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Medicaid Task 2

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Medicaid: An Understanding
Christina S.
WGU

Medicaid is a government program that is aimed at helping insure people who have limited income, for themselves and their children. It’s a great program that helps insure millions of people who would otherwise go uninsured.
Because Medicaid is a federal government payer program, it is held to high standards when it comes to state licensure and accreditation. Healthcare professionals must get legal approval to practice from the state licensure. They must maintain accurate information like, contact information, products and services furnished and more. The Physician Quality Reporting System is one way to help meet clinical quality standards and report them. The eligible professionals are responsible for making sure they are using the documents for the correct program year. This program also encourages them to report information that will help them assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time (CMS.gov, Physician quality reporting system, 2015.) Another one of the ways Medicaid is effected by this is through the Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) that was developed by the Centers for Medicare and Medicaid Services (CMS). Through this healthcare organizations have to meet these health and safety standards to start and continue participating in the Medicaid program. CMS also ensures that the standards of accrediting organizations recognized by CMS meet or exceed standards set forth in the CoPs\CfCs (CMS.gov, Conditions for Coverage (CfCs) and Conditions of Participation (CoPs), 2013.)
Medicaid reimbursement rates can vary, depending on each states policies and other determining factors. Each state can establish their own Medicaid provider payment rates within federal requirements. There are...

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