Medicaid

Study Finds Surprise in Sources of Medicaid, CHIP Growth

While enrollment in Medicaid and CHIP has been greatest among low-income families working full-time for small businesses, growth in Medicaid and CHIP among low-income families employed full-time by big businesses has been rising faster in recent years. According to a new study published in the journal Health Affairs, Medicaid and CHIP enrollment among low-income families employed full-time by large companies rose from 45 percent to 69 percent between 2008 and 2016.  The driving force behind this growing reliance on public insurance appears to be the shift of health insurance costs from companies to employees:  employee share of health insurance premiums [...]

2019-07-08T14:40:03-04:00July 8, 2019|Medicaid|

CMS Outlines New Medicaid Program Integrity Activities

The federal government will introduce a number of initiatives to combat Medicaid waste, fraud, and abuse in the coming months. In an article on the Centers for Medicare & Medicaid Services’ blog, CMS administrator Seema Verma outlined her agency’s major Medicaid program integrity efforts of the past year, including: Oversight of state Medicaid claiming and program integrity Disallowing unallowable claims of federal funding Increased audits and oversight Data sharing and partnerships Education, technical assistance, and collaboration Reducing improper payments Initiatives to be introduced in the coming months include (as described in the blog post): A proposed comprehensive update to Medicaid’s [...]

ACA Tied to Reduced Disparities in Cancer Care

Improved access to health insurance has led to reduced racial disparities in the diagnosis and treatment of cancer. As reported by the Washington Post, According to researchers involved in the racial-disparity study, before the ACA went into effect, African Americans with advanced cancer were 4.8 percentage points less likely to start treatment for their disease within 30 days of being given a diagnosis.  But today, black adults in states that expanded Medicaid under the law have almost entirely caught up with white patients in getting timely treatment, researchers said. Another study found that since the reform law’s implementation in Medicaid [...]

2019-06-10T06:00:04-04:00June 10, 2019|Affordable Care Act, Medicaid|

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 [...]

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

Proposed Immigration Rule Discourages Medicaid Enrollment

A proposal by the U.S. Department of Homeland Security is discouraging participation in Medicaid and other government safety-net programs. A proposed Homeland Security regulation would establish new criteria for determining whether individuals seeking admission into the U.S. might eventually become “public charges”:  people who would depend on public resources to meet their needs rather than the resources of friends, family, sponsors, or private organizations or be able to provide for themselves or their families.  Among those criteria are past use of government aid programs and current income and health status. Since the regulation was proposed last October, many legal immigrants, [...]

2019-06-03T15:21:21-04:00June 3, 2019|Medicaid|

Medicaid Waiver Process Often Lacks Transparency, GAO Finds

States’ applications for federal Medicaid waivers often lack transparency, according to a new report by the U.S. Government Accountability Office. According to the GAO, the chief problem with the transparency of state applications for Medicaid waivers arises when states either seek to amend waivers they have already obtained or amend waiver applications currently under review by the Centers for Medicare & Medicaid Services.  Too often, the GAO found, states neither subject such amendments to public review and comment nor adequately explain to stakeholders the implications of the amendments they are proposing. To address this problem, the GAO recommends that CMS [...]

2019-05-23T09:52:40-04:00May 23, 2019|Medicaid|

More Medicaid Matching Funds for Only Partial Medicaid Expansion?

The federal government is considering providing an unusual amount of federal Medicaid matching funding for only partial state Medicaid expansion. At least that’s what Centers for Medicare & Medicaid Services administrator Seema Verma told a health care conference in Georgia last week. The state of Georgia has proposes partially expanding its Medicaid population.  Under the Affordable Care Act, states that fully expand their Medicaid programs under the terms established by the 2010 health care law receive nine dollars in federal matching funds for every one dollar they spend on their Medicaid expansion population.  States that only partially expand their Medicaid [...]

CMS Speeds Up Medicaid Review Process

The federal government has greatly increased the speed with which it is reviewing and approving state applications to modify their Medicaid programs. Most often, such applications involve Medicaid state plan amendments and section 1915 waiver requests. According to a recent post on the CMS blog (in CMS’s own words), Between calendar years 2016 and 2018, there was a 16 percent decrease in the median approval time for Medicaid SPAs [note:  state plan amendments]. Seventy-eight percent of SPAs were approved within the first 90 day review period during calendar year 2018, a 14 percent increase over 2016. Between calendar year 2016 [...]

New Poverty Level Standards to Jeopardize Medicaid Eligibility?

The Trump administration is considering changing how the federal government measures inflation for the purpose of calculating the federal poverty level. Such a change, if implemented, could potentially reduce inflation-related increases in the federal poverty level, which in turn could limit the ability of some individuals and families to qualify, or continue to qualify, for a variety of public safety-net services – including, potentially, Medicaid. Among the possible alternatives to the current methodology for calculating inflation is the Chained Consumer Price Index for All Urban Consumers.  The Obama administration also explored substituting this index for the current inflation factor. The [...]

2019-05-13T06:00:02-04:00May 13, 2019|Medicaid|

MACPAC Seeks Input on IMDs

A 2018 law calls for the Medicaid and CHIP Payment and Access Commission to report to Congress on institutions for mental diseases, or IMDs, receiving Medicaid payments.  The law specifies that MACPAC solicit input from a variety of sources, including the Centers for Medicare & Medicaid Services, state Medicaid and mental health agencies and authorities, Medicaid insurers, Medicaid advocates, and others. To help fulfill this requirement, MACPAC is now soliciting views from stakeholders.  Among the many subjects on which MACPAC seeks input are (in MACPAC’s words), state requirements, including certification, licensure and accreditation applied to IMDs seeking Medicaid payment and [...]

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