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Most private insurance contracts allow providers and enrollees to obtain prior assurance that a claim will be covered.
The Centers for Medicare & Medicaid Services (CMS) should prohibit routine or blanket use of advance beneficiary notices (ABNs) by providers.
Under the current Medicaid financing system, federal Medicaid funding increases in response to increases in enrollment, service costs, and service use.
Federal and state governments should maintain the entitlement nature of Medicaid funding so all who qualify will be covered.
Congress should evaluate the federal Medicaid funding formula to determine if it distributes federal funds equitably among states, consistent with Title XI
States and federal governments must ensure that all Medicaid beneficiaries have meaningful opportunities to exercise their statutory grievance and appeal r