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Medicaid

August 21, 2019 | Daily News

CMS agreed to clarify diagnostic code requirements, assist states Medicaid agencies in correctly reporting the National Provider Identifiers (NPIs) of providers who prescribe opioids and ensure all beneficiaries can be uniquely identified in the national Medicaid claims database after an HHS Office of Inspector General (OIG) report said that national data are incomplete.

August 20, 2019 | Daily News

Two new lawsuits, including one brought by health care providers, are seeking to block the Trump administration’s so-called public charge rule, which aims to make it harder for legal immigrants to become permanent U.S. residents if they use Medicaid or other forms of public assistance.

August 19, 2019 | Daily News

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.

August 16, 2019 | Daily News

CMS on Friday (Aug. 16) officially denied Utah’s request for enhanced federal funding for a partial Medicaid expansion -- as well as Utah’s proposed enrollment caps policy, which the agency said essentially amounted to a partial expansion with the higher match -- but the agency has yet to decide whether it will approve the state’s request for per-capita caps.

August 16, 2019 | Daily News

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.

August 16, 2019 | Daily News

State officials should educate providers on the role of palliative care, create avenues for Medicaid reimbursement for palliative care and devise palliative care best practices to improve access, according to the National Academy for State Health Policy.

August 13, 2019 | Daily News

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.

August 13, 2019 | Daily News

Democratic presidential candidate and South Bend, Indiana Mayor Pete Buttigieg unveiled a rural health plan that closely mirrors that of other Democratic presidential candidates, including Sen. Elizabeth Warren’s proposals on reimbursement, telehealth and workforce disparities, and Sen. Michael Bennet’s call for CMS to adopt new payment policies to tackle social determinants of health.

August 13, 2019 | Daily News

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.

August 12, 2019 | Daily News

The Trump administration on Monday (Aug. 12) finalized a controversial rule that will make it more difficult for legal immigrants who receive Medicaid to become permanent U.S. residents, drawing outcry from stakeholders across the health care industry who say the policy will drive up the number of uninsured patients and increase the costs of uncompensated care.

August 12, 2019 | Daily News

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.

August 09, 2019 | Daily News

The House Energy & Commerce Committee wants CMS Administrator Seema Verma to testify this fall as part of the committee’s oversight of Medicare and Medicaid, a committee source told Inside Health Policy.

August 09, 2019 | Daily News

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.

August 08, 2019 | Daily News

State Medicaid programs soon will be required to implement stricter controls around opioid prescriptions and will also gain the option to more easily access federal money to care for beneficiaries with substance use disorders in large inpatient treatment centers.

August 08, 2019 | Daily News

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).

August 07, 2019 | Daily News

HHS recently withdrew rules proposed decades ago that would have codified the HHS Office of Inspector General’s ability to penalize hospitals that offer doctors incentives to reduce care for Medicare and Medicaid beneficiaries and would have expanded an existing safe harbor to include waivers of beneficiary cost sharing for those with certain Medigap plans.

August 06, 2019 | Daily News

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).

August 02, 2019 | Daily News

Centene CEO Michael Neidorff last week touted the company’s exchange business and pointed to the administration’s final health reimbursement arrangement proposed rule as well as Georgia and Utah’s efforts to leverage the private sector for their Medicaid expansion as potential growth opportunities.

August 02, 2019 | Daily News

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.

July 31, 2019 | Daily News

A federal appeals court has scheduled an oral argument for Oct. 11 on the legality of Medicaid work requirements.

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