Archive for Federal Medicaid issues
SNAP was among 27 Pennsylvania health care organizations to send a joint letter to senators Bob Casey and Pat Toomey pointing out aspects of the House-passed American Health Care Act that could jeopardize access to care for medically vulnerable Pennsylvanians. Among the issues addressed in the letter are how the House-passed proposal would detract from the role of Medicaid in fighting the state’s opioid crisis; the proposed reduction in tax credits to help purchase health insurance; the challenge posed by a per capita approach to Medicaid financing; the potential loss of health care jobs; the likelihood of large numbers of Pennsylvanians losing their health insurance and state Medicaid costs rising significantly; and the erosion of consumer protections. See the complete … Read More
Over the past three years a dozen states have proposed establishing a work requirement for eligibility for their Medicaid programs and in its proposed FY 2018, the Trump administration has called for extending the ability to impose such a requirement to all states. But how would a Medicaid work requirement work? To whom would it apply and what kinds of work might satisfy such a requirement for the approximately 22 million Medicaid recipients (out of 76 million total recipients) to whom it might apply? Work requirements would have significant implications for the patients and communities that Pennsylvania safety-net hospitals serve, and possibly for the hospitals as well. A new Commonwealth Fund report looks at these and other issues. Go here … Read More
Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. The agency performs policy and data analysis and offers recommendations to Congress, the Department of Health and Human Services, and the states. During two days of meetings, MACPAC commissioners received the following presentations: Federal CHIP Funding Update: When Will States Exhaust Their Allotments? Review of June Report Chapter: Program Integrity in Medicaid Managed Care Review of June Report Chapter: Medicaid and the Opioid Epidemic Medicare Savings Program: Eligible But Not Enrolled Medicaid Reform: Implications of Proposed Legislation Preliminary Findings From Evaluations of Medicaid Expansions Under Section 1115 Waivers Potential Effects of Medicaid Financing Reforms on Other Health and Social Programs Review of June Report Chapter: Analysis … Read More
Both Congress and a number of states have discussed introducing work requirements into their Medicaid programs. Such a proposal was part of the American Health Care Act, a number of governors and state legislators have discussed work requirements as a condition of Medicaid eligibility, and some states are reportedly considering including such requirements in section 1115 Medicaid waiver applications. In a new report, the Congressional Research Service examines the U.S. Department of Health and Human Services’ authority to grant such waivers and how courts might look at such requirements if they were be contested. Go here to see the Congressional Research Service report “Judicial Review of Medicaid Work Requirements Under Section 1115 Demonstrations.”
The Medicaid and CHIP Payment and Access Commission has released several new reports, including: a look at how states exercise flexibility in their individual Medicaid programs; methodologies for setting Medicaid per capita caps; a review of how states are addressing high-cost hepatitis C drugs in their Medicaid programs; an analysis of Medicaid disproportionate share hospital payment (Medicaid DSH) allotments and payments; and an analysis of when states will exhaust their CHIP allotments. MACPAC is a non-partisan legislative branch agency that advises Congress, the states, and the administration on Medicaid and CHIP payment and access issues. Find links to these and other MACPAC reports here, on the MACPAC web site.
In a new report, the Commonwealth Fund looks at Medicaid per capita caps, an idea that has been discussed for years, that was part of the as-yet unsuccessful American Health Care Act, and a proposal that is almost certain to resurface in the near future. Among other things, the article explains what per capita caps are and how they would work describes how per capita caps differ from current Medicaid policy considers how the implementation of per capita caps might affect low-income people, providers, and insurers Learn more in the Commonwealth Fund article “Essential Facts About Health Reform Alternatives: Medicaid Per Capita Caps,” which can be found here.
That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants. In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act. Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement. Does the lack of a work requirement encourage people in Medicaid expansion states to withdraw from the workforce? Is a work requirement a way to raise the income of beneficiaries just enough to … Read More
Last week the Centers for Medicare & Medicaid Services announced a final rule addressing the treatment of third-party payers in calculating Medicaid uncompensated care costs. This calculation affects individual hospitals’ Medicaid disproportionate share (Medicaid DSH) limit. According to CMS, This rule clarifies federal requirements regarding the treatment of third party payers in determining the hospital-specific Medicaid DSH payment limit, which is set by statute as a hospital’s “uncompensated costs” incurred in providing hospital services to Medicaid and uninsured patients. The final rule makes clearer our existing policy that uncompensated costs include only those costs for Medicaid eligible individuals that remain after accounting for all payments received by or on behalf of Medicaid eligible individuals, including Medicare and other third party … Read More
While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well: replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants. In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid. Among the issues the brief addresses are: why such a switch would matter to low-income seniors at all how it might … Read More
In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial Alignment Initiative” Pennsylvania’s private safety-net hospitals serve especially large numbers of dually eligible Medicare and Medicaid beneficiaries, so such programs … Read More