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  • New CCF-Commonwealth Paper Examines How Block Grant Financing Severely Harmed Puerto Rico’s Medicaid Program

    Edwin Park

    My new paper for the Commonwealth Fund analyzes how Puerto Rico’s Medicaid block grant financing contributed to Puerto Rico’s overall fiscal and debt crisis and resulted in a Medicaid program that is far less generous than what is provided in the states. Puerto Rico’s experience thus offers critical lessons to federal and state policymakers about…

  • A Parting Gift for the Incoming Administration: “Good Guidance Practices”

    Andy Schneider

    This week—two weeks before the inauguration of a new President—the self-proclaimed “Good Guidance Practices” regulation issued by the outgoing Secretary of the Department of Health and Human Services (HHS) takes effect. As proposed in August, the regulation was not so good for Medicaid and CHIP. In its final form, published on December 7, the regulation…

  • Comments to CMS on Proposed Changes to Medicaid and CHIP Policies and Procedures Relating to Prior Authorization and Electronic Exchange of Health Care Data

    Joan Alker

    The Georgetown University Center for Children and Families submitted the following comments to CMS on the proposed changes to current Medicaid and CHIP policies and procedures relating to prior authorization and electronic exchange of health care data. Comments-Prior-Auth-NPRM-FINAL  

  • Study on Intergenerational Health Mobility Provides Strong Case for Early Childhood Interventions

    Aubrianna Osorio

    Examining how children’s health compares to the health of their parents can offer valuable insight into the individual, family, and community-level factors that affect a child’s health status. This is the aim of a new Health Affairs article from Jason Fletcher and Katie Jajtner at the University of Wisconsin-Madison, which seeks to bring an intergenerational…

  • CMS Releases Guidance on Unwinding the COVID-19 MOE

    Cathy Hope

    States and stakeholders now have the long-awaited CMS guidance on advance planning in Medicaid and CHIP for the end of the public health emergency (PHE). There’s a lot to digest in this 54-page State Health Official letter (SHO). It discusses what happens to the various pandemic-related authorities and waivers and what states must do to…

  • Comments on Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency

    Joan Alker

    The Georgetown University Center for Children and Families submitted the following comments to the U.S. Department of Health and Human Services on CMS-9912-IFC, “Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency.” CCF Comments CMS-9912-IFC Final

  • Medicaid Managed Care Covid-19 Advocacy Action Guide

    CCFadmin

    Georgetown University CCF partnered with the American Academy of Pediatrics (AAP) to produce a Medicaid Managed Care COVID-19 Advocacy Action Guide. The guide explains how practitioners and child health advocates can work with MCOs and state policymakers to increase financial support for pediatric and primary care practices serving children and families enrolled in Medicaid. The…

  • Advocacy Guide Outlines Strategies for Supporting Primary Care Practitioners in Medicaid Managed Care Networks During Pandemic

    Andy Schneider

    The pandemic has not been good for children or their physicians. Well-child and other non-emergency visits are down, so children are missing important screening benchmarks as well as immunizations.  Pediatric practitioners who are paid on a fee-for-service basis have seen their revenues fall and the financial stability of their practices imperiled. The situation has improved…

  • What’s Happening to CHIP Enrollment During the Pandemic?

    Joan Alker

    In 2020, at Georgetown University CCF and elsewhere, there has been a lot of discussion about and tracking of what is happening with Medicaid enrollment. Between the recession and the disenrollment freeze, Medicaid enrollment has trended upwards – a recent study from the Kaiser Family Foundation looking at Medicaid managed care enrollment in 30 states…

  • Medicaid Managed Care: The Case for Transparency in the Biden Administration

    Andy Schneider

    On the way out the door, CMS Administrator Seema Verma issued changes to Medicaid managed care regulations that, among other things, weaken the standards for measuring the adequacy of managed care organization (MCO) provider networks. These changes, which will be effective December 14, were adopted over the objections of CCF and other beneficiary advocates. They…

  • New CCF-Commonwealth Fund Report Highlights Long-Term Benefits of Medicaid Coverage for Pregnant Women and Children

    Joan Alker

    A new report written by my colleagues Edwin Park, Allie Corcoran and I for the Commonwealth Fund examines and summarizes the growing body of research documenting the long-term benefits of Medicaid eligibility for pregnant women and children. Because Medicaid/CHIP expansions were phased in over time, and states reacted on different timetables to federal options and requirements,…

  • Medicaid Managed Care Transparency: Advocacy Around External Quality Review Reports

    Emma Hurler

    As anyone who cares about children’s health knows, it is important to know how Medicaid managed care organizations (MCOs) are performing for the children enrolled in their plans. Access to quality data on a plan-specific basis is a vital part of determining which plans are doing the job well and which plans are falling short.…

  • Can a Biden Administration Reverse the Rise in Uninsured Children?

    Joan Alker

    A few weeks ago I blogged about how a Biden Administration could go about unwinding Medicaid Section 1115 work reporting requirement waivers. Since Section 1115 demonstrations are clearly in the purview of the Secretary of Health and Human Services, a Biden Administration is in the driver’s seat (within the confines of the statute of course!)…

  • “Improper Payment” Rates for 2020: Another Year, Another Attempt to Tarnish the Popular Medicaid Program

    Andy Schneider

    $100 billion—with a “b”—is a large number. So when the headline on the op-ed in the New York Post screams “Medicaid hemorrhaging $100B on Americans ineligible for the program” most readers will understandably frown and think: “This doesn’t sound good, even in a pandemic. What’s going on here?” The author, Brian Blase, is not a…

  • Comments on Proposed SUNSET Rule

    Andy Schneider

    Georgetown University Center for Children and Families submitted the following comments to the U.S. Department of Health and Human Services on the proposed SUNSET rule. CCF Comments SUNSET NPRM

  • Medicaid Expansion Increased Preventive Care for Pregnant and Postpartum Women, New Study Finds

    Maggie Clark

    Medicaid expansion increased the use of key preventive health services by women before and after pregnancy, a new study published in Health Affairs found. The findings add to the evidence that expanding Medicaid coverage to all low-income adults does translate into more utilization of preventive care that can improve the health and wellbeing of women…

  • New Report Explains How Medicaid Expansion is Key to Ending HIV Epidemic in USA

    Adam Searing

    As we live through the COVID-19 pandemic, our other challenging health problems haven’t gone away. In recognition of World AIDS Day and in honor of all those whose lives have been affected by HIV/AIDS, I would like to focus attention on public policy options that could help finally eliminate HIV in the United States. Long…

  • HIV and Medicaid Expansion: Failure of Southern States to Expand Medicaid Makes Elimination of HIV Infection in the United States Much Harder to Achieve

    CCFadmin

    By Adam Searing, JD, MPH and Adaora A. Adimora, MD, MPH Introduction Advances in public health programs and medical treatment mean HIV can be treated successfully in the long term, improving the health of individuals and reducing the spread of the virus. While the federal government has multiple initiatives aimed at addressing and eventually eliminating…

  • Open Enrollment FAQ of the Week: What Does My Plan Cover?

    CCFadmin

    With Open Enrollment now well underway, consumers are weighing their options for 2021 and trying to find the right plan that meets their health needs. As consumers make their decision, it is important for them to understand what they are buying and what coverage their plan provides. Throughout the enrollment period, the Georgetown University Center…

  • Medicaid Managed Care Procurement: Opportunity for Transparency?

    Andy Schneider

    In most states, the responsibility for ensuring that children enrolled in Medicaid receive needed services rests with managed care organizations (MCOs).  They are stewards for millions of children and billions of Medicaid funding intended to meet children’s health care needs.  Yet there is little transparency about how individual MCOs are performing for children.  The logical…