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Archive for January 2018

A New Use for Section 1115 Medicaid Waivers?

Historically, states have pursued section 1115 Medicaid waivers as a means of expanding Medicaid eligibility. But the Centers for Medicare & Medicaid Services now appears to be looking at granting 1115 waivers to help states reduce their Medicaid populations. According to a new report published by the Commonwealth Fund, CMS is encouraging states – both Medicaid expansion and non-expansion states – to launch demonstration programs designed to reduce enrollment in “means-tested public assistance” programs such as Medicaid.  In their efforts to cut spending and reduce Medicaid enrollment, states are expected to seek section 1115 waivers to experiment with means of doing so such as: establishing monthly premiums for Medicaid recipients eliminating retroactive eligibility imposing lifetime limits on how long individuals … Read More

Posted in Federal Medicaid issues

Administration Lays Groundwork for Medicaid Work Requirements

The Centers for Medicare & Medicaid Services has issued guidelines for states interested in adding a work requirement component to their Medicaid programs. With nearly a dozen states applying to implement controversial Medicaid work requirements, CMS has issued a guidance letter to state Medicaid directors outlining the criteria it will use when considering such applications. The new policy does not mandate work requirements in state Medicaid programs; it only presents the parameters CMS will use when considering the applications of states wishing to impose such requirements. For  more information about the new policy, see the following resources: CMS’s news release announcing the new policy The letter CMS sent to state Medicaid directors explaining the new policy A CMS FAQ on … Read More

Posted in Federal Medicaid issues

U.S. House Committee Calls for Action on 340B

The section 340B prescription drug program has flaws and needs change, a report by the House Energy and Commerce Committee has concluded. The program, which requires pharmaceutical companies to provide discounts on prescription drugs to be dispensed on an outpatient basis to qualified providers that serve large numbers of low-income patients, has been controversial in recent years.  As the number of providers eligible for the program has grown, pharmaceutical companies have claimed that the program is expensive, is being abused, and is responsible for driving up prescription drug costs while providers insist that 340B is a vital tool in helping them serve low-income patients.  Congress, meanwhile, has questioned the program’s growth and sought accountability for how providers use the savings … Read More

Posted in Medicare, Pennsylvania safety-net hospitals

Report Looks at Work Requirements

As a growing number of states consider implementing work requirements as a condition for Medicaid eligibility, the Urban Institute has released a report that describes work requirements in various government cash assistance, nutrition assistance, and housing assistance programs and considers the degree to which those requirements have achieved their policy objectives. The report also describes the applications that eight states have submitted to the federal government seeking permission to introduce a work requirement in their Medicaid programs. Go here to see the Urban Institute report Work Requirements in Social Safety Net Programs: A Status Report of Work Requirements in TANF, SNAP, Housing Assistance, and Medicaid.

Posted in Federal Medicaid issues

New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

The Pennsylvania Department of Human Services has issued a new Medical Assistance Bulletin titled “Hospital Responsibilities Related to the Uncompensated Care Program and Charity Care Plans.” According to the document, The purpose of this Medical Assistance (MA) Bulletin is to remind hospitals of the requirements for the Hospital Uncompensated Care Program (Program) and reinforce the responsibility of hospitals to actively engage patients when determining eligibility for the Program. See the entire Bulletin here.  

Posted in Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance
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