Medicaid

Feds Open Door for Exemptions from Medicaid IMD Exclusion

New federal guidelines will make it easier for state Medicaid programs to cover mental health services provided in institutions for mental diseases (IMD). For years, Medicaid regulations greatly limited the ability of states to pay for care – generally, care related to substance abuse disorder treatment – provided in IMDs; this was generally known as the IMD exclusion. The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act, which was passed in 2018, opened the door for more exceptions to these limits, and last week, [...]

iqtsupport2019-11-13T06:00:36-05:00November 13, 2019|Centers for Medicare & Medicaid Services, Medicaid|

Immigrants Intimidated by New Public Charge Guidelines?

Immigrants served by community health centers appear less inclined than in the past to seek public aid to help them with their medical problems. And community health center staff believes this is the result of confusion and fear as a result of changing federal immigration policies. As stated in the Kaiser Family Foundation issue brief “Impact of Shifting Immigration Policy on Medicaid Enrollment and Utilization of Care among Health Center Patients,” Health centers reported that, in recent months, immigrant patients have declined to enroll or reenroll themselves and/or their children in Medicaid for fear of public charge. Health center respondents [...]

iqtsupport2019-10-16T06:00:49-04:00October 16, 2019|Medicaid, Medicaid regulations|

Millions Eligible for Health Insurance Remain Uninsured

More than 15 million Americans who are currently entitled to free or subsidized health insurance are currently uninsured. Among them are 11 million who are eligible for Medicaid but have not applied for benefits and 4.2 million who could afford insurance with the help of federal premium subsidies and either have decided not to take advantage of those subsidies or are unaware of the availability of such subsidies. In addition, another two million people would be eligible for Medicaid if their states expanded their Medicaid program as authorized by the Affordable Care Act. In light of such figures, it is [...]

iqtsupport2019-09-16T06:00:48-04:00September 16, 2019|Affordable Care Act, Medicaid|

CMS Chief Criticizes Health Care Proposals

In an address to the Better Medicare Alliance 2019 Medicare Advantage Summit, Centers for Medicare & Medicaid Services Administrator Seema Verma criticized Medicare for All proposals, said Medicare “public option” proposals are no better, and called the Affordable Care Act a failure,. Verma also insisted that greater reliance on market forces would improve Medicare and Medicaid, said the 340B prescription drug program is harming the health care system, and called for a reduction of federal regulations that limit how and where people can receive care. She said reduced regulations have spurred hundreds of new plans to participate in the Medicare [...]

iqtsupport2019-07-23T10:10:59-04:00July 23, 2019|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare regulations|

Trading Loan Forgiveness for Serving Medicaid Patients

The state of California is paying off some doctors’ medical school debts in exchange for a commitment to care for Medicaid patients. Under a new state program, physicians and dentists can see their medical debt eliminated or greatly reduced in exchange for a five-year commitment during which at least 30 percent of their patients are served by Medi-Cal, the state’s Medicaid program. The state expects to spend $340 million in this manner in the coming year, with the money coming from Proposition 56 tobacco tax revenue. That measure included a $2 tax increase on every pack of cigarettes sold in [...]

iqtsupport2019-07-17T10:28:28-04:00July 17, 2019|Medicaid|

CMS Proposes Easing Medicaid Access Protections

States would have to do less to ensure access to Medicaid-covered services for their Medicaid population under a new regulation proposed by the Centers for Medicare & Medicaid Services. In 2015, CMS required states to track their Medicaid fee-for-service payments and submit them to the federal government as part of a process to ensure that Medicaid payments were sufficient to ensure access to care for eligible individuals. Now, CMS proposes rescinding this requirement, writing in a news release that This proposed rule is designed to help streamline federal oversight of access to care requirements that protect Medicaid beneficiaries. CMS anticipates [...]

iqtsupport2019-07-16T10:33:57-04:00July 16, 2019|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

Study Finds Surprise in Sources of Medicaid, CHIP Growth

While enrollment in Medicaid and CHIP has been greatest among low-income families working full-time for small businesses, growth in Medicaid and CHIP among low-income families employed full-time by big businesses has been rising faster in recent years. According to a new study published in the journal Health Affairs, Medicaid and CHIP enrollment among low-income families employed full-time by large companies rose from 45 percent to 69 percent between 2008 and 2016. The driving force behind this growing reliance on public insurance appears to be the shift of health insurance costs from companies to employees: employee share of health insurance premiums [...]

iqtsupport2019-07-08T14:40:03-04:00July 8, 2019|Medicaid|

CMS Outlines New Medicaid Program Integrity Activities

The federal government will introduce a number of initiatives to combat Medicaid waste, fraud, and abuse in the coming months. In an article on the Centers for Medicare & Medicaid Services’ blog, CMS administrator Seema Verma outlined her agency’s major Medicaid program integrity efforts of the past year, including: Oversight of state Medicaid claiming and program integrity Disallowing unallowable claims of federal funding Increased audits and oversight Data sharing and partnerships Education, technical assistance, and collaboration Reducing improper payments Initiatives to be introduced in the coming months include (as described in the blog post): A proposed comprehensive update to Medicaid’s [...]

iqtsupport2019-07-03T10:12:38-04:00July 3, 2019|Centers for Medicare & Medicaid Services, Medicaid|

Protections Overlooked as Medicaid Reforms are Implemented

In its eagerness to help states introduce changes in their Medicaid programs and reduce administrative burdens, the Centers for Medicare & Medicaid Services is ignoring regulatory requirements designed to understand and measure the impact of those changes on beneficiaries. According to an analysis by the Los Angeles Times, many states seeking to implement Medicaid work requirements have not projected how many of their beneficiaries would be affected by those requirements nor have they projected how many beneficiaries who are removed from the Medicaid rolls will gain employment after losing their Medicaid benefits. Both projections are required under Medicaid regulations adopted [...]

iqtsupport2019-02-15T06:00:51-05:00February 15, 2019|Centers for Medicare & Medicaid Services, MACPAC, Medicaid, Medicaid regulations|

Government More Effective Than Private Sector at Controlling Health Care Costs

For the past dozen years, Medicare and Medicaid have done a better job of controlling rising health care costs than private insurers. Since 2016, according to a new report from the Urban Institute, private insurers’ costs per enrolled member have risen an average of 4.4 percent a year. By contrast, Medicare costs have risen an average of 2.4 percent per enrollee and Medicaid costs have risen just 1.6 percent per enrollee. The primary driver of Medicare cost increases has been prescription drug spending. For Medicaid the primary driver has been physician services and administrative costs. For private insurers, the main [...]

iqtsupport2019-02-13T06:00:47-05:00February 13, 2019|Medicaid, Medicare|