Medicaid

Forty-two states reportedly have applied and been approved for extensions to submit to CMS their initial spending plans and narratives required to access the increased federal Medicaid matching funds for home- and community-based services from the American Rescue Plan, a trend one stakeholder says was expected and isn’t likely to hurt states’ abilities to use the funds.

President Joe Biden’s proposal to invest $400 billion in home- and community-based services would boost funding for social determinants of health within the HCBS program, and some health care stakeholders are optimistic the investment could be a step towards broader social determinants funding.

Centene is paying $143 million total to settle with Ohio and Mississippi over allegations that the health insurer used pharmacy benefit schemes to overcharge the states, and Centene is setting aside an additional $1.1 billion to settle with other states over similar allegations.

Medicaid expansion is gaining traction in Wyoming, even passing the Wyoming House of Representatives earlier this year, but with a July special session to discuss the policy now off the table and concerns among state lawmakers about using Medicaid funding to pay for abortion care, roadblocks remain.

Congress should consider bipartisan policies to bolster home- and community-based services, Senate Finance Committee ranking Republican Mike Crapo (ID) said during a committee hearing on the HHS fiscal 2022 budget Thursday (June 10), but he is concerned that President Joe Biden’s proposal to invest $400 billion may come with labor reforms that could further harm the inpatient caregiving workforce.

Home- and community-based care stakeholders remain optimistic that Congress will pass President Joe Biden’s proposal to spend $400 billion on Medicaid home care as the White House shifts its infrastructure talks toward reaching a deal with a bipartisan group of senators that reportedly includes Sen. Rob Portman (R-OH), an HCBS supporter, and others who have backed home care before.

As key House lawmakers look at potentially crafting a public option that would compete with private insurers on the ACA exchanges, a county-backed health plan in Los Angeles that offers Medicaid and exchange plans is touting its own story as a potential model for certain markets.

Nursing homes estimate more than 1,600 skilled nursing facilities could close in 2021 and disrupt residents’ care if HHS doesn’t distribute the remaining provider relief and extend its deadline to spend the relief from June 30 to Dec. 30, 2022.

Nebraska has decided to withdraw its Section 1115 waiver application that required people in the Medicaid expansion population to participate in work and other personal responsibility requirements in order to access dental, vision and over-the-counter medication benefits, and as of Oct. 1 all Medicaid beneficiaries will now have access to these benefits.