Noteworthy News

Archive for Medicaid

 

House to Set Sights on Medicare, Medicaid Cuts in 2018

The House of Representatives will pursue entitlement spending cuts next year, House Speaker Paul Ryan recently explained on a radio program. That means Medicare, Medicaid, and possibly even Social Security. Ryan said that We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit… Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that’s really where the problem lies, fiscally speaking. Medicare and Medicaid cuts would be very harmful to the nation’s private, non-profit urban safety-net hospitals. [&hellip

New Help With Addressing Low-Income Patients’ Social Services Needs?

One of the long-time barriers to states and hospitals addressing low-income patients’ social services needs and the social determinants of health has been a lack of resources for such assistance.  Medicaid, in particular, has not been a financial participant in such efforts. But that may be changing. The new federal Medicaid managed care regulation, updated nearly two years ago, allows for the inclusion of some non-clinical services as covered Medicaid services and for funding for such services to be folded into Medicaid managed care plans’ capitation rates and medical loss ratios.  The updated regulation also encourages greater coordination of care [&hellip

CMS Guidance on MCO Payments is Good News for Safety-net Hospitals

New guidance from the Centers for Medicare & Medicaid Services on the use of directing supplemental Medicaid resources to hospitals through Medicaid managed care organizations is good news for many urban safety-net hospitals across the country. In many states, new revenue generated by state hospital taxes (assessments) are routed through the state’s Medicaid managed care plans.  Recently, however, it has not been clear whether the federal government would permit continued use of this mechanism. An early November bulletin from CMS, however, clarifies that this approach is still permissible, which is good news for many urban safety-net hospitals located in states [&hellip

Medicaid Retroactive Eligibility: A Dying Policy?

A growing number of states are ending or limiting retroactive eligibility for Medicaid:  the practice of Medicaid reimbursing providers for the care they deliver to Medicaid-eligible patients for up to three months even if those patients had not previously enrolled in Medicaid. Arkansas, Indiana, and New Hampshire have ended the practice for some categories of Medicaid patients and Iowa joined them on November 1.  In addition, Delaware, Maryland, Massachusetts, and Utah impose some limits on retroactive Medicaid eligibility for at least some Medicaid-eligible individuals. While the purpose of retroactive eligibility ostensibly is to ensure a health care safety-net for low-income [&hellip

CMS Shares Vision for Medicaid

Medicaid is about to undergo major changes, CMS administrator Seema Verma outlined in a news release yesterday and in a speech to state Medicaid directors. According to the news release, those changes include: re-establishing a state-federal partnership that Verma believes has become too much federal and not enough state giving states greater freedom to innovate offering new guidelines for how states can align their individual programs with federal Medicaid objectives new guidance on section 1115 waivers longer section 1115 waivers with simpler review processes CMS willingness to consider proposals to impose work requirements on Medicaid beneficiaries Medicaid and CHIP “scorecards” [&hellip

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