2019
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New Mexico: Some Good Waiver News for a Change
Those of us who follow Medicaid waiver activity around the country can feel that we’re being constantly assaulted by bad news. So here’s some good news to brighten your day: instead of proposing burdensome requirements that limit access to Medicaid enrollment and services, New Mexico is planning to improve its section 1115 waiver – known…
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SC Public Comments Show Opposition to Work Requirement and Support for Expansion
Two months ago, South Carolina followed the example of five other non-expansion states and submitted a proposal to CMS to impose work reporting requirements targeted at low-income parents. Unlike the other non-expansion states, however, South Carolina’s waiver does propose an expansion of coverage from 67% FPL to 100% FPL. CCF recently updated our analysis of…
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Medicaid Work Requirements: Another Win for Beneficiaries, Another Loss for CMS
CMS Administrator Seema Verma is visibly proud of her agency’s Medicaid and CHIP scorecard, which she claims has ushered in “a new era of accountability and transparency in Medicaid”. The scorecard includes measures of, among other things, federal administrative accountability; one of those measures reports the percentage of Section 1115 demonstration applications that CMS approved…
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Legislative Victory to Ensure Automatic Early Intervention Eligibility for Illinois’ Lead-Poisoned Children
Lead poisoning is the most pervasive environmental health hazard affecting children. According to the Centers for Disease Control and Prevention (CDC), there are nearly half a million children ages 1-5 in the United States with blood lead levels (BLL) above 5 micrograms per deciliter (µg/dL) — the reference value recommended by the CDC for initiation of public health actions,…
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Research Update: New Study on Medicaid Fee Bump on Prenatal Care Utilization
This week, I am reading a study finding that a temporary increase in Medicaid reimbursement rates for primary care in 2013-2014 increased utilization of prenatal care among expectant mothers, particularly among non-Hispanic Black/African American women. The Maternal and Child Health Journal’s Effect of the Medicaid Primary Care Rate Increase on Prenatal Care Utilization Among Medicaid-Insured…
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Parents Talk About Social Needs Screening – Identify Trust as a Major Issue
“First, more than anything else, the pediatrician should earn your trust.” — Parent from Queens, New York Unmet basic needs, such as food insecurity, in childhood can have long-lasting and wide-ranging consequences for kids, including increased risk for chronic health conditions, behavioral problems and poor academic performance. For these reasons the American Academy of Pediatrics…
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Senate Finance Committee Considers Bipartisan Bill to Lower Federal and State Medicaid Drug Costs
Editor’s Note: The Senate Finance Committee reported the bill on July 25, 2019 (without substantive changes to its Medicaid provisions.) On Thursday, July 25, the Senate Finance Committee is scheduled to consider bipartisan drug pricing legislation (known as the Prescription Drug Pricing Reduction Act). While much of the bill focuses on provisions related to Medicare…
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CMS Guidance Spotlights Ways Medicaid Can Support Mental Health and Substance Use Disorder Services in Schools
The Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a Joint Informational Bulletin that offers a helpful roadmap to states and schools on the ways certain Medicaid authorities can help support school-based mental health and substance use disorder services for children and adolescents. As…
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Research Update: Medicaid Expansion Associated with Decrease in Cases of Reported Child Neglect
This week, I am highlighting a study suggesting that Medicaid expansion was associated with reductions in number of reported cases of child neglect. This study builds on prior research finding that Medicaid expansion is associated with greater parental financial stability and access to mental health care. In this study, researchers compared reported cases of child…
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MACPAC Releases FactSheet on CHIP Health Services Initiatives
Not everyone knows that states are allowed to use a limited amount of CHIP funding to implement health services initiatives (HSIs) – activities that protect the public health, promote a state’s capacity to deliver public health services, or accomplish public health goals relating to improving the health of children, including children in Medicaid and CHIP.…
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Call for Public Comments on Annual Review of the Core Sets of Health Quality Measures in Medicaid and CHIP
Each year, a multi-stakeholder group is selected through a nomination process to review and make recommendations on the child and adult core sets of health care quality measures in Medicaid and CHIP. This year, I was pleased to participate as a member of the workgroup, which was facilitated by a great team at Mathematica. It’s…
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New Study Finds Medicaid Per Capita Caps and Block Grants Would Lead to Deep Cuts to Children’s Coverage and Access
Avalere Health issued a new study conducted for the Children’s Hospital Association, estimating how much a per capita cap or block grant could significantly cut federal Medicaid spending on children nationally and on a state-by-state basis, relative to current law. The study models the impact of four illustrative per capita caps and block grants. It…
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Medicaid Work Requirements: Is Momentum Stalling?
Last week marked the 18-month anniversary of CMS guidance urging states to apply for Section 1115 Medicaid waivers to impose work reporting requirements as a condition of eligibility. One day after issuing the guidance (January 12, 2018) CMS approved the first state, Kentucky, to go forward with work reporting requirements along with numerous other harmful…
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CMS Administrator Verma Proposes to Repeal the Medicaid Access Rule
For the past two years, CMS Administrator Seema Verma has wanted to “rollback” the Medicaid Access Rule. That’s the CMS regulation that implements the requirement in the Medicaid statute that rates paid to physicians and other providers be “sufficient” so that enough participate in Medicaid to give beneficiaries access to covered services. In the…
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Child Enrollment in Medicaid and CHIP Slips Again
We continue to closely monitor the trends in child enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) following our report on the precipitous enrollment decline in 2018. As of March 2019, overall child enrollment in Medicaid and CHIP was down an additional 41k children in the first quarter of 2019. However, the national…
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Trump Administration Withdraws Harmful Drug Rebate Safe Harbor Rule
On July 10, the Trump Administration announced that it would withdraw a proposed rule to eliminate the safe harbor in the federal anti-kickback law for rebates negotiated by pharmacy benefit managers (PBMs) on behalf of Medicaid managed care plans and Medicare Part D plans. This is a highly welcome move. As we have explained since…
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House Committee Advances Bill to Sustain Medicaid Programs in the Territories and Avoid Deep, Harmful Cuts
On July 11, by voice vote, the Health Subcommittee of the House Energy and Commerce Committee reported out essential legislation (H.R. 3631) to avert large federal Medicaid funding shortfalls the territories will face starting in 2020. Without additional federal funding the bill would provide, the territories would have no choice but to institute damaging cuts…
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Proposed HUD Rule Adds to Climate of Fear for Immigrant Families, Puts America’s Children at Greater Risk of Homelessness
Yesterday was the deadline for comments on yet another anti-immigrant proposed rule, this one targeting over 55,000 citizen children in mixed status families that rely on prorated housing assistance under current program rules. We joined other child health groups in submitting comments, underscoring the serious negative impacts of homelessness and housing insecurity for child well-being…
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Real Protections for Kids and Families in the Newest Texas Medicaid Managed Care Laws
In June 2018, the Dallas Morning News began publishing a series of in-depth investigative reports on Texans harmed through Medicaid managed care, potential conflicts of interest, and weaknesses in oversight and enforcement of Medicaid managed care contracts. The articles resulted in public hearings in the Texas House of Representatives that further explored the issues and allowed the public to comment. In…
