Noteworthy News

Archive for April, 2015


Providers Can’t Sue Over Low Medicaid Payments

Health care providers may not turn to the courts when they believe their state Medicaid program is not paying them enough for the services they deliver, the Supreme Court has decided. Instead, they must seek help from the federal government, which makes the rules that govern Medicaid provider payments. The Supreme Court decision overturns a lower court ruling in response to a suit by facilities in Idaho that provide residential services to the disabled claiming that the state was paying them less than it had agreed to pay. As a result, providers must now turn to the Centers for Medicare [&hellip

How States View Medicaid Reform

What are states looking for from “Medicaid reform”? How do they evaluate the prospects of reform proposals – and how do they evaluate reforms that have been implemented? Across the country, states are pursuing Medicaid reform through section 1115 waivers, Delivery System Reform Incentive Payment Programs (DSRIP), the State Innovation Models (SIM) Initiative, and other means. As they do, they must decide what innovations to pursue and then make decisions about whether those they have chosen have achieved their objectives and produced genuine payment and delivery system reform, improved outcomes, and laid a foundation for further improvement. Many of these [&hellip

GAO Reports on CHIP Extension

As a House-approved bill that would extend authorization for the Children’s Health Insurance Program (CHIP) for two years awaits Senate consideration, the U.S. Government Accountability Office (GAO) has issued a mandated evaluation of the program. Among the GAO’s findings, it concluded that children enrolled in the program … (1) had substantially better access to care, service use, and preventive care when compared with uninsured children; and (2) experienced comparable access and service use when compared with privately insured children. It also found that nearly all children between the age of one and two enrolled in CHIP or Medicaid made at [&hellip

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