CMS Proposes Rule to Codify 12-Month Continuous Eligibility and Improvements to Maternal Health

CMS released a proposed rule related to Medicare hospital outpatient and ambulatory surgical center payments that also includes provisions codifying the Consolidated Appropriations Act of 2023 (CAA) requirement that states provide 12-months of continuous eligibility to all children in Medicaid and CHIP under age 19 as of January 1, 2024. While most of the rule […]

CMS Expresses Concern over States with Large Shares of Application Backlogs

Much has been written about the enormous task state agencies have faced as they returned to routine operations during the unwinding of the Medicaid continuous enrollment requirement. While the primary focus (rightfully) has been around renewals and the renewal process, states have other eligibility and enrollment operational responsibilities including processing applications for new applicants or […]

Medicaid Managed Care Quality Strategy and Quality Rating System

The Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality final rule makes significant improvements to managed care quality requirements, including boosting transparency and reducing reporting lag times. When fully enacted, these changes will transition states from reporting a single overall quality rating for a managed care plan to rating all […]