Category: Medicaid

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 Proposes Changes to the Regulations Governing Medicaid and CHIP Managed Care

On November 14, 2018, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule making changes to the Medicaid and Children’s Health Insurance Program (CHIP) Managed Care regulations. CMS had notified states in March 2017 that it was doing a thorough review of Medicaid and CHIP Managed Care regulations, which were last overhauled ...

Health Policy News November Edition

This month’s edition of Health Policy News highlights recent developments related to the Medicaid program. At the Federal level, we provide a summary of the recently published Proposed Rule on Medicaid and CHIP Managed Care, as well as an overview of a recent State Medicaid Director Letter regarding opportunities to increase access to behavioral health ...

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 October Edition

 Introduction This month’s edition of Health Policy News focuses on recent developments relative to drug policy, which has been an ever-growing focus at the State and Federal level. We continue our coverage of efforts relative to drug cost control with short summaries of recent decisions on Section 1115 Waivers submitted by Massachusetts and Oklahoma, and ...

White House issues report on the opioid epidemic

On July 31, 2017, the White House posted the initial findings and recommendations of its Commission on Combatting Drug Abuse and the Opioid Crisis. The Commission cites evidence that: 142 Americans die from drug overdoses per day. Only 10 percent of the 21 million persons with a substance use disorder (SUD) are receiving appropriate treatment ...

Section 1332 State Innovation Waiver – Recent developments and the newly-released checklist

In follow-up to its letter to Governors regarding the Section 1332 Waiver opportunity, the Centers for Medicare and Medicaid Services (CMS) and the Department of Treasury released a Section 1332 checklist on May 16 designed to help states pursue ACA State Innovation Waivers. Section 1332 of the ACA allows states to waive specific ACA provisions ...

CBO estimates that AHCA would severely increase the number of uninsured persons

On May 24, 2017, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released estimates on the impact of the proposed H.R. 1628, the American Health Care Act of 2017 (AHCA), as passed by the U.S. House of Representatives on May 4, 2017.  AHCA would partly repeal the Affordable Care Act (ACA). ...

New ACA-Related announcements from the Federal Administration

The administration is taking more limited steps to influence implementation of the law, including two upcoming changes to enrollment through Marketplaces announcements last month. On May 15, the Centers for Medicare and Medicaid Services (CMS) announced that it will be proposing a rule to have enrollment into Federally-facilitated Small Business Marketplace (known as Small Business Health Options ...

Transitional health plans to continue through 2018

In November of 2013, the Centers for Medicare & Medicaid Services (CMS) introduced the concept of “grandmothered plans,” coverage in place prior to 2014 that would have been prohibited as of 2014 as a result of changes under the Affordable Care Act (ACA). CMS issued guidance permitting those plans to be renewed for existing policyholders ...