Coverage Denied: Medicaid Patients Suffer as Layers of Private Companies Profit

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Kaiser Health News - Chad Terhune

Marcela Villa isn’t a big name in healthcare — but she played a crucial role in the lives of thousands of Medicaid patients in California. Her official title: denial nurse.

Each week, dozens of requests for treatment landed on her desk after preliminary rejections. Her job, with the assistance of a part-time medical director, was to conclusively determine whether the care — from doctor visits to cancer treatment — should be covered under the nation’s health insurance program for low-income Americans.

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