Medicaid

CMS Offers States New Medicaid Path for Opioid Treatment

The Centers for Medicare & Medicaid Services (CMS) has issued new guidance to states advising them on how they can use section 1115 Medicaid waivers to improve access to treatment for Medicaid recipients struggling with opioid abuse problems. According to the 14-page guidance letter from CMS to state Medicaid directors, CMS is now offering a more flexible, streamlined approach to accelerate states’ ability to respond to the national opioid crisis while enhancing states’ monitoring and reporting of the impact of any changes imsplemented through these demonstrations. As the opioid crisis continues to raise alarm and highlight the need for better [...]

iqtsupport2017-11-08T06:00:52-05:00November 8, 2017|Centers for Medicare & Medicaid Services, Medicaid|

Despite Uncertainty, States Plan to Raise Medicaid Rates

Even though events in Washington leave the future of Medicaid unclear, 44 states still intend to raise at least some of their Medicaid rates in 2018. Inpatient payments to hospitals are not among the major targets of the planned rate increases: only 17 states plan to increase Medicaid inpatients payments while the others plan to keep those rates as they are or even reduce them. Learn more about trends in Medicaid enrollment, spending, and rates in the Kaiser Family Foundation’s annual survey of state Medicaid programs, the results of which can be found here.

iqtsupport2017-10-26T06:00:12-04:00October 26, 2017|Medicaid|

Braving the Unknown, States Increase Medicaid Benefits

Despite the prospect of Congress and the administration enacting major reductions of federal Medicaid spending as part of repealing and replacing the Affordable Care Act, more than half the states expanded their Medicaid programs in 2017 and many plan to do so in 2018 as well. In all, 26 states expanded or enhanced Medicaid benefits this year while 17 plan to do so next year. Most of the changes involve enhancing mental health and substance abuse treatment services. Learn more about expanded Medicaid benefits in the face of anticipated reductions in Medicaid spending in this Healthcare Finance News report.

iqtsupport2017-10-23T06:00:49-04:00October 23, 2017|Medicaid|

Suit Claims Low Medicaid Rates are Discriminatory

A lawsuit filed in state courts in California argues that the state’s low Medicaid payments amount to discrimination against the state’s large Hispanic Medicaid population. California pays among the lowest rates in the country to physicians, making health care inaccessible for some, and the suit maintains that this is a civil rights issue in which low rates amount to discrimination. The suit is based on state anti-discrimination and equal protection laws, and many other states have similar laws on the books. Observers question whether the low rates constitute discrimination against the suit’s Hispanic plaintiffs because the low rates affect the [...]

iqtsupport2017-10-03T10:00:05-04:00October 3, 2017|Medicaid|

GAO: Improvement Needed in MLTSS Oversight

The Centers for Medicare & Medicaid Services needs to improve the job it does overseeing state Medicaid programs of managed long-term services and supports. According to a new report by the U.S. Government Accountability Office, 22 states use MLTSS programs to help qualified seniors continue living independently in the community and to save money on nursing home costs. CMS’s oversight of these efforts, and of the use of federal funds, is inconsistent and often falls short when monitoring key considerations such as provider network adequacy, critical incidents, and appeals and grievances. To address these concerns, the GAO recommends that CMS [...]

iqtsupport2017-09-21T06:00:37-04:00September 21, 2017|Medicaid, Medicaid long-term services and supports|

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 Takes First Steps Toward Medicaid DSH Cuts

Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services. The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states. The cuts were established in the [...]

iqtsupport2017-07-31T06:00:34-04:00July 31, 2017|Centers for Medicare & Medicaid Services, hospitals, Medicaid|

Behavioral Health Services in Medicaid Expansion States

The U.S. Government Accountability Office has performed a limited study of the utilization of Medicaid behavioral health services in Medicaid expansion states. The study, based on data from New York, Washington, Iowa, and West Virginia, found that the two most heavily utilized behavioral health services were diagnostic and psychotherapy services and that more than two-thirds of behavioral health patients were prescribed anti-depressants. More people sought help for mental health challenges that for substance abuse problems. Medicaid officials in the selected states concluded that enrollment in Medicaid enhanced access to behavioral health care. Learn more about the study’s findings in the [...]

iqtsupport2017-07-28T06:00:52-04:00July 28, 2017|Affordable Care Act, Medicaid|

GAO Looks at Use of Telehealth in Medicare, Medicaid

The U.S. Government Accountability Office has examined the use of telehealth services in the Medicare and Medicaid programs. In a study that looked at current Medicare practices, sampled Medicaid practices in six states, and consulted selected provider, payment, and patient associations, the GAO evaluated the extent to which telehealth is used in Medicare and Medicaid today, factors that affect the use of telehealth in Medicare, and the degree to which new payment and delivery models might affect future telehealth utilization in Medicare. The report does not offer recommendations. The GAO released its findings in a new report titled Telehealth: Use [...]

iqtsupport2017-07-26T06:00:39-04:00July 26, 2017|Medicaid, Medicare|

Medicaid Enrollees: Access and Quality Are Good

Medicaid beneficiaries are generally satisfied with their access to care and the quality of care they receive. Or so reports a new study based on results of the federal Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for December of 2014 to July of 2015. According to the survey, nearly half of Medicaid patients rated their overall care 7.9 or greater on a scale of 10; 84 percent reported that they had been able to receive all of the care they needed over the past six months; and most were generally satisfied with the coverage. Relatively few reported [...]

iqtsupport2017-07-12T13:55:49-04:00July 12, 2017|Medicaid|