Medicaid regulations

Medicaid Work Requirements on the Way Out?

Medicaid work requirements appear to be going away in the wake of the Supreme Court agreeing to a Biden administration request to postpone arguments in a case brought by the Trump administration seeking to reverse previous court rulings blocking implementation of such requirements. To date, 12 states have received federal approval to implement Medicaid work requirements although only one such effort, in Arkansas, ever got off the ground.  All of the efforts eventually stalled in the face of legal challenges and administrative obstacles.  Upon taking office, the Biden administration informed the 12 states that it was considering withdrawing their approvals [...]

2021-03-16T13:00:38-04:00March 16, 2021|Medicaid, Medicaid regulations|

Administration to Review Public Charge Rule

President Biden has ordered a review of the federal public charge rule. The controversial rule, which would limit immigration to the U.S. for people who might at some point become dependent on public aid programs, has been the subject of litigation since it was proposed in 2019. The White House executive order directs …the Secretary of State, the Attorney General, the Secretary of Homeland Security, and the heads of other relevant agencies, as appropriate…[to] review all agency actions related to implementation of the public charge ground of inadmissibility… The officials were ordered to report their findings to the president within 60 [...]

2021-02-05T06:00:20-05:00February 5, 2021|Medicaid, Medicaid regulations, Medicare regulations|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The October 2020 MACPAC meeting opened with a panel discussion on restarting Medicaid eligibility redeterminations when the public health emergency ends.  It included Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities; René Mollow, deputy director for health care benefits and eligibility at the California Department of Health Care Services; and Lee Guice, director of policy and operations at the Department for Medicaid Services, Kentucky Cabinet for [...]

MFAR is Dead

At least for now. The controversial Medicaid Fiscal Accountability Regulation, slated for implementation this fall over the objections of many health care stakeholders, will not move forward at this time. In a tweet earlier this week, Centers for Medicare & Medicaid Services Administrator Seema Verma wrote that We've listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study.  Therefore, CMS is withdrawing the rule from the regulatory agenda. If implemented, opponents maintained, the regulation would have: Deprived states of important, established policy-making prerogatives. Created [...]

2020-09-16T06:00:25-04:00September 16, 2020|Medicaid, Medicaid regulations|

CMS Finalizes FY 2021 Payments to Hospitals

Medicare has announced how it will pay hospitals for inpatient care in FY 2021 with publication of its annual inpatient prospective payment system regulation last week. Among the changes announced by the Centers for Medicare & Medicaid Services: A 2.9 percent increase in fee-for-service inpatient rates. A compromise on its proposal to require hospitals to report their payer-specific negotiated rates with Medicare Advantage plans. Changes in how Medicare will calculate Medicare disproportionate share (Medicare DSH) uncompensated care payments. A much smaller cut than originally proposed in the pool of funds for Medicare DSH uncompensated care payments. Minor adjustments in the [...]

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services. In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy. In new guidance, CMS presents two methodologies for accounting for its mid-year policy change [...]

Coronavirus Update: March 31, 2020

Coronavirus Update: March 31, 2020 Yesterday the federal Centers for Medicare & Medicaid Services (CMS) published a major update of Medicare and Medicaid regulations that included blanket waivers of a large number of Medicare and Medicaid regulations and requirements.  The following is a summary of the major aspects of this new regulation. New Policies and Waivers From Medicare and Medicaid Regulations and Requirements CMS has introduced dozens of changes that involve waivers from current regulations and requirements.  A comprehensive, 26-page CMS document describing these changes can be found here and below are the highlights organized into four broad categories: increasing [...]

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The February 2020 MACPAC meeting opened with a continuation of MACPAC’s examination of Medicaid’s role in maternal health, when Medicaid officials from Michigan, New Jersey, and North Carolina joined the Commission to discuss how their states are addressing maternal morbidity and mortality.* The Commission plans to include a chapter on maternal health in its June 2020 report to Congress. Commissioners later turned their attention to policy options for improving enrollment in the Medicare Savings Program. [...]

MFAR Backlash Continues

Diverse health care and government interests are rallying around their opposition to the proposed Medicaid fiscal accountability rule. The regulation, proposed by the Centers for Medicare & Medicaid Services in November, would impose new limits on the ability of states to finance their share of their Medicaid spending, potentially jeopardizing provider payments and the ability of high-volume Medicaid providers to operate without suffering great losses. In all, CMS received more than 4200 written comments in response to the proposed regulation, most of them expressing opposition.  Among those doing so were state governments, the National Governors Association, hospitals and hospital associations, [...]

2020-03-02T06:00:22-05:00March 2, 2020|Medicaid, Medicaid DSH, Medicaid regulations|

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company. MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could …reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone.  States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications. Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch [...]

2020-02-18T13:28:21-05:00February 18, 2020|hospitals, Medicaid, Medicaid regulations|
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