Medicaid

The Democratic governor of Michigan on Monday (Sept. 23) signed legislation meant to soften the state’s planned Medicaid work requirements and, at the same time, called on the Republican-led legislature to do more to avoid coverage losses when the requirements take effect next year.

The Center for Medicare and Medicaid Innovation (CMMI) says its current focus is to implement the dozen or so new models unveiled prior to former CMMI Director Adam Boehler’s departure from CMS.

The effective federal matching rate for Puerto Rico’s Medicaid funding in each of the last five years has been well above the statutory cap of 55%, and HHS has released $1.2 billion in supplemental funding to the island based on progress that the Puerto Rican government has made in setting up anti-fraud measures, according to a letter from CMS Administrator Seema Verma to Senate Finance Chair Chuck Grassley (R-IA).

Several high-profile health experts were upset by CMS Administrator Seema Verma’s recent blog in which she denied the increase in uninsured Americans was due to a decline in Medicaid enrollees and instead blamed it on the Affordable Care Act, including Families USA Eliot Fishman who told Inside Health Policy he has been frustrated by the GOP’s narrow focus on the unsubsidized population even as affordability remains a challenge for lower-income people.

Fifty-nine percent of Medicaid beneficiaries under the age of 21 received a well-child screening in fiscal 2017 -- a decrease of five percentage points from fiscal 2010 and well short of CMS’ target ratio of 80%, according to a new report from the Government Accountability Office.

Senate Appropriations health subcommittee Chair Roy Blunt (R-MO) released a fiscal 2020 HHS funding bill on Wednesday (Sept. 18) that would extend some health programs set to expire on Sept. 30 for an additional year, despite work done by the House Energy & Commerce Committee and the Senate health committee this summer to extend these programs for a longer period of time.

Mental health and substance use treatment advocates are calling on Congress to reauthorize funding for mental health clinics, remove barriers to medication-assisted treatment and allow mental health counselors to bill Medicare.

State efforts to manage the costs of care for high-expenditure Medicaid beneficiaries have had mixed results, and the most significant barriers to better care management are difficulties dealing with social determinants of health, shortages of providers in rural areas and an inability to contact some beneficiaries, the Government Accountability Office says in a new report.

Plans say prior authorization for medication-assisted treatment (MAT) for individuals with substance use disorders helps the treatment be used safely and effectively, but providers are worried that prior authorization is a barrier to treatment in the middle of an opioid crisis.