Medicaid

CMS on Monday (Feb. 11) unveiled proposals to impose new interoperability requirements on providers, including new conditions of Medicare participation for hospitals as well as new stipulations for Medicare Advantage, Medicaid and exchange plans.

Rural Health Association of Tennessee Executive Director Rebecca Jolley said she is cautiously optimistic that CMS won’t approve the state’s request to add work requirements to its Medicaid program, as the state has not expanded the program under the Affordable Care Act, and she added that she’s nervous about the disproportionate impact such a program would have on rural areas.

A contentious proposal to replace Utah’s voter-approved Medicaid expansion plan with one from state lawmakers that is both more restrictive and more expensive advanced in the Utah legislature Monday (Feb. 4).

Republican lawmakers in Utah are trying to fast-track a bill that would undo the Medicaid expansion that the state’s voters approved in November and replace it with a more limited expansion proposal containing work requirements and spending caps.

New Mexico is pushing to have a Medicaid buy-in bill that could reduce premiums as much as 29 percent in place by the end of next year -- a move that could put the state on the map as the first to implement such a program.

As House Progressive Caucus Co-Chair Rep. Pramila Jayapal (D-WA) gathers co-sponsors for an upcoming Medicare for All bill, which she says will be different than Sen. Bernie Sanders’ (I-VT) single-payer bill, Democrats signal they are open to a variety of approaches when it comes to single-payer or Medicare expansion.

Senate health committee leaders on Tuesday (Jan. 29) pushed for a five-year funding package for community health centers -- more than double the funding provided the last time lawmakers extended funding for those providers.

Sens. Bill Cassidy (R-LA) and Mark Warner (D-VA) are seeking comments on a draft bill to exempt performance-based drug-reimbursement contracts from the Medicaid best price rule, anti-kickback law and the so-called Stark law against doctor self-referrals, the senators announced Tuesday (Jan. 29).

Sen. Chuck Grassley (R-IA), the new Senate Finance Committee chairman, said that HHS Secretary Alex Azar is likely using the administration’s International Price Index model for Medicare Part B to extract concessions from pharmaceutical companies after the committee’s first in a series of planned hearings on prescription drug pricing.