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Medicaid

April 25, 2019 | Daily News

CMS Administrator Seema Verma said the agency is working to get a final rule updating the Program of All-Inclusive Care for the Elderly published as part of CMS’ commitment to improving care for those dually eligible for Medicare and Medicaid.

April 24, 2019 | Daily News

Members of Congress from both parties are intervening on opposite sides of a hot-button lawsuit that will help determine whether Medicaid beneficiaries can sue their state government if the state removes certain medical providers -- such as those that perform abortions -- from the state’s Medicaid program.

April 24, 2019 | Daily News

CMS Administrator Seema Verma on Wednesday (April 24) invited states that aren’t currently participating in the duals demonstration to talk with the agency about starting their own version, whether through the capitated financial alignment model, the managed fee-for-service model or some other state-specific model worked out with the agency.

April 23, 2019 | Daily News

The advocacy arm of the American Cancer Society launched a major education campaign on Tuesday (April 23) to promote Medicaid in red states at a time when efforts to pass Medicaid expansion in some of those states appear to be gaining traction.

April 23, 2019 | Daily News

Ohio Attorney General Dave Yost (R) on Monday (April 22) called for the Ohio legislature to enact four policies targeting spread pricing practices by pharmacy benefit managers that would route all state drug purchases through a single PBM contract, give the state auditor unrestricted authority to review all PBM drug contracts, make PBMs fiduciaries and ban nondisclosure agreements regarding drug pricing with the state.

April 22, 2019 | Daily News

Lawmakers in two Western states are only a few steps away from approving legislation that could result in government-sponsored health plans competing for the first time in the Affordable Care Act’s health insurance exchanges.

April 22, 2019 | Daily News

A federal appeals court has agreed to expedite its consideration of the two cases challenging the legality of Medicaid work requirements after CMS asked that the cases be accelerated.

April 19, 2019 | Daily News

The Montana legislature gave final approval to a six-year extension of the state’s Medicaid expansion Thursday (April 18), along with a request for CMS to approve work requirements, and Gov. Steve Bullock (D) indicated he would sign it into law.

April 19, 2019 | Daily News

The Congressional Budget Office estimates that 1.4 million more people went uninsured in 2018 compared to 2016 and most of the drop came from unsubsidized individuals in the individual market.

April 19, 2019 | Daily News

According to new information by the HHS Office of Civil Rights (OCR) released Friday (April 19), smartphone apps created by third-party developers and not by providers or business associates covered under the Health Insurance Portability and Accountability Act (HIPAA) are not subject to HIPAA rules, even if a breach occurs.

April 19, 2019 | Daily News

CMS reversed course and, along with the Office of the National Coordinator for Health IT, will give stakeholders an additional 30 days to comment on proposed interoperability rules the agencies released in February, pushing the comment deadline back to June 3.

April 17, 2019 | Daily News

CMS is seeking an accelerated appeal in the litigation over Medicaid work requirements because, according to the agency, a district judge’s recent rulings that invalidated work requirements in Arkansas and Kentucky will cause “significant disruption to the detriment of the states and the federal government.”

April 17, 2019 | Daily News

Kentucky’s Cabinet of Health and Family Services touted an independent evaluator’s plan to use a randomized control population to evaluate the state’s controversial work requirements program, but the evaluation’s approval is now on hold as CMS appeals a pair of judicial decisions that blocked Medicaid work requirements in Arkansas and Kentucky.

April 15, 2019 | Daily News

A measure to continue Montana’s Medicaid expansion and add work requirements to the program cleared a key legislative hurdle Monday (April 15).

April 15, 2019 | Daily News

A provision in the Trump administration’s point-of-sale rebate proposal questioning whether formulary placement-related rebates are protected by the anti-kickback statute generated strong reactions from the generic drug and pharmacy benefit manager lobbies, which are at odds on the issue.

April 12, 2019 | Daily News

HHS should issue guidance to help states understand what therapeutic foster care services can be covered under Medicaid and improve the coordination of those services, federal Medicaid advisers said Thursday (April 11).

April 12, 2019 | Daily News

Federal Medicaid advisers expressed general support for CMS’ goal to encourage better sharing of electronic health records through its recent proposed rule on interoperability, but they declined Friday (April 12) to weigh in with any formal comments on the proposed rule, even as a few commissioners worried that the rule’s timeline for implementing new data-access requirements is too aggressive.

April 12, 2019 | Daily News

Federal Medicaid advisers voted Thursday (April 11) to recommend that Congress eliminate the requirement for states to establish a Recovery Audit Contractor program.

April 11, 2019 | Daily News

Federal Medicaid advisers voted Thursday (April 11) to recommend that Congress change the definition of the so-called Medicaid shortfall in order to re-impose stricter limits on the amount of supplemental payments that disproportionate-share hospitals can receive.

April 11, 2019 | Daily News

Congressional Medicaid advisers voted unanimously Thursday (April 11) to recommend removing the drug-rebate cap in Medicaid, a recommendation that also is backed by the Trump administration and a key House Republican, after several MACPAC members grew comfortable with removing the cap since initially expressing doubts at a March meeting.

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