Medicaid

Conflicts of Interest Mar HCBS

States’ efforts to provide home- and community-based services to elderly and disabled Medicaid beneficiaries who need assistance to continue living independently continue to be plagued with conflicts of interest that the Centers for Medicare & Medicaid Services is not adequately addressing. Or so concludes a new study published by the U.S. Government Accountability Office. According to the GAO, …conflict of interest remain in regard to HCBS providers and managed care plans. HCBS providers may have a financial interest in the outcome of needs assessments, which could lead to overstating needs and overprovision of services. CMS has addressed risks associated with [...]

Safety-Net Hospitals Under the Gun

Safety-net hospitals across the country face a new challenge: adjusting to several cuts in the supplemental payments they receive from the federal government to help them serve the low-income residents of the communities in which they are located. First there is a $2 billion cut in Medicaid disproportionate share hospital payments (Medicaid DSH). These are payments made to hospitals that serve especially large numbers of low-income patients. These payments help safety-net hospitals with the unreimbursed expenses they incur caring for such patients. This cut, mandated by the Affordable Care Act but twice delayed by Congress, took effect on January 1. [...]

iqtsupport2018-01-19T06:00:18-05:00January 19, 2018|Affordable Care Act, hospitals, Medicaid, Medicare, Medicare cuts|

Administration Lays Groundwork for Medicaid Work Requirements

The Centers for Medicare & Medicaid Services has issued guidelines for states interested in adding a work requirement component to their Medicaid programs. With nearly a dozen states applying to implement controversial Medicaid work requirements, CMS has issued a guidance letter to state Medicaid directors outlining the criteria it will use when considering such applications. The new policy does not mandate work requirements in state Medicaid programs; it only presents the parameters CMS will use when considering the applications of states wishing to impose such requirements. For more information about the new policy, see the following resources: CMS’s news release [...]

iqtsupport2018-01-16T06:00:52-05:00January 16, 2018|Centers for Medicare & Medicaid Services, Medicaid|

A New Use for Section 1115 Medicaid Waivers?

Historically, states have pursued section 1115 Medicaid waivers as a means of expanding Medicaid eligibility. But the Centers for Medicare & Medicaid Services now appears to be looking at granting 1115 waivers to help states reduce their Medicaid populations. According to a new report published by the Commonwealth Fund, CMS is encouraging states – both Medicaid expansion and non-expansion states – to launch demonstration programs designed to reduce enrollment in “means-tested public assistance” programs such as Medicaid. In their efforts to cut spending and reduce Medicaid enrollment, states are expected to seek section 1115 waivers to experiment with means of [...]

iqtsupport2018-01-16T06:00:16-05:00January 16, 2018|Centers for Medicare & Medicaid Services, Medicaid|

Medicaid Expansion Helps Save Hospitals

Hospitals in states that took advantage of the Affordable Care Act to expand their Medicaid programs are six times less likely to close than hospitals in non-expansion states. And the impact of Medicaid expansion is even more beneficial for hospitals that serve rural communities. These are among the new findings in a new study that examines the effect of Medicaid expansion on hospital finances and hospital closures. Among those findings, We found that the ACA’s Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of [...]

iqtsupport2018-01-10T06:00:57-05:00January 10, 2018|Affordable Care Act, hospitals, Medicaid|

Report Looks at Work Requirements

As a growing number of states consider implementing work requirements as a condition for Medicaid eligibility, the Urban Institute has released a report that describes work requirements in various government cash assistance, nutrition assistance, and housing assistance programs and considers the degree to which those requirements have achieved their policy objectives. The report also describes the applications that eight states have submitted to the federal government seeking permission to introduce a work requirement in their Medicaid programs. Go here to see the Urban Institute report Work Requirements in Social Safety Net Programs: A Status Report of Work Requirements in TANF, [...]

iqtsupport2018-01-09T06:00:48-05:00January 9, 2018|Medicaid|

Medicaid Directors Meet

The National Association of Medicaid Directors held its fall conference recently outside Washington, D.C. This is an important event at which policy-makers and policy experts meet to discuss Medicaid programs, trends, challenges, and opportunities. Many of the materials used during that conference are now publicly available, including video clips from speeches by CMS Administrator Seema Verma and others and presentations on a number of subjects, including: delivering care across rural and frontier America Medicaid’s role in supporting community engagement and economic mobility busting the silos of physical and behavioral health care alternative payment models and addressing the social determinants of [...]

iqtsupport2017-12-21T06:00:09-05:00December 21, 2017|Medicaid|

MACPAC Meets

The non-partisan legislative branch agency that advises Congress, the administration, and the states on Medicaid and CHIP-related issues met recently in Washington, D.C. The following is the Medicaid and CHIP Payment and Access Commission’s own summary of its meeting. The December 2017 meeting of the Medicaid and CHIP Payment and Access Commission began with a brief update on the State Children’s Health Insurance Program (CHIP). Although federal funding for the CHIP expired at the end of September, legislation to renew funding was still pending in Congress. The Commission then heard from a panel discussing state tools to manage drug utilization [...]

iqtsupport2017-12-20T06:00:38-05:00December 20, 2017|Medicaid|

Medicaid Discovery: More Services Can Reduce Costs

States that invest additional money addressing the social service needs of their highest-cost Medicaid patients are finding that the savings they gain from doing so exceed the cost of providing the social services. Often, by as much as two dollars of savings for every one dollar spent. With relatively small numbers of Medicaid patients consuming a significant portion of state Medicaid resources, providing additional social service assistance to such individuals can both improve their health and save money for the states according to a new report from the National Governors Association. Most of these patients suffer from multiple medical problems, [...]

iqtsupport2017-12-18T06:00:07-05:00December 18, 2017|Medicaid|

House to Set Sights on Medicare, Medicaid Cuts in 2018

The House of Representatives will pursue entitlement spending cuts next year, House Speaker Paul Ryan recently explained on a radio program. That means Medicare, Medicaid, and possibly even Social Security. Ryan said that We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit... Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking. Learn more about Ryan’s remarks, the administration’s priorities, and what other members of Congress are saying [...]

iqtsupport2017-12-14T06:00:11-05:00December 14, 2017|Medicaid, Medicare, Medicare cuts|