Medicaid

Tennessee will seek to convert its Medicaid program into one financed by a federal block grant under a bill passed by state lawmakers during a dramatic final day of the state’s legislative session -- the latest example of a Republican-controlled state eager to work with CMS to enact what some health law experts see as legally questionable Medicaid block grants.

The Trump administration late Wednesday (May 1) told a federal appeals court it agrees with a district judge’s ruling that the entire health care law is invalid, yet also asked the court to retain certain ACA provisions the administration claims would not harm the plaintiffs, including updates to Medicare fraud laws – a move that left key legal experts scratching their heads.

Congressional Medicaid advisers are seeking information from stakeholders about how states regulate large inpatient psychiatric facilities, what types of services those facilities provide, and the availability of outpatient services for patients after being discharged.

Progressives and Medicare for All advocates warn that proposals allowing people to opt into Medicare or Medicaid could end up attracting primarily sick and older Americans, thus skewing the risk pools and raising costs for everyone.

A federal judge granted a request from New Hampshire to intervene on the side of CMS in defending the state’s plan to enact Medicaid work requirements.

New Hampshire wants a federal judge to let the state help defend CMS’ approval of its plan to implement Medicaid work requirements.

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.

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.

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.