Medicaid

MACPAC to Talk Medicaid Financing, Supplemental Payments, More

Members of the Medicaid and CHIP Payment and Access Commission will meet publicly on Thursday, April 11 and Friday, April 12. Subjects on the two-day session’s agenda include: Medicaid and children’s health insurance program (CHIP) financing access to home- and community-based services supplemental Medicaid hospital payments such as Medicaid disproportionate share (Medicaid DSH) Medicaid unwinding recommendations for MACPAC’s June report to Congress Go here for a closer look at the MACPAC meeting agenda and for information about how to participate in the meeting.

joe2024-04-09T18:26:20+00:00April 10, 2024|hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met publicly last week in Washington, D.C. The following is MACPAC’s own summary of its meeting. The March 2024 MACPAC meeting began with proposed recommendations on improving the transparency of Medicaid financing. The proposed recommendations are intended to improve the transparency of Medicaid financing methods, state-level financing amounts, and provider-level financing amounts. The presentation also included a recommendation to apply the proposed Medicaid financing transparency requirements to the State Children’s Health Insurance Program (CHIP). Staff reviewed the rationale for the recommendations and the implications for various stakeholders. The Commission will vote on [...]

joe2024-03-13T16:48:07+00:00March 14, 2024|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicaid regulations for the disabled|

Millions Dropped From Medicaid Rolls

With the two-year “Medicaid unwinding” process nearly half complete, 9.5 million Americans have lost their Medicaid coverage – among them more than 3.7 million children. To date, 48 million of the 71 million people enrolled in Medicaid at pandemic’s end have had their eligibility reviewed. So far, many of those who were at first ruled ineligible were dropped for procedural reasons, such as failing to file paperwork on time, but many of those people eventually had their benefits restored. Still, estimates that 15 million people would lose their Medicaid eligibility by the time the process ended appear to be overlying [...]

joe2024-02-08T22:22:10+00:00February 13, 2024|Medicaid|

States Using Medicaid Money to Address Homelessness

Trusting in the adage that “an ounce of prevention is worth a pound of cure,” more and more states are using Medicaid funds to address homelessness. The theory, not fully tested, is that providing housing to the homeless, along with other social supports, will reduce their use of hospital emergency rooms, improve their overall health, and end up saving taxpayer money. Some are skeptical, believing health care money should be spent on health care services. Today, 19 states are using some of their Medicaid resources to provide housing to the homeless. Leading the way is California, which is spending $12 [...]

joe2024-02-07T17:56:09+00:00February 8, 2024|Medicaid, Medicaid and homelessness, Medicaid and housing|

Preventable Medicaid Hospitalizations Vary Based on Race, Eligibility Path

Preventable hospitalizations among Medicaid patients vary based on the race of the patient and how that patient came to be eligible for Medicaid, according to a new analysis by the Urban Institute. According to a review of preventable hospitalizations in 21 states, the report concluded that: … the three most common types of potentially preventable hospitalizations for Medicaid-enrolled adults were asthma/COPD (0.2 percent of enrollees had at least one such hospitalization in 2019), diabetes (0.4 percent of enrollees had at least one such hospitalization in 2019), and heart failure (0.2 percent of enrollees had at least one such hospitalization in [...]

joe2024-01-29T19:09:49+00:00January 30, 2024|health equity, Medicaid|

Feds Tackles State Medicaid Redetermination Problems With Penalties

The Centers for Medicare & Medicaid Services has unveiled plans to penalize states that fail to comply with federal standards for redetermining the eligibility of individuals who enrolled in their Medicaid programs during the COVID-19 emergency. Under a new CMS regulation, states that fail to report on their Medicaid eligibility efforts and comply with current requirements face penalties that include civil penalties and reductions in the rate at which the federal government matches state Medicaid expenditures. According to a new interim final rule, CMS is implementing … reporting requirements and enforcement authorities in the Social Security Act (the Act) that [...]

joe2023-12-05T16:30:03+00:00December 6, 2023|COVID-19, Medicaid|

Medicaid Now Covering Care on the Street

Medicaid is now paying providers for “street medicine”: care provided to the homeless and delivered on the street as opposed to in traditional medical settings such as clinics, offices, and hospitals. For years, programs throughout the country have focused on enrolling the homeless in Medicaid and, whether they are insured by Medicaid or not, providing care to such individuals right on the street. Traditionally, however, such care has almost always been rejected for payment by Medicaid. Beginning in October, however, Medicaid began reimbursing providers for such care. The homeless, providers have long maintained, are in dire need of care to [...]

admin2023-11-01T06:00:43+00:00November 1, 2023|Medicaid|

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers. It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

Inadequate Data Hinders Federal Approach to Health Equity

Federal efforts to develop and improve payment models and other programs designed to foster health equity are often hamstrung by poor data: inconsistent data requests from program to program and flawed and incomplete data reporting by those participating in those programs. As a result, federal policymakers often are unable to tell whether programs – both those developed specifically to address health equity and those that are not – are having the desired effect on health equity. The result, according to a new study from the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation, is that 1) [...]

admin2023-07-19T10:50:34+00:00July 19, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity|

Federal Health Policy Update for May 25

The following is the latest health policy news from the federal government for May 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee has advanced to the full House two bills with significant implications for health care providers. H.R. 3561 calls for delaying $8 billion a year in Medicaid DSH cuts for two years – cuts scheduled to take effect in October; imposing site-neutral payments for drug infusion services provided in off-campus hospital outpatient departments; imposing stronger price transparency requirements on hospitals; and requiring hospitals to report selected ownership [...]

admin2023-05-25T15:37:35+00:00May 25, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Telehealth|