Medicaid

Although it’s an off year for state legislatures, states are expected to make progress on legislation and initiatives to lower drug prices, and state attorneys general are showing more interest in protecting residents from high drug prices, according to National Academy for State Health Policy Executive Director Trish Riley.

Two top Democrats are asking the HHS Office of Inspector General to look at the legality of Tennessee’s Medicaid block grant proposal that is pending CMS’ approval, just weeks after key stakeholders said CMS lacks authority to approve the proposal.

Federal appellate judges suggested Monday (Jan. 13) that CMS’ attempt to require that drug makers include list prices in television advertisements might lead to consumer confusion without bringing down drug prices.

Stakeholders are calling on House Energy & Commerce Committee leaders to hold a hearing on a bill that would authorize grants to states and local entities to tackle social determinants of health for Medicaid beneficiaries.

Kansas is a step closer to expanding Medicaid after Democratic Gov. Laura Kelly and Republican Senate Majority Leader Jim Denning on Thursday (Jan. 9) announced a bipartisan proposal to expand Medicaid that also includes Republican-pushed provisions, including premium assistance to help newly-eligible beneficiaries pay for commercial insurance if available to them.

A nationwide injunction blocking the Trump administration from implementing its so-called public charge rule will remain in effect while litigation over the rule continues, a federal appeals court ruled Wednesday (Jan. 8).

The House Energy & Commerce health subcommittee considered three bills Wednesday (Jan. 8) that would strengthen patient protections for Medicare and Medicaid, and the hearing has given beneficiary advocates hope that these protections will be included in legislative packages passed this year.

Medicare and Medicaid advocates, attorneys and researchers say HHS lacks authority to approve Tennessee’s Medicaid block grant proposal, and the state’s request to deregulate managed care plans, lock-out beneficiaries guilty of fraud and modify enrollment would harm beneficiaries.

The Medicaid And CHIP Payment and Access Commission released a report Monday (Jan. 6) finding that Institutions for Mental Diseases, or IMDs, lack clear federal oversight and face a patchwork of state regulation as many states sidestep the restriction that prevents Medicaid from paying for inpatient services in these large facilities.