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Medicaid

September 30, 2019 | Daily News

The White House budget office has begun its review of a final CMS rule that aims to loosen various requirements in the landmark Medicaid managed care regulations adopted by the Obama administration in 2016.

September 25, 2019 | Daily News

CMS finalized a rule Wednesday (Sept. 25) that revamps the Conditions of Participation and Conditions of Coverage for hospitals, home health providers, transplant centers, ambulatory surgical centers and other providers and facilities by removing regulations that CMS deemed burdensome or unnecessary.

September 25, 2019 | Daily News

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.

September 24, 2019 | Daily News

CMS Administrator Seema Verma called on insurance plans to work with CMS to drive value-based arrangements, warning that, while premiums are going down for Medicare Advantage plans, private insurers could become obsolete if Medicare for All were to move forward.

September 24, 2019 | Daily News

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.

September 23, 2019 | Daily News

Advocates for Medicaid beneficiaries on Monday (Sept. 23) filed another lawsuit challenging Medicaid work requirements -- this time by contesting the controversial policy, along with various other coverage restrictions, in an 1115 waiver for Indiana.

September 23, 2019 | Daily News

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).

September 23, 2019 | Daily News

CMS on Monday (Sept. 23) released a final method for implementing annual Medicaid Disproportionate Share Hospital pay cuts from fiscal 2020 through fiscal 2025.

September 20, 2019 | Daily News

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.

September 19, 2019 | Daily News

The House on Thursday (Sept. 19) passed a short-term continuing resolution to fund the government through Nov. 21 and avert a government shutdown Oct. 1, and the Senate reportedly will take up the CR next week.

September 19, 2019 | Daily News

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.

September 18, 2019 | Daily News

A package of so-called health extenders was tucked into the continuing resolution introduced in the House late Wednesday (Sept. 18) to avert a government shutdown Oct. 1.

September 18, 2019 | Daily News

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.

September 17, 2019 | Daily News

Tennessee on Tuesday (Sept. 17) unveiled its proposal to receive much of its federal Medicaid money in the form of a block grant -- a plan that includes requests for a closed drug formulary and significant new freedom from federal regulatory requirements on managed care contracts, optional benefits and how Medicaid funds can be used.

September 17, 2019 | Daily News

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.

September 16, 2019 | Daily News

The Certified Community Behavioral Health Clinic demonstration program lost its funding Friday (Sept. 13) for the second time this year after a short-term extension lapsed, threatening access to medication-assisted treatment and the jobs of those who work at these clinics, according to patient advocates.

September 16, 2019 | Daily News

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.

September 13, 2019 | Daily News

CMS on Friday (Sept. 13) warned states that it will use “deferrals, disallowances or compliance actions” to enforce a new regulatory policy that prevents states from automatically deducting union dues from Medicaid payments made to independent home health workers.

September 13, 2019 | Daily News

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.

September 12, 2019 | Daily News

The Certified Community Behavioral Health Clinic demonstration program will lose its funding on Friday (Sept. 13) if the Senate does not act to pass another extension, and, despite reassurances by senators that funding is a priority, nothing appears to be moving forward ahead of that deadline.

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