as a $100,000 nest egg or a home, into the trust, families can ensure these resources are preserved for loved ones rather than being consumed by nursing home expenses, offering peace of mind for the future. #MedicaidPlanning #AssetProtection #ElderLaw #Trusts #EstatePlanning

📣 Attention NJ Medicaid providers: If your organization discovers an overpayment, self-reporting it to OSC can lead to greater flexibility in repayment. 📝 Medicaid providers are legally required to report and repay any inappropriate payments they discover. The Office of the State Comptroller strongly encourages providers to do so, and may reduce interest, extend repayment timelines, or waive penalties. In fiscal year 2025, ten providers voluntarily disclosed to OSC that they had received inappropriate New Jersey Medicaid payments and returned a total of $1.8 million. 💸 Self-disclosures help ensure Medicaid dollars are not wasted. Learn more about self-disclosures: 🔗 https://bit.ly/3ICZeIQ

💡 Medicaid’s Role in Long-Term Care: What Families Need to Know Medicaid has become the primary payer for long-term care in the U.S.—but most families are unprepared for how complex the eligibility process can be. At Stinson Law Firm, we regularly work with families who are shocked to discover that: ▪️ Income and asset limits can disqualify them ▪️ The application process is time-consuming and document-heavy ▪️ Mistakes can delay care or lead to unnecessary spend-downs 🎯 With proper planning, families don’t have to lose their savings to get the care they need. Our latest article breaks down: ✔️ What Medicaid actually covers for long-term care ✔️ Key eligibility factors and planning strategies ✔️ Why legal guidance makes all the difference 🔗 Read it here: https://lnkd.in/g3ZHcQBK If you’re a caregiver, financial advisor, or healthcare professional helping families plan for the future, let’s connect. #ElderLaw #MedicaidPlanning #LongTermCare #AssetProtection #IndianaLawyer #HealthcarePlanning #CaregiverSupport #StinsonLawFirm #MedicaidEligibility #LegalPlanning

Thinking About Medicaid? Don’t Go At It Alone. Applying for Medicaid isn’t just paperwork—it’s a critical time for protecting your assets. We’ve had clients say they had no idea they should talk to an attorney first. Common advice like “just split your assets” or “spend down what you can” often leads to unnecessary loss. The truth: there are ways to protect more—sometimes all—of your assets. Medicaid planning is complex, but the right strategy makes all the difference for your future and your family. Before you apply, talk to an attorney who understands Medicaid and asset protection. We’re here to help! https://buff.ly/kIJSySB #MedicaidPlanning #AssetProtection #ElderLaw #McKennaBethke #CunninghamDalman

This is a cool article that is quite relevant to our current governmental shutdown. The authors looked at Emergency Medicaid spending at the state level and found some really interesting findings. 1. Even in the states with the highest number of undocumented immigrants, Emergency Medicaid spending comprised less than 1% of all Medicaid expenditures. 2. Emergency Medicaid comprised an average of 0.4% of total Medicaid expenditures at a cost of less than $10 per resident. 3. 11 states did not report their Emergency Medicaid expenditures. What does that all mean? First for context, the Budget Reconciliation Law substantially reduces federal emergency Medicaid funding, cutting the federal match rate from 90% for ACA expansion populations to each state’s previous rate, ranging from 50% to 76% in 2025. Emergency Medicaid is used to pay hospitals for acute services such as labor and delivery, which by law will be provided whether the hospital gets reimbursed or not and whether the person is legally in this country or not. So it means that, no the Democrats aren't trying to pay for healthcare for people who aren't in the country legally but rather are trying to help hospitals get reimbursed for care that they would have to provide one way or another. It also means that one of the main points in the government shutdown is spending that amounts for a very small fraction of the total Medicaid costs. Lastly it means that since 11 states didn't even report data, the information being used to make these decisions isn't even complete, which seems to be a common theme surrounding health with the current administration. Decisions are made for political reasons, and not for healthcare related reasons. #obesityexplained #childhoodobesitytreatmentpioneer

As someone who has spent more than two decades working closely with patients, families, and care teams, I’ve seen first-hand how healthcare decisions ripple through every aspect of our lives—including our homes, finances, and futures. Starting in 2026, cuts to Medicaid and insurance funding could raise your healthcare premiums by $1,000–$3,000 more per month. For families, that’s not just a number on paper. If your partner is diagnosed with cancer, those extra costs could mean losing the stability of your home. If your parents need long-term care, it could mean countless sleepless nights as you step in because facilities are understaffed and underfunded. Here’s the reality: • Federal Medicaid does not provide full benefits to undocumented immigrants. By law, it only covers emergency services, and that spending is less than 1% of the Medicaid budget. • The vast majority of Medicaid dollars go to seniors, people with disabilities, children, and low-income families. • Seniors and disabled Americans make up the largest share of costs because of long-term care and nursing home expenses. This is not a partisan issue. It’s about protecting the people who raised us, loved us, and built our communities. Your mother. Your father. Your neighbor who ages without children to help. Your partner who may one day face a devastating diagnosis. Every day in nursing homes, I see families navigating these struggles. It’s a battleground that shouldn’t exist in a country with so many resources. We need to ask ourselves: are we comfortable cutting care for seniors and the disabled while billionaires receive tax breaks? At its core, this is about compassion, responsibility, and values. About protecting people, not profits. About ensuring the health and dignity of those who came before us—and safeguarding the future for the next generation.

People on TennCare— Tennessee's Medicaid Program— who lose their healthcare coverage have the right to appeal. From 2023 to 2024, 500,000 TennCare enrollees lost their coverage. Of that 500,000, 70% were cut off because they didn’t complete the paperwork by the deadline. TJC's Executive Director and Co-Founder Michele Johnson says, "families who did everything right but ran into obstacles beyond their control, from postal errors to hospitalization, would be left without care." There is a "good cause" exception within TennCare, which is a legally sufficient reason for missing a deadline. But this policy could disappear under a proposed rule change. Read more in this article by The Tennessean here: 🔗 https://lnkd.in/ewnWv8WF

It has been a while since I have shared thoughts about the CCBHC model and my ongoing concerns about its long-term financial viability. From a services standpoint, CCBHCs are far ahead of the fragmented systems that came before. The model challenges us to provide truly integrated, whole-person care—behavioral health, physical health, and social supports working in tandem. That vision remains one of the most important shifts in community mental health in decades. But from a financial standpoint, the story is much more complicated. In states like Kansas, without Medicaid expansion, the payer mix looks increasingly difficult. Many centers are seeing Medicaid cover only 50 to 70 percent of their total services, with the rest financed through commercial insurance, local funding, grants, or uncompensated care. For a community mental health center with a $30 million annual budget, that means the shortfall could range from $9 million to $15 million every year depending on the proportion of Medicaid-covered care. Even under the best of those scenarios, that gap represents an enormous strain on organizations that are already operating with tight margins and broad mandates to serve everyone. I think this is a critical conversation. I will continue to put it out there and hope that I get some traction.

Oklahoma lawmakers hosted an interim study to explore how recent federal changes will impact Oklahoma’s hospitals, patients, and state budget. 🏥 What’s at stake: ➡️ $6.7 billion in hospital funding could be lost over 10 years as provider payments are reduced. ➡️ Rural hospitals already struggling to make payroll may face closure risks. ➡️ Work requirements could affect up to 126,000 Oklahomans receiving Medicaid coverage. ➡️ A $50 billion federal Rural Health Transformation Program aims to help states stabilize care — Oklahoma’s application is due in November. 📉 Hospital leaders warn that without action, service cuts—especially in mental health and rural care—may be unavoidable.