Another issue was that government Medicare and Medicaid agencies struggled to design claim forms, define billing instructions, and process submitted forms so that we could be paid for the care we provided. Medicare even gave us cash advances and we came to an agreement at the end of the year by comparing the total cash received with the total claims made.
When I started, our billing department had expanded beyond hospital space. We have taken over apartments in an adjoining residential building to cope with the additional workload. Empty tubs were literally overflowing with waiting papers.
Medicaid was structured so that the states administered the program and the federal government paid the states half or more of the total cost. In turn, states have delegated tasks to county health departments. Each state was required to submit its plan for Medicaid eligibility levels and coverage to the Federal Health Care Funding Administration (HCFA), now the Centers for Medicare and Medicaid Services (CMS), for approval under the law. federal.
Before Medicaid, New York City had more generous public health benefits for the needy than almost any other state, so it took advantage of new federal cost-sharing arrangements to design more generous eligibility standards and expand coverage. Medicaid has been a huge success, but rising health care costs have proven to be a substantial fiscal burden on counties and states. Jurisdictions with budget constraints have begun to devise methods to restrict Medicaid programs such as work requirements and bonuses.