Category: Innovation Waivers

Early Lessons Learned from Implementing Community Engagement Requirements

Sixteen states have submitted Section 1115 Waivers to the Center for Medicare and Medicaid Services (CMS), requesting that a person’s eligibility to receive Medicaid be contingent on their participation in community engagement activities (also referred to as “work requirements”). States have flexibility to define the activities that would meet community engagement or work requirements, and ...

CMS Issues Guidance on Medicaid Behavioral Health Delivery System Reform

On November 13, 2018, the Centers for Medicare and Medicaid Services (CMS) released a letter to State Medicaid directors outlining a wide range of opportunities for states to design innovative delivery systems for adults and children with serious mental health conditions. The CMS letter offers guidance on strategies to improve care for such individuals using ...

Health Policy News May 2018

In this edition of Health Policy News, we continue our series of updates on state innovation in health policy. In follow-up to last year’s series on 1332 State Innovation Waivers, this year we have focused on other ideas and efforts percolating across the country and aimed at strengthening health insurance markets and expanding access to ...

Health Policy News February 2018

In this month’s edition of Health Policy News, we highlight legislative, regulatory, and administrative developments at the federal level. Just last week, on February 20, 2018, several federal departments jointly released a proposed rule seeking to expand access to Short-Term Limited-Duration Insurance (STLDI) plans. Also, on February 9, 2018, the President signed H.R. 1892, the ...

Developments in Section 1332 State Innovation Waivers

Progress has continued on state efforts to secure Section 1332 State Innovation Waivers. Oregon submitted a waiver application at the end of August, seeking support for a state-based reinsurance program, and that application has since been determined complete. Iowa submitted two recent updates to its pending waiver application, which it initially submitted in June. Its ...

Behavioral Health’s Move Toward Value-Based Purchasing

“Alternative payment models are not an option for behavioral health providers,” Arizona Medicaid Director Tom Betlach said, “They are your growth strategy.” Betlach’s point was very clear and it resonated with the more than 5,500 attendees at NatCon, where Payment Reform – be it alternative payment methodologies (APMs) or value-based purchasing (VBP) models like Delivery ...