News: CMS cuts over 65,000 providers from the Medicaid rolls in 15 states

Under the Affordable Care Act (ACA), providers have to recertify their Medicaid reimbursement eligibility. Because of this provision, more than 65,000 providers across 15 states lost their spots on the Medicaid roll, according to Modern Healthcare.

The goal of the recertification requirement was to reduce fraud, waste, and abuse in the Medicaid program. Improper Medicaid payments reached $30 billion in 2015, according to CMS. This means the improper payment rate reached 9.8%, nearly double the rate in 2013, Modern Healthcare reported. CMS has not yet released the 2016 improper payment report.

While many providers were cut from the program, still others may have left voluntarily. Many state Medicaid programs have been criticized for low reimbursement, often only paying 60% of the Medicare rate for the medical services provided, Modern Healthcare reports.

Despite the number of providers dropped from Medicaid’s roles, the National Center for Health Statistics (NCHS) reported that about 69% of office-based physicians are currently accepting new Medicaid patients and around 84% are accepting new Medicare patients.

Editor’s note: To read the complete coverage from Modern Healthcare, click here. To read about the CMS compliance programs, click here.