Medicaid regulations

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 [...]

iqtsupport2020-08-29T13:00:57-04:00August 29, 2020|Centers for Medicare & Medicaid Services, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations|

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 [...]

iqtsupport2020-03-31T20:24:34-04:00March 31, 2020|Coronavirus, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Telehealth|

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. [...]

iqtsupport2020-03-06T06:00:04-05:00March 6, 2020|hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare|

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, [...]

iqtsupport2020-03-02T06:00:22-05:00March 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 [...]

iqtsupport2020-02-18T13:28:21-05:00February 18, 2020|hospitals, Medicaid, Medicaid regulations|

Health Care Groups Rebel Against Proposed Federal Regulation, Program

The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups. The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them. The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal [...]

iqtsupport2020-02-07T06:00:27-05:00February 7, 2020|Centers for Medicare & Medicaid Services, DeBrunner & Associates, hospitals, Medicaid, Medicaid 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 Medicaid and CHIP Payment and Access Commission kicked off its December meeting with highlights from its forthcoming issue of MACStats: Medicaid and CHIP Data Book, due out December 18, 2019. MACStats brings together statistics on Medicaid and State Children’s Health Insurance Program (CHIP) enrollment and spending, federal matching rates, eligibility levels, and access to care measures, which come from multiple sources. Later the Commission discussed a proposed rule that the Centers for Medicare [...]

iqtsupport2019-12-16T13:50:19-05:00December 16, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicaid upper-payment limit|

Administration Reveals Regulatory Priorities for 2020

The Trump administration’s health care regulatory priorities for 2020 have been outlined by the Office of Management and Budget in a newly released “Statement of Regulatory Priorities for Fiscal Year 2020.” The statement, an annual OMB document, organizes the priorities as follows: Facilitating patient-centered markets Fixing health care financing through protecting private insurance and Medicare Fixing health care financing through reforming the individual market Fixing health care financing through making the ACA and Medicaid fiscally sustainable Bringing value to health care through price and quality transparency Bringing value to health care through patient-centered health IT Bringing value to health care [...]

iqtsupport2019-11-22T06:00:34-05:00November 22, 2019|Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations, Medicare, Medicare regulations|

Verma Hints at More Medicaid Changes, Deregulation

Stay tuned for more Medicaid changes, Centers for Medicare & Medicaid Services administrator Seema Verma told a Las Vegas health care gathering last week. CMS, she told her audience, will …soon outline new opportunities for states to flip the Medicaid paradigm and free themselves from federal micromanagement. While Verma offered few details, one idea clearly emerged: there will be more deregulation. She insisted, for example, that Medicaid work requirements are not dead. While such requirements have run into trouble in the courts in recent months, she explained that CMS is developing new implementation guidelines to address some of the challenges [...]

iqtsupport2019-10-31T06:00:04-04:00October 31, 2019|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

Immigrants Intimidated by New Public Charge Guidelines?

Immigrants served by community health centers appear less inclined than in the past to seek public aid to help them with their medical problems. And community health center staff believes this is the result of confusion and fear as a result of changing federal immigration policies. As stated in the Kaiser Family Foundation issue brief “Impact of Shifting Immigration Policy on Medicaid Enrollment and Utilization of Care among Health Center Patients,” Health centers reported that, in recent months, immigrant patients have declined to enroll or reenroll themselves and/or their children in Medicaid for fear of public charge. Health center respondents [...]

iqtsupport2019-10-16T06:00:49-04:00October 16, 2019|Medicaid, Medicaid regulations|