Tag: CMS

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 ...

1115 Waiver Decisions issued by CMS

As we addressed in our report this past Spring, the use of Section 1115 Medicaid Waivers to address rising drug costs was a notable feature of the Federal administration’s recent drug proposal, and is an emerging policy trend.[1] The Federal administration’s 2019 budget proposes providing five states with Medicaid demonstration authority to test “drug coverage ...

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 ...

Health Policy News Hosts Round Table Discussion of Public Option Programs

On October 9th, Health Policy News held the second event in our 2018 Fall Webinar Series. This webinar featured a round table discussion on the history of public options, and the various design and programmatic options available to states crafting such programs. The webinar summarized and updated information included in the HPN report released this ...

Movement on drug cost containment at both the state and federal level

Health Policy News has devoted significant attention to State and Federal efforts to contain drug costs, including recently issuing a report and legislative tracking tool entitled “ Rising Prescription Drug Costs: A report on state and federal efforts to contain costs”. As we head into the summer we offer readers a few short updates on ...

States Pursue Unique Approaches to Permit Non-Compliant Health Plans

While much of the attention over the debate over the Affordable Care Act (ACA) has centered at the Federal level, states continue to act as the laboratories for innovation. Last year Health Policy News featured a series of updates on activity around Section 1332 State Innovation Waivers in the states – with a focus primarily ...

Mitigating the Loss of the Individual Mandate: State Based Health Insurance Mandates

In December 2017, the federal administration’s tax bill – the Tax Cuts and Jobs Act, phased out the individual mandate requirements, with the penalty for failing to have qualified insurance eliminated starting in 2019. For 2018, the mandate remains, with the penalty set at $695 per adult or 2.5% of household income, whichever is higher.  ...