medicaid unwinding

Analysis Looks at Problems Plaguing Unwinding of Medicaid Continuous Eligibility

Since the end of the continuous Medicaid eligibility that was a major part of the Families First Coronavirus Response Act, more than 14 million Americans have lost their Medicaid eligibility. In a new analysis, KFF looks at the challenges both consumers and states have encountered in attempting to review the eligibility of the Medicaid population and to ensure that those who are no longer eligible can be directed to other options for health insurance. Among the factors addressed in this analysis are: State outreach to affected individuals, the effectiveness of those efforts, and the adjustments states have made along the [...]

joe2024-01-23T20:01:41-05:00January 24, 2024|hospitals, Medicaid|

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 meeting. MACPAC’s December 2023 meeting opened with a session that highlighted findings related to sexual orientation and gender identity (SOGI) data collection as part of the Commission’s focus on the collection of primary language and limited English proficiency, SOGI, and disability data for the purposes of assessing and addressing health disparities. During this discussion, we reviewed the purpose of SOGI data and federal and state priorities for collecting these data, which includes an overview of [...]

joe2023-12-19T15:36:42-05:00December 19, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for December 7

The following is the latest health policy news from the federal government for December 1-7. Some of the language used below is taken directly from government documents. Congress While Congress has more than a month before the next federal funding deadline of January 19, committees are working to prepare and pass health care legislation. On the House calendar for floor votes next week is H.R. 5378, the Lower Costs, More Transparency Act. This bill would eliminate the pending cuts to Medicaid DSH for two years (those cuts are temporarily suspended through January 19); introduce site-neutral payments for drug administration services [...]

joe2023-12-07T21:50:17-05:00December 7, 2023|340b, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Medicaid Redeterminations Trigger Increase in Self-Pay Care

As states continue redetermining Medicaid eligibility for participants who were protected from disenrollment during the COVID-19 emergency, the number of patients telling providers they will pay for their own hospital, primary care, and emergency department visits has risen. The increase in self-pay has been greatest for emergency department visits, and overall, the increases occurred most often in states that began disenrolling Medicaid participants as soon as the continuous eligibility afforded by the Families First Coronavirus Response Act ended. The rise in self-pay patients suggests that many previous Medicaid participants have not obtained new health insurance since their Medicaid eligibility ended. [...]

joe2023-11-30T19:16:48-05:00December 4, 2023|COVID-19, Medicaid|

Federal Health Policy Update for November 30

The following is the latest health policy news from the federal government for November 17-30. Some of the language used below is taken directly from government documents. No Surprises Act CMS has released two new FAQs to provide guidance in advance of the Independent Dispute Resolution portal reopening for batched disputes and air ambulance disputes; that service remains temporarily suspended. These FAQs together explain how certified IDR entities may determine whether a dispute is appropriately batched in light of recent court rulings; provide information about policy for extending existing IDR deadlines once the federal IDR portal reopens to all batched [...]

joe2023-11-30T20:59:02-05:00November 30, 2023|Centers for Medicare & Medicaid Services, COVID-19, Federal Update, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Medicaid Unwinding Continues

States continue to work on redetermining Medicaid eligibility for those who were enrolled in the program during the period of continuous eligibility that extended through the COVID-19 public health emergency and ended on March 31. Six months into what has come to be known as Medicaid unwinding, approximately 30 percent of the 95 million people enrolled in the program when the unwinding process officially began have now had their eligibility reviewed. Among them, 16 million have seen their eligibility renewed while 8.8 million have been disenrolled from the program. The numbers vary considerably from state to state, with different states [...]

iqtsupport2023-10-26T06:00:16-04:00October 26, 2023|Medicaid|

Federal Health Policy Update for October 19

The following is the latest health policy news from the federal government for October 13-19. Some of the language used below is taken directly from government documents. Congress At this moment there is still no Speaker of the House of Representatives. After 20 and then 22 House Republicans voted against Rep. Jim Jordan (R-Ohio) on Tuesday and Wednesday this week, Mr. Jordan has joined others, including senior Democrats, in supporting a plan to expand the powers of the temporary speaker, Rep. Patrick McHenry (R-NC). Mr. Jordan remains the speaker designee, an option that will enable him to continue to seek [...]

iqtsupport2023-10-19T15:01:13-04:00October 19, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, Telehealth|

Medicaid Unwinding Runs Into More Problems

When the COVID-19-era policy of continuous Medicaid eligibility came to an end and the process known as Medicaid unwinding began, policymakers expected significant numbers of people who lost their Medicaid eligibility to find new, affordable coverage in Affordable Care Act health insurance exchange plans. But while bureaucratic snafus that have resulted in millions of people losing their Medicaid eligibility because of paperwork problems rather than income that exceeded Medicaid eligibility criteria have received the most post-pandemic attention, other challenges have arisen that are preventing people from finding new, affordable insurance to replace their Medicaid coverage. Among them: ACA plans are [...]

iqtsupport2023-10-09T06:00:41-04:00October 9, 2023|Affordable Care Act|

Federal Health Policy Update for August 31

The following is the latest health policy news from the federal government for August 25-31. Some of the language used below is taken directly from government documents. No Surprises Act For the second time in less than a month a court has rejected how federal agencies are implementing the Independent Dispute Resolution process of the No Surprises Act. A federal court concluded that the process for establishing the Qualifying Payment Amount, or QPA – the median rate insurers pay for in-network services and a critical factor in settling payment disputes – inappropriately permits insurers to depress that rate and unfairly [...]

iqtsupport2023-08-31T16:09:59-04:00August 31, 2023|Centers for Medicare & Medicaid Services, Medicaid, Medicare, MedPAC|

States Introduce Changes on Medicaid Unwinding

With more than five million people already dropped from state Medicaid rolls and the federal government telling them they are not doing a good job, some states are introducing changes in how they review the eligibility of their Medicaid population as part of the Medicaid unwinding process. With the end of the formal public health emergency and continuous Medicaid eligibility, states have begun the significant challenge of reviewing the eligibility of all of their Medicaid participants. Last month the Centers for Medicare & Medicaid Services sent letters to all 50 states outlining their individual shortcomings in their efforts so far. [...]

iqtsupport2023-08-23T06:00:10-04:00August 23, 2023|Medicaid|