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Medicare and Medicaid

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Medicare and Medicaid

U.S. government programs in effect since 1966. Medicare covers most people 65 or older and those with long-term disabilities. Part A, a hospital insurance plan, also pays for home health visits and hospice care. Part B, a supplementary plan, pays for doctors' services, tests, and other services. Requirements and benefits are complex. Patients pay deductibles and copayments. Medicaid, a joint federal-state program, covers low-income people under age 65 and those who have exhausted Medicare benefits. It pays for hospital care, doctors' services, nursing-home care, home health services, family planning, and screening. Participating states must offer Medicaid to all persons on public assistance but decide their own eligibility guidelines. Many physicians refuse to treat Medicaid patients because of low reimbursement levels.



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Although Medicare and Medicaid costs are on the rise, the rate of growth decelerated in 2003 compared with previous years, according to a study in the January/February 2005 issue of Health Affairs.
The Centers for Medicare and Medicaid Services (CMS) is engaged in several initiatives designed to support states' Medicaid program integrity efforts, but the agency's oversight is limited, says a new report by the General Accounting Office (GAO).
Jensen has served since 2000 as the medical director of the Western Integrity Center (WIC), the program safeguard contractor for the Centers for Medicare and Medicaid Services (CMS), for 15 Western states.
 
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