medicaid unwinding

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|

Feds Pointing Fingers on Medicaid Unwinding Shortcomings

After months of vague, general assertions about shortcomings in states’ efforts to redetermine the eligibility of their Medicaid participants as part of the post-pandemic continuous Medicaid unwinding process, the federal government is now revealing which states are having problems – and what those problems are. In public letters to the 50 states, the Centers for Medicare & Medicaid Services cites three major shortcomings in states’ efforts: paperwork problems, long call center waiting times, and the slow processing of applications. According to the letters, 36 states are falling short on at least one of these measures and five are failing on [...]

iqtsupport2023-08-16T06:00:38-04:00August 16, 2023|Medicaid|

Federal Health Policy Update for August 10

The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot initiate new disputes. Learn more from this CMS notice. CMS [...]

iqtsupport2023-08-10T16:32:27-04:00August 10, 2023|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Millions Cut From Medicaid, CHIP Rolls

Nearly four million Americans have already had their Medicaid or CHIP eligibility terminated as part of the so-called Medicaid unwinding process, according to data compiled by KFF Health News from state and federal sources. That figure, moreover, accounts for only 38 states and the District of Columbia. According to the KFF Medicaid Enrollment and Unwinding Tracker, At least 3,790,000 Medicaid enrollees have been disenrolled as of July 27, 2023, based on the most current data from 38 states and the District of Columbia. There is wide variation in disenrollment rates across reporting states, ranging from 82% in Texas to 10% [...]

iqtsupport2023-07-31T12:00:53-04:00July 31, 2023|Medicaid|

Some States Struggling With Medicaid Eligibility Redeterminations

As many as 12 states have struggled to comply with federal guidelines for redetermining eligibility of their Medicaid population – enough so that the federal government has had to intervene. The Centers for Medicare & Medicaid Services has reportedly halted Medicaid eligibility redeterminations in six states since April and worked closely with six more after concluding that they were not complying with its guidelines for how to go about redetermining the eligibility of the nearly 94 million Americans who were on the Medicaid rolls when the COVID-19 public health emergency ended. During that emergency, many people became newly eligible for [...]

iqtsupport2023-07-24T06:00:49-04:00July 24, 2023|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.” The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

iqtsupport2023-07-20T16:54:58-04:00July 20, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for July 13

The following is the latest health policy news from the federal government for June 30 – July 13. Some of the language used below is taken directly from government documents. 340B CMS has published a proposed regulation outlining how it plans to reimburse hospitals for reductions in 340B prescription drug payments that it implemented from 2018 to 2022 but that a federal court found to be illegal. The agency calculates that it owes participating 340B providers $9 billion, which it proposes paying to those providers in single lump-sum payments. CMS also proposes offsetting these payments through reductions in future non-drug [...]

iqtsupport2023-07-13T15:50:46-04:00July 13, 2023|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|