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CMS: Not Done With Medicaid Work Requirements

Despite the ruling of a federal court that Kentucky’s new Medicaid work requirement violates federal law, the Centers for Medicare & Medicaid Services has not ruled out approving future requests from state governments to impose work requirements on Medicaid recipients. Or so asserted CMS administrator Seema Verma at a recent health care event in Washington, D.C. The Washington Examiner reports that at that event, Verma said that We are looking at what the court said.  We want to be respectful of the court’s decision while trying to push ahead with our policy and our goals. CMS currently has applications from [&hellip

New Policy Threatens Provider Medicaid Payments

Health care providers that fail to join the provider networks of Missouri Medicaid managed care plans will see their Medicaid payments cut 10 percent by the state under a new state policy. The purpose of the policy, according to the state, is to encourage hospitals and physicians to join the provider networks of three managed care plans that serve more than 700,000 residents of the state.  Providers, on the other hand, say this policy will discourage them from serving Medicaid patients at all and will detract from their ability to negotiate reasonable rates with the state’s three Medicaid managed care [&hellip

NAUH Comments on Proposed Changes in Medicare Payments (Part 2 of 3)

In a letter to the Centers for Medicare & Medicaid Services, the National Association of Urban Hospitals has offered extensive comments on CMS’s proposed regulation describing how it intends to pay hospitals for Medicare-covered services in FY 2019.  NAUH offered these comments in response to CMS’s request for stakeholder input. In this space yesterday NAUH presented its comments to CMS regarding how the agency proposes calculating Medicare disproportionate share (Medicare DSH) payments in the coming fiscal year.  Today, NAUH shares its views on aspects of the proposed regulation that address the Medicare hospital readmissions reduction program, Medicare’s quality reporting program, [&hellip

NAUH Comments on Proposed Changes in Medicare Payments (Part 1 of 3)

In a letter to the Centers for Medicare & Medicaid Services, the National Association of Urban Hospitals has offered extensive comments on why the Medicare cost report’s S-10 worksheet remains unsuited for use when calculating hospital Medicare disproportionate share (Medicare DSH) uncompensated care payments. In support of this view and in response to the publication of CMS’s draft inpatient prospective payment system regulation detailing how it envisions paying acute-care hospitals in FY 2019 and CMS’s invitation for stakeholders to comment on this proposal, NAUH submitted extensive comments about problems associated with using the S-10 in this manner – and also [&hellip

Short-Term Plans May Short-Change Purchasers

The short-term health insurance plans that the administration proposes making more available to consumers as an alternative to comprehensive health insurance that meets Affordable Care Act coverage requirements may leave consumers with greater out-of-pocket costs and less coverage for some critical services. According to a Kaiser Family Foundation review of available short-term, limited duration plans in 10 markets across the country, those plans: often do not cover mental health and substance abuse services and outpatient prescription drugs may turn down individuals or charge them higher premiums based on age, gender, or health status, including pre-existing conditions require greater cost-sharing by [&hellip

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