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Medicaid

March 31, 2015 | Daily News

The Supreme Court ruled Tuesday (March 31) that providers can't sue states over Medicaid rates, in part because HHS handles rate setting and the law on rate setting is too broad for federal courts to take up.

March 30, 2015 | Daily News

CMS released strategies for states to save money with biosimilars Monday (March 30) that include placing biosimilars on preferred drug lists in return for drug companies offering extra rebates.

March 24, 2015 | Daily News

The Medicaid and CHIP Payment and Access Commission met Tuesday (March 24) to discuss beneficiaries' troubles with getting access to specialty care as well as new models stressing value-based payments within the Medicaid system.

March 23, 2015 | Daily News

Hospitals spent an estimated $7.4 billion less on uncompensated care costs in 2014 than they would have if coverage stayed at its 2013 level -- a 21 percent drop in the cost of treating uninsured and underinsured patients, according to an HHS report released Monday (March 23).

March 22, 2015 | Daily News

Senate Finance Committee Democrats warned House SGR negotiators Saturday that there is “no guarantee” they’ll vote for legislation to replace the Sustainable Growth Rate physician payment formula without a four-year funding extension of the Children’s Health Insurance Program, reacting to an emerging House deal that includes a two-year CHIP extension with a 23 percent state-funding increase. Finance Democrats jointly issued a public statement on Saturday outlining individual members' myriad concerns, with a four-year CHIP extension being the only one they identified as a “united” priority for the entire caucus.

March 20, 2015 | Daily News

The children's advocacy group First Focus continued its push for a four-year extension of the CHIP funding in a letter to lawmakers Thursday (March 19), pointing out that governors representing both parties support an extension that would last at least until 2019.

March 17, 2015 | Daily News

Sen. Patty Murray (D-WA) reintroduced legislation to extend for two years an expired Affordable Care Act provision that required state Medicaid programs to pay doctors the higher Medicare rates, and some sources say this year's version gives CMS more power to determine how much Medicaid managed care organizations reimburse doctors.

March 12, 2015 | Daily News

Discounts on expensive hepatitis C drugs could be within reach for half the country because the pharmacy benefit manager that negotiated discounts on hepatitis C drugs for Missouri is linked to Medicaid plans across America.

March 10, 2015 | Daily News

CMS announced Tuesday (March 10) a third type of accountable care organization that will be allowed to operate more like Medicare Advantage plans.

March 09, 2015 | Daily News

The estimated net cost to the federal government for the ACA's major provisions has decreased by about $142 billion, mainly due to lowered projections of health insurance premiums -- which translates to reduced federal subsidies -- and a slight lowering of the number of people expected to get exchange coverage from 2016 through 2025, according to a new budget update released by the Congressional Budget Office on Monday (March 9).

March 06, 2015 | Daily News

Many congressional Medicare advisers said Thursday (March 5) they aren’t sure they want to suggest Medicare pay cuts for outpatient drugs that could undermine the 340B program because there isn’t much evidence the drug-discount program encourages doctors to buy more expensive brands and they’re not even sure of the goals of the 340B program.

March 04, 2015 | Daily News

Congressional Medicare advisers on Thursday (March 5) will discuss whether the 45 percent of Medicare acute care hospitals in the 340B drug discount program should be paid lower rates for administering drugs in outpatient departments, according to the meeting agenda.

February 27, 2015 | Daily News

CMS opened an invitation to stakeholders across the industry to join the Health Care Payment Learning and Action Network to expand alternative payment models beyond Medicare and into Medicaid and the private sector and laid out details for how the forum will work.

February 26, 2015 | Daily News

Contrary to GOP plans, commissioners on the Medicaid and CHIP Payment and Access Commission on Thursday (Feb. 26) urged Congress to renew the Children's Health Insurance Program quickly and without fundamental changes to the program.

February 24, 2015 | Daily News

House Ways and Means member Tom Price (R-GA) said Tuesday (Feb. 24) that lawmakers will likely attach a funding extension for the Children's Health Insurance Program to an upcoming permanent fix to the flawed Medicare physician payment formula, and hours later key House and Senate Republicans jointly released a draft CHIP funding bill with major program revisions that sparked concerns from some low-income and children's advocates.

February 24, 2015 | Daily News

The National Governors Association's Health and Human Services Committee met Sunday (Feb. 22) to discuss strategies for states to save money on Medicaid by moving toward value-based pay.

February 23, 2015 | Daily News

A recently released survey shows state Children's Health Insurance Program directors are counting on Congress to extend funding of the program, but timing is key as some directors say they may begin closing their programs if Congress doesn't act by spring.

February 17, 2015 | Daily News

As the country prepared to end the second open enrollment season under the Affordable Care Act this past weekend, states were trying to move past the failures of the first sign-up season and channel lessons learned into future best practices.

February 13, 2015 | Daily News

Hospitals in states that have expanded Medicaid are beginning to plan for the possibility that the state programs could easily unravel if future elections lessen support for the expansion efforts, an official with America's Essential Hospitals said Tuesday (Feb. 10).

February 09, 2015 | Daily News

Now approaching its second run through Congress, the ACE Kids Act seeks to expand treatment options for sick Medicaid and CHIP kids, but the bill sparked concern from some Medicaid directors who argue they are already doing much of what the bill seeks to promote.

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