Medicaid

CMS Proposes New Medicaid Managed Care Regulation

Just two years after a major overhaul of Medicaid managed care regulations, the Centers for Medicare & Medicaid Services is again proposing changes in how the federal government regulates the delivery of managed care services to Medicaid beneficiaries. Under the newly proposed regulation, states would: be free to implement more changes in their managed care programs without seeking federal permission; have slightly more flexibility in how supplemental payments are made to hospitals through managed care plans and implement some such changes without federal approval; be permitted to redefine what constitutes an adequate provider network for managed care plans; and not [...]

iqtsupport2018-11-14T06:00:22-05:00November 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

Election Brings Good News for Medicaid

Medicaid came out on top in elections throughout the country last week. With the arrival of a Democratic majority in the House, attempts to repeal the Affordable Care Act, including its Medicaid expansion, appear to have come to an end – at least for now. Voters in three states approved ballot questions to expand their states’ Medicaid programs. And two states elected governors likely to expand their states’ Medicaid programs. Learn more about what the mid-term elections meant to Medicaid and its future in this Washington Post story.

iqtsupport2018-11-12T06:00:13-05:00November 12, 2018|Medicaid|

MACPAC: Let’s “hit the pause button” on Medicaid Work Requirements

The non-partisan legislative branch agency that advises Congress and the administration on Medicaid issues will ask the administration to delay approving any more state Medicaid work requirements. That was the decision reached by the Medicaid and CHIP Payment and Access Commission when it met last week. MACPAC warned that the work requirement currently being implemented in Arkansas, the first state to introduce such a requirement, is flawed and needs further work before moving forward. The agency also believes the federal government should increase its oversight of new Medicaid work requirements before additional states begin implementing similar, already-approved Medicaid work requirements. [...]

iqtsupport2018-10-30T06:00:17-04:00October 30, 2018|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 October 2018 MACPAC meeting covered a range of front-line issues in Medicaid, leading off with an analysis of disproportionate share hospital (DSH) allotments on Thursday morning. Following the analysis, the Commission discussed options for March recommendations on how to structure DSH allotment reductions that are scheduled to begin in fiscal year 2020. The Commission later resumed the discussion it began in September on work and community engagement requirements, presenting new data from Arkansas [...]

iqtsupport2018-10-29T06:00:58-04:00October 29, 2018|Medicaid, Medicaid regulations|

Medicaid Expansion Didn’t Hurt Access After All

The expansion of Medicaid in nearly two-thirds of the states has not affected access to care for Medicare participants in those states. According to a new analysis by the National Bureau of Economic Research, Medicare patients had no more trouble getting timely doctors’ appointments, suffered no increase in costs, and experienced no increase in waiting times after their state expanded its Medicaid program under the Affordable Care Act. Learn more about these findings in this Healthcare Dive report or go here for access to the National Bureau of Economic Research report “The Impact of Insurance Expansions on the Already Insured: [...]

iqtsupport2018-10-24T06:00:27-04:00October 24, 2018|Affordable Care Act, Medicaid|

New Report Looks at Medicaid Buy-In

While there has been a great deal of public discussion of late about “Medicare for all,” less attention has been paid to the concept of permitting people to buy into their state’s Medicaid program. Now, the Rockefeller Institute of Government has published a new report that presents the different approaches to the concept of Medicaid buy-in. It also seeks to address six major questions of potential Medicaid buy-in efforts: How large is the intended population of new enrollees? What kind of coverage would be offered? How would enrollment be financed? How would rates be set? Would the program use standard [...]

iqtsupport2018-10-23T06:00:04-04:00October 23, 2018|Medicaid|

Medicaid APMs Moving in New Directions

For the most part, states’ use of alternative payment models in their Medicaid programs so far have focused on the work done by primary and acute-care providers. Now, a number of states are starting to extend their use of APMs in other areas, including: behavioral health providers safety-net providers long-term care providers For a look at what states are doing to drive value in Medicaid payments in these new areas, see the Commonwealth Fund article “The Next Generation of Paying for Value in Medicaid,” which can be found here.

iqtsupport2018-10-18T06:00:25-04:00October 18, 2018|Alternative payment models, Medicaid|

Proposed “Public Charge” Regulation Could Hit Medicaid, Hospitals

If a regulation proposed by the Department of Homeland Security to redefine what constitutes a “public charge” is adopted, millions of people currently enrolled in the Medicaid and Children’s Health Insurance Program might choose to disenroll from those programs rather than risk losing their opportunity to obtain legal permanent resident status in the U.S. The proposed regulation seeks to filter out of possible residency status individuals who might become public charges, or dependent on government programs, over time. A new analysis published by the Kaiser Family Foundation concluded that Under the proposed rule, individuals with lower incomes, a health condition, [...]

iqtsupport2018-10-17T06:00:51-04:00October 17, 2018|Medicaid|

DSRIP Evolves

Medicaid Delivery System Reform Incentive Payment waivers, unleashed by the Affordable Care Act and other Obama administration initiatives, sought to foster a greater focus on value in the delivery of health care. Medicaid DSRIP waivers typically provided new Medicaid funds to health care organizations that met performance goals for improving the quality of care, improving health care outcomes, and improving health care infrastructure in ways that improved care quality and outcomes. To a significant extent, early DSRIP programs helped protect Medicaid payments to hospitals that were jeopardized by hospital-specific and state-wide upper-payment limit problems. State DSRIP initiatives are now moving [...]

iqtsupport2018-10-04T06:00:03-04:00October 4, 2018|Medicaid|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. to review a number of Medicaid- and CHIP-related issues. MACPAC members heard presentations on and discussed the following issues: Multistate Collaboration: Panel on State Perspectives Themes from Interviews on the Development of Hospital Payment Policies DSH Payments: Policy Changes and Policy Options Operational Considerations for Work and Community Engagement Requirements Medicaid Coverage of New and High Cost Drugs Managed Care Oversight Oversight of UPL Payments: Additional Analyses and Policy Options Mandated Report: Therapeutic Foster Care Find outlines of these subjects and additional materials by clicking the links [...]

iqtsupport2018-09-25T06:00:56-04:00September 25, 2018|MACPAC, Medicaid, Medicaid managed care, Medicaid regulations|