This study uses data on Medicaid physician fees in 1993 and 1998 to document variation in Medicaid fees across the country, describe changes in Medicaid fees, and contrast how Medicaid physician fees have changed relative to those in Medicare between 1993 and 1998. The results show that 1998 Medicaid fees vary widely, as has been documented in earlier studies, but that states with low average f...

1 3 3 0 G S T R E E T N W , W A S H I N G T O N , D C 2 0 0 0 5 P H O N E : 2 0 2 3 4 7 5 2 7 0 , F A X : 2 0 2 3 4 7 5 2 7 4 W E B S I T E : W W W . K F F . O R G How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees Executive Summary Under the Affordable Care Act (ACA), beginning in 2014, states will be able to expand Med...

Because agency enforcement of the Medicaid statute against non-compliant states is utterly impractical, Medicaid providers and beneficiaries have relied on section 1983 litigation to protect themselves against the harmful effects of state cutbacks on Medicaid spending by privately enforcing two particular provisions of the Medicaid statute against the states. However, because of several legisla...

In this article, the authors simulate the effects on Federal and State Medicaid expenditures of increasing Medicaid fees to Medicare fee schedule (MFS) levels. Strict adoption of the MFS by the States would increase total Medicaid spending by approximately 4 percent, $2.5 to $2.9 billion. Because Medicaid fees vary across States, so does the impact of adopting the MFS. Medicaid spending would i...

Although Medicaid is regarded as a federal entitlement program, nowhere does the Medicaid statute explicitly recognize a federal right of action to enforce recipients' rights. Arguably, the Supreme Court, rather than Congress, first recognized the right of Medicaid recipients to protection of federal law. A controversial 2001 federal court decision, however, called into question the continuing ...

There is considerable interest in examining how Medicaid payment affects nursing home care. This study examines the effect of Medicaid payment methods and reimbursement rates on the delivery of rehabilitation therapy to Medicaid nursing home residents in six States from 1992-1995. In States that changed payment from prospective facility-specific to prospective case-mix adjusted payment methods,...

BACKGROUND Although national cross-sectional estimates of the percentage of children enrolled in Medicaid are available, the percentage of children enrolled in Medicaid over longer periods of time is unknown. Also, the percentage and characteristics of children who rely on Medicaid throughout childhood, rather than transiently, are unknown. METHODS We performed a longitudinal examination of M...

This study examines the patterns of length of stay (LOS) and inpatient costs for both Medicaid managed care and nonmanaged care patients using data from Medicaid patients aged 18 to 64 years who were discharged from hospitals in Florida between 2006 and 2012. This study used pooled cross-sectional multilevel modeling. The results show that the type of Medicaid program in which patients were enr...

Medicaid provides health insurance for 54 million Americans. Using the Census Bureau's Supplemental Poverty Measure (which subtracts out-of-pocket medical expenses from family resources), we estimated the impact of eliminating Medicaid. In our counterfactual, Medicaid beneficiaries would become uninsured or gain other insurance. Counterfactual medical expenditures were drawn stochastically from...

Medicare Advantage Special Needs Plans (SNPs) for dual eligibles--individuals who qualify both for Medicare and Medicaid benefits--have the potential to coordinate Medicare benefits with state-administered Medicaid benefits. States that aim to develop such programs may choose from among three potential models: 1) a Medicaid program in which the beneficiary voluntarily enrolls in a single manage...