Tag: Medicaid

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 ...

CMS Proposes Changes to Rules related to Medicaid Access to Care Requirements

On March 23rd, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would exempt states from requirements to analyze and monitor access to care in the Medicaid program under certain circumstances. The proposal seeks to amend 42 CFR 447.203(b), which sets forth the process for states to document whether Medicaid payments ...

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 ...

Administration budget proposal includes health care changes

The administration released its budget proposal on February 12, 2018. As expected, the proposal includes a number of changes related to health care. The budget plan revives the Affordable Care Act (ACA) repeal, with a proposal similar to the Graham Cassidy Heller Johnson bill. Specifically, the budget plan proposes a staged repeal and replace, with ...

President Signs Bipartisan Budget Act

On February 9, 2018, President Trump signed H.R. 1892, the Bipartisan Budget Act of 2018.  The new law reauthorizes federal funding for many health programs, modifies scheduled reductions in Medicaid disproportionate share hospital (DSH) allotments to states, tightens third party liability (TPL) billing requirements, and updates requirements affecting Medicare Advantage plans, accountable care organizations (ACOs), ...