Archive for March 2018

Addressing Socio-Economic Challenges Through Medicaid Payment Policies

Amid the growing awareness of the impact of social factors on health, policy-makers are increasingly interested in finding ways to address those factors through state Medicaid programs. In a new blog post, the journal Health Affairs offers six ways for states to address social determinants of health through Medicaid managed care programs. classify certain social services as covered benefits under the state’s Medicaid plan explore additional flexibility afforded states through section 1115 waivers use value-based payments to support investment in social interventions use incentives and withholds to encourage plan investment in social interventions integrate efforts to address social issues into quality improvement activities reward plans with effective investments in social interventions with higher rates Learn more about how states can … Read More

Posted in Federal Medicaid issues

New Report Details Key Health Care Provisions in February Budget Bill

The Congressional Research Service has published a new report describing the health care-related provisions in the Bipartisan Budget Act of 2018 that Congress passed last month to fund the federal government. A major part of that law was the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act, and the new report includes descriptions of the Medicare, Medicaid, CHIP, public health, and other health care aspects of the law. Go here to find the Congressional Research Service report Bipartisan Budget Act of 2018 (P.L. 115-123): Brief Summary of Division E—The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act.

Posted in Federal Medicaid issues, Medicare

Readmissions Program Working; Expansion in Order?

The Medicare hospital readmissions reduction program is working, according to the Medicare Payment Advisory Commission. And it may even be worth expanding to additional medical conditions, MedPAC members believe. According to MedPAC, hospital readmissions among patients with medical conditions covered by the readmissions reduction program have declined faster than readmissions among patients with medical conditions not covered by the program, suggesting that expanding the program to additional medical conditions could lead to an even greater reduction in the number of avoidable Medicare-covered readmissions. Learn more about changes in the readmission rate since the readmissions reduction program was introduced and whether those reductions can accurately be attributed to the program this MedPage Today article.

Posted in Medicare


Members of the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. last week to discuss a number of Medicaid and CHIP meetings.  The following is MACPAC’s summary of this meeting. MACPAC’S March 2018 meeting began with a review of two draft chapters with recommendations that will be included in MACPAC’s June 2018 report, the first to improve operation of the Medicaid drug rebate program and the second to improve the clarity of substance use disorder (SUD) confidentiality regulations. At the opening session the Commission reviewed a draft chapter on Medicaid drug policy and later voted to approve two recommendations presented at its December 2017 meeting to (1) close a loophole in current law that allows drug manufacturers … Read More

Posted in Federal Medicaid issues

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has just released the February 2018 edition of its Health Law PA News. Included in this edition are articles on Governor Wolf’s proposed FY 2019 budget, including for Medicaid and other health care programs; challenges arising in the implementation of the Community HealthChoices program of Medicaid managed long-term services and supports; home health services and missed nursing shifts; and the potential implications for Pennsylvania of the federal government’s recent decision to invite states to seek to introduce work requirements for participants in their Medicaid programs. Find these stories and others here, in the latest edition of Health Law PA News.

Posted in Pennsylvania Medicaid, proposed FY 2019 Pennsylvania state budget

New Bill Proposes Greater 340B Accountability

A new bill proposed last week by Senator Chuck Grassley (R-IA) seeks to foster greater accountability among participants in the federal government’s section 340B prescription drug discount program. The three-page bill is called the Ensuring the Value of the 340B Program Act of 2018, and according to a news release from the senator, its purpose is to require …participating hospitals to report the total acquisition costs for drugs collected through the 340B program, as well as revenues received from all third party papers for those same drugs. The 340B program provides discounts on prescription drugs dispensed on an outpatient basis to hospitals that qualify for participation based on how many low-income patients they serve. Grassley’s proposal is the fourth 340B … Read More

Posted in Medicare, Pennsylvania safety-net hospitals
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