Medicaid & State Programs
For more than 20 years, HMS has partnered with Medicaid programs throughout the United States to address their coordination of benefit, overpayment, and program integrity needs. We recover roughly $1 billion annually for our clients, and save them billions more in cost avoidance.
Our services help clients meet the federal mandate that Medicaid be the payor of last resort, and contain costs while expanding coverage to more of their at-risk citizens. HMS addresses all types of services covered by commercial insurers or Medicare, including inpatient, outpatient, skilled nursing facility, home health care, physician/professional, ambulance, long-term care, durable medical equipment, and pharmacy services.
In addition to state Medicaid agencies, HMS also provides services to other state programs, including:
- State Children's Health Insurance Programs
- General pharmacy programs
- Senior pharmacy programs
- State pharmacy assistance programs
- State employee benefit plans
- State Departments of Health