Medicaid regulations

CMS Shares Vision for Medicaid

Medicaid is about to undergo major changes, CMS administrator Seema Verma outlined in a news release yesterday and in a speech to state Medicaid directors. According to the news release, those changes include: re-establishing a state-federal partnership that Verma believes has become too much federal and not enough state giving states greater freedom to innovate offering new guidelines for how states can align their individual programs with federal Medicaid objectives new guidance on section 1115 waivers longer section 1115 waivers with simpler review processes CMS willingness to consider proposals to impose work requirements on Medicaid beneficiaries Medicaid and CHIP “scorecards” [...]

iqtsupport2017-11-08T13:00:50-05:00November 8, 2017|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

New Rules Facilitate Integration of Physical, Behavioral Care

New federal regulations are facilitating better integration of physical and behavioral health services for the Medicaid population. Two developments, in particular, are advancing this integration: the 2016 Medicare managed care rule and a 2016 rule implementing the Mental Health Parity and Addiction Equity Act of 2008. Together, these rules encourage providers to perform comprehensive assessments of their patients, increase flexibility for providers in how they use Medicaid payments, and pave the way for improvements in the use of information technology that foster better integration of physical and behavioral medical care. A new issue brief from the Commonwealth Fund presents in [...]

iqtsupport2017-10-31T06:00:27-04:00October 31, 2017|Medicaid managed care, Medicaid regulations|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. Among the issues MACPAC commissioners discussed during their two-day meeting were: delivery system reform incentive payment programs Medicaid enrollment and renewal processes managed care oversight monitoring and evaluating section 11115 demonstration waivers Medicaid coverage of telemedicine services MACPAC advises the administration, Congress, and the states on Medicaid and CHIP issues. It is a non-partisan agency of the legislative branch of government. Go here to find background information on these and other subjects as well as links to the presentations that MACPAC staff made to the commissioners during [...]

iqtsupport2017-09-20T06:00:11-04:00September 20, 2017|MACPAC, Medicaid, Medicaid managed care, Medicaid regulations|

CMS Seeks to Track Post-ASC Hospitalizations

The Centers for Medicare & Medicaid Services has announced a new initiative to track hospital admissions among Medicare patients who have recently been served at an ambulatory surgical center. The new measure would become part of the agency’s broader quality reporting efforts. The federal government has a large stake in the performance of ambulatory surgical centers: it spends $4 billion a year on care for more than three million Medicare patients at such facilities. Learn more about the project CMS calls “Development of a Facility-Level Quality Measure of Unplanned Hospital Visits after General Surgery Procedures Performed at Ambulatory Surgical Centers” [...]

iqtsupport2017-07-14T06:00:56-04:00July 14, 2017|Medicaid regulations, Medicare|

The Prospect of a Medicaid Work Requirement

Over the past three years a dozen states have proposed establishing a work requirement for eligibility for their Medicaid programs and in its proposed FY 2018, the Trump administration has called for extending the ability to impose such a requirement to all states. But how would a Medicaid work requirement work? To whom would it apply and what kinds of work might satisfy such a requirement for the approximately 22 million Medicaid recipients (out of 76 million total recipients) to whom it might apply? A new Commonwealth Fund report looks at these and other issues. Go here to find the [...]

iqtsupport2017-05-31T16:28:01-04:00May 31, 2017|Medicaid, Medicaid regulations|

States Get More Time to Improve Approach to Serving the Elderly, Disabled

The federal government is giving state three additional years to improve their Medicaid-funded efforts to help keep the elderly and the disabled in the community. The requirement, established in 2014 for implementation by 2019, requires states to do more to enable the elderly to remain in their homes rather than go to nursing homes and to help the disabled live and work in the community or at least have greater control of their own lives while residing in group home settings. Among the approaches states have been developing in response to the federal requirements are offering seniors programs of long-term [...]

iqtsupport2017-05-16T06:00:49-04:00May 16, 2017|Medicaid, Medicaid and housing for the disabled, Medicaid regulations|