Medicaid

Many of the people who gained coverage after the enactment of the Affordable Care Act did so by enrolling in Medicaid despite apparently having incomes that should have disqualified them from the program, according to a new study released by the National Bureau of Economic Research.

Seventeen states and the District of Columbia are involved in lawsuits challenging the controversial so-called public charge rule finalized Monday, arguing that the rule undermines the role of public programs such as Medicaid and does not improve self-sufficiency for immigrants.

A federal appeals court on Tuesday (Aug. 13) reversed a lower court’s ruling and sided with CMS in a move that prevents hospitals from receiving Medicaid DSH payments to cover costs for which they have already been compensated by private insurers or Medicare.

Democratic presidential candidate Sen. Kirsten Gillibrand (NY) released a rural health plan Wednesday (Aug. 7) that calls for expanding long-term services and supports (LTSS), but otherwise echoes the calls of other Democratic presidential candidates for more Medicare and Medicaid reimbursement and telehealth services as candidates increasingly focus on rural health in their presidential bids.

John O’Brien, HHS’ top drug-pricing official, is stepping down after nine months and will be replaced by John Brooks, the principal deputy director of the Center for Medicare and formerly a White House Domestic Policy Council official, HHS announced Monday (Aug. 12). The departure comes after several of President Donald Trump’s marquee drug-pricing policies were blocked or pulled in recent months.

CMS encouraged state Medicaid agencies on Thursday (Aug. 8) to alter state operational policies or state plans as needed to participate in a new model and allow emergency medical services (EMS) providers to administer on-scene treatment or transport a Medicaid beneficiary to a location other than a hospital and still receive Medicaid reimbursement.

An expected proposal from the Substance Abuse and Mental Health Services Administration to change 42 CFR Part 2 could be released this month, according to stakeholders who want to see the stringent privacy scheme aligned with Health Insurance Portability and Accountability Act (HIPAA).

The National Association of Attorneys General called on House and Senate leaders to vote on bills that would loosen the strict privacy scheme known as 42 CFR Part 2, pass legislation to remove barriers to accessing buprenorphine, and fully eliminate the Institutions for Mental Diseases (IMD) exclusion in order to expand access to medication-assisted treatment (MAT).

Sen. Marsha Blackburn (R-TN) introduced a rural health agenda on Thursday (Aug. 1) that bundles three bills she introduced this week, one with support from Democratic Whip Dick Durbin (D-IL), that would incentivize more physicians to work in rural areas, expand access to federally qualified health centers (FQHC) and increase use of telehealth in rural areas.