Medicaid

Indiana is asking CMS to let the state extend its Medicaid program, called the Healthy Indiana Plan, for an additional 10 years, to 2030, after closing the door on the possibility of using the agency’s newly unveiled guidance to block grant its program.

The Government Accountability Office released a report on Wednesday (Feb. 12) suggesting that CMS should be able use state audits to more accurately measure Medicaid improper eligibility rates -- payments tied to ineligible beneficiaries -- to allow the agency to better recoup those payments.

CMS on Wednesday (Feb. 12) asked stakeholders for suggestions on how to improve rural maternal health and increase the readiness of rural providers, particularly for obstetric emergencies.

The Trump administration again proposed making it easier for states to extend Medicaid coverage for up to one year after a beneficiary with a history of substance use disorders has a baby, despite repeated calls by maternal health advocates to allow states to extend coverage for all postpartum beneficiaries.

The Trump administration’s proposed 2021 budget unveiled Monday (Feb. 10) would exempt qualified residential treatment programs from a restriction that prevents Medicaid from paying for inpatient stays in certain large facilities.

A leading telehealth company and health plans suggest closing the gap on access to mental and behavioral health services is a top priority for virtual care in 2020 as they continue to adjust telehealth services to consumers’ needs and push lawmakers to pass legislation expanding access to such services.

Governors, hospitals and nursing homes tell CMS to withdraw its proposed Medicaid Fiscal Accountability Regulation as it would hurt states’ ability to fund their programs and the agency hasn’t really looked at the proposal’s impact, while Medicaid directors ask CMS to talk with states and refine the regulatory provisions through multiple rules.

CMS’ plan to allow states to receive a capped amount of federal money for parts of their Medicaid programs is the latest instance of the agency aggressively pushing the boundaries of its legal authority -- and the likelihood of protracted court challenges over the policy may deter states from adopting it, according to health lawyers and regulatory experts.

CMS’ new policy that ties closed Medicaid drug formularies to block grants is a double whammy for the drug industry because sources say block grants amplify the negotiating power of closed formularies.