Medicaid regulations

Stakeholders Respond to CMS “Patients Over Paperwork” RFI

More than 400 stakeholders responded to the federal government’s request for ideas to reduce the administrative burden associated with serving publicly insured patients. The request was disseminated via a Centers for Medicare & Medicaid Services request for information that was part of the agency’s “Patients over Paperwork” initiative. Among the groups that responded were the American Hospital Association, The American Association of Colleges of Nursing, the Critical Access Hospital Coalition, the Coalition of Long-Term Acute-Care Hospitals, the National Rural Association of Rural Health Clinics, the American Academy of Ophthalmology, the American Academy of Family Physicians, the American Hospital Association, and [...]

iqtsupport2019-08-16T10:27:17-04:00August 16, 2019|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

CMS Proposes Easing Medicaid Access Protections

States would have to do less to ensure access to Medicaid-covered services for their Medicaid population under a new regulation proposed by the Centers for Medicare & Medicaid Services. In 2015, CMS required states to track their Medicaid fee-for-service payments and submit them to the federal government as part of a process to ensure that Medicaid payments were sufficient to ensure access to care for eligible individuals. Now, CMS proposes rescinding this requirement, writing in a news release that This proposed rule is designed to help streamline federal oversight of access to care requirements that protect Medicaid beneficiaries. CMS anticipates [...]

iqtsupport2019-07-16T10:33:57-04:00July 16, 2019|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

CMS Seeks Help With Reducing Administrative and Regulatory Burdens

Reducing administrative and regulatory burdens is the subject of a new request for information issued last week by the Centers for Medicare & Medicaid Services. In the RFI, CMS explains that it is especially interested in “…innovative ideas that broaden perspectives on potential solutions to relieve burden and ways to improve” reporting and documentation requirements coding and documentation requirements for Medicare or Medicaid payment prior authorization procedures policies and requirements for rural providers, clinicians, and beneficiaries policies and requirements for dually enrolled (Medicare and Medicaid) beneficiaries beneficiary enrollment and eligibility determination CMS processes for issuing regulations and policies Comments are [...]

iqtsupport2019-06-12T06:00:42-04:00June 12, 2019|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

PACE Regulation Updated

PACE programs will have new flexibility under a recent update of regulations governing Programs of All-Inclusive Care. As described by the National Association of Medicaid Directors, the new regulation Allows PACE team members to fulfill multiple roles on the care team; Allows certain non-physician providers to serve in the place of primary care physicians on the care team; Clarifies that PACE programs offering prescription drug benefits are subject to Medicare Part D regulations; Eliminates requirements for PACE organizations to seek waivers for several of the most commonly waived aspects of PACE regulation; and Updates CMS's enforcement actions to promote accountability [...]

iqtsupport2019-06-11T06:00:59-04:00June 11, 2019|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

Administration Ramps Up Scrutiny of Immigrants’ Use of Public Benefits

Immigrants’ sponsors could be more likely to be held financially responsible for the cost of public benefits those immigrants receive under a new memorandum issued by the White House. The requirement itself is not new; the purpose of the memorandum is to encourage federal agencies to enforce existing laws that state that, according to the memorandum, …when an alien applies for certain means-tested public benefits, the financial resources of the alien’s sponsor must be counted as part of the alien’s financial resources in determining both eligibility for the benefits and the amount of benefits that may be awarded. Financial sponsors [...]

iqtsupport2019-06-06T06:00:08-04:00June 6, 2019|Medicaid, Medicaid regulations|

CMS Adopts Rule to Protect Medicaid Payments

A new Medicaid provider payment reassignment regulation eliminates the ability of states to divert any portion of Medicaid payments to third parties. Such diversion was authorized, in a limited manner, in 2014, when CMS created an exception to the existing prohibition on the diversion of provider payments to third parties. That exception involved diversion of payments to selected third parties, mostly in-home personal care workers, but in this new, final regulation, the agency eliminates this exception, maintaining that it is inconsistent with the Social Security Act. Learn more about the new regulation in a CMS news release or see the [...]

iqtsupport2019-05-07T06:00:52-04:00May 7, 2019|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 Commission wrapped up its work on the June 2019 Report to Congress on Medicaid and CHIP at the April meeting, with sessions reviewing four of the report’s five draft chapters on Thursday morning, and votes on potential recommendations later in the afternoon. First on Thursday’s agenda was a draft June chapter on Medicaid prescription drug policy, which contained draft recommendations to provide states with a grace period to determine Medicaid drug coverage and [...]

iqtsupport2019-04-16T06:00:59-04:00April 16, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations|

Protections Overlooked as Medicaid Reforms are Implemented

In its eagerness to help states introduce changes in their Medicaid programs and reduce administrative burdens, the Centers for Medicare & Medicaid Services is ignoring regulatory requirements designed to understand and measure the impact of those changes on beneficiaries. According to an analysis by the Los Angeles Times, many states seeking to implement Medicaid work requirements have not projected how many of their beneficiaries would be affected by those requirements nor have they projected how many beneficiaries who are removed from the Medicaid rolls will gain employment after losing their Medicaid benefits. Both projections are required under Medicaid regulations adopted [...]

iqtsupport2019-02-15T06:00:51-05:00February 15, 2019|Centers for Medicare & Medicaid Services, MACPAC, 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. Hospital payment was a key focus of MACPAC’s January meeting with the Commission voting on Thursday to approve two sets of recommendations, the first addressing the structure of disproportionate share hospital (DSH) allotment reductions and the second directed to improving compliance with upper payment limit requirements. Both sets of recommendations are slated for inclusion in MACPAC’s March 2019 Report to Congress on Medicaid and CHIP. Later that morning, the Commission discussed a study on [...]

iqtsupport2019-01-31T06:00:32-05:00January 31, 2019|MACPAC, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations|

CMS to Create New Office for Regulatory Reform

In 2019 the Centers for Medicare & Medicaid Services intends to create a new office to address regulatory reform. CMS administrator Seema Verma recently announced her intention to create this office, but other than saying its priority would be to reduce regulatory burden, offered no details. See a brief notice about the new office here.

iqtsupport2018-12-26T09:51:55-05:00December 26, 2018|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|