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Unlike Medicare, which won’t pay for poor performance, Medicaid pays for services rendered, period. If you’re a shitty provider, there’s a calculus for when to
by Spooky23 2y ago
Unlike Medicare, which won’t pay for poor performance, Medicaid pays for services rendered, period. If you’re a shitty provider, there’s a calculus for when to bill Medicaid for a lower, guaranteed payment vs Medicare.
There’s a wide variety of shenanigans at the provider, managed care and state/county level. A big part of the performative shipping of migrants and poor people to northern states is all about shifting Medicaid expenses.
This happens often to mental patients, who often find themselves released from a police station or hospital, at a bus station with a ticket to NYC.
- nobody9999 2y ago>Unlike Medicare, which won’t pay for poor performance, Medicaid pays for services rendered, period. I don't believe that's true. Do you have any evidence for this? I have never heard of anyone challenging a Medicare reimbursement for "poor performance." In fact, billing codes often don't make a whole lot of sense, yet are approved without question just because the billing code exists. What's more, Medicare and Medicaid fraud are often perpetrated[0] by the same folks without and done in exactly the same way. [0] https://www.cnbc.com/2023/03/09/how-medicare-and-medicaid-fraud-became-a-100b-problem-for-the-us.html https://www.cnbc.com/2023/03/09/how-medicare-and-medicaid-fr...
- Spooky23 2y agohttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08348-w https://bmchealthservres.biomedcentral.com/articles/10.1186/... The most common way they do this is with hospital re-admissions. The hospital eats the cost, which is often because of poor hygiene and nursing practices.