Medicaid

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|

Implications of Medicaid Block Grants

States will be able to pursue new Medicaid block grants under guidance recently sent by federal regulators to state Medicaid directors. But what does that mean? In a new article, the Commonwealth Fund examines how the Centers for Medicare & Medicaid Services’ Medicaid block grants will work (for states that choose to pursue them; they are not mandatory), the new flexibility block grants will give states, and how the new approach will give states some relief from CMS oversight and delivery system requirements. Learn more from the Commonwealth Fund article “What Does New Block Grant Guidance Mean for the Medicaid [...]

iqtsupport2020-02-06T10:04:51-05:00February 6, 2020|Medicaid|

Not Surprisingly, Higher Medicaid Rates Improve Access

Higher Medicaid payments for substance abuse disorder treatment lead to better access to such treatment, a new report by the U.S. Government Accountability Office has concluded. According to the study, which focused on six states, State officials and SUD [substance abuse disorders] providers in the selected states with larger rate changes reported greater effects on SUD service availability compared to those in states with smaller changes. For example, state officials said that larger rate increases helped increase the number of SUD providers participating in Medicaid, but did not generally note SUD service availability effects for smaller rate increases. Providers in [...]

iqtsupport2020-02-04T06:00:57-05:00February 4, 2020|Medicaid|

CMS Introduces New Approach to Medicaid Block Grants

States would be able to convert part of their Medicaid programs into block grants under a new program introduced by the federal government. The program, which the Centers for Medicare & Medicaid Services calls “Healthy Adult Opportunity,” would encompass services only for adults under the age of 65 who are not eligible for Medicaid because of disability or the need for long-term care, services, and supports and who are not otherwise eligible for the pre-Affordable Care Act Medicaid program. Under the program, states can develop either a total expenses model or per enrollee model for their block grants and would [...]

iqtsupport2020-01-31T06:00:43-05:00January 31, 2020|Affordable Care Act, Medicaid|

Supreme Court Lifts Public Charge Rule Ban

The U.S. can now reject visa and green card applicants based on their financial prospects after a new Supreme Court ruling this week. This ruling has potential long-term implications for health care providers. Last August a new Department of Homeland Security regulation took effect that authorized the federal government to reject immigrants’ applications for visas and green cards if their financial situation and employment prospects suggested that they might become a “public charge” and dependent on government safety-net programs like Medicaid and food stamps. A number of groups sued to prevent the rule’s implementation and federal courts imposed an injunction [...]

iqtsupport2020-01-30T06:00:23-05:00January 30, 2020|hospitals, Medicaid|

GAO Finds Obstacles to Treatment for Opioid Abuse

Several obstacles get in the way of Medicaid patients receiving treatment for opioid use and addiction. So concludes the U.S. Government Accountability Office in a recent study. According to the GAO, the barriers to Medicaid patients receiving medication-assisted treatment for opioid use and addiction – a combination of behavioral therapy and certain medications – include: The failure of state Medicaid programs to cover such services. GAO found that 40 percent of state Medicaid programs do not cover certain drugs widely used to treat opioid addiction. Prior authorization requirements can slow the process of patients receiving the treatment they need. Some [...]

iqtsupport2020-01-29T06:00:28-05:00January 29, 2020|Medicaid|

Medicaid Expansion Slows Opioid Deaths

Opioid deaths are less likely to occur in states that expanded their Medicaid programs under the Affordable Care Act, according to a new study. According to the study, Adoption of Medicaid expansion was associated with a 6% lower rate of total opioid overdose deaths compared with the rate in nonexpansion states... Counties in expansion states had an 11% lower rate of death involving heroin… and a 10% lower rate of death involving synthetic opioids other than methadone… compared with counties in nonexpansion states. In addition, Medicaid expansion, the study found, has made treatment for substance abuse disorders more widely available. [...]

iqtsupport2020-01-16T06:00:49-05:00January 16, 2020|Affordable Care Act, Medicaid|

Interview With Seema Verma

In late December, PBS broadcast an interview with Centers for Medicare & Medicaid Services administrator Seema Verma. Kaiser Health News has published a transcript of excerpts from that interview during which Verma discusses Medicaid – including enrollment, eligibility, services, and children – Medicare for all, administration attempts to reduce health care costs, protection for people with pre-existing conditions, and more. Read those excerpts in the Kaiser Health News article “One-On-One With Trump’s Medicare And Medicaid Chief: Seema Verma."

iqtsupport2020-01-07T11:50:05-05:00January 7, 2020|Centers for Medicare & Medicaid Services, Medicaid|

Pennsylvania to Introduce Medicaid PDL on January 1

Starting on January 1, Pennsylvania will employ a preferred drug list for its Medicaid program – a list that applies to both fee-for-service and managed care patients. And as many as 150,000 of the state’s 2.8 million Medicaid beneficiaries may find themselves facing changes in their prescription drugs. The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services, which administers the state's Medicaid program. While physicians may submit requests to the state for exemptions for specific patients for specific purposes, those exemptions may be relatively uncommon: [...]

iqtsupport2019-12-26T11:42:42-05:00December 26, 2019|Medicaid, Pennsylvania, Pennsylvania Medicaid, Pennsylvania Medical Assistance|

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|