Medicaid managed care plans have long covered “In Lieu of Services” (ILOS), which are services that are provided in substitution of traditional Medicaid state plan services. For example, a managed care plan might provide a community-based depression screening in lieu of an office visit screening. In 2016, CMS first defined the contours of ILOS in […]
May is Mental Health Awareness Month. And with Medicaid (alongside the Children’s Health Insurance Program) serving as the largest payer of behavioral health services and covering more than half of all children in the US, you can’t talk about mental health without also talking about Medicaid and CHIP. In March 2024, President Biden signed into […]
Download the Full Report Here On March 9, 2024, President Biden signed into law the Consolidated Appropriations Act, 2024 (P.L. 118-42). The Consolidated Appropriations Act, 2024 (CAA 2024) includes a number of Medicaid and Children’s Health Insurance Program (CHIP) provisions related to mental health and substance use disorder (SUD) care and coverage including provisions extending […]
The Medicaid Managed Care Rule published on May 10 has lots of moving parts. As my colleague Leo Cuello explains, the rule includes provisions to increase the transparency of state directed payments (SDPs). The rule also contains a number of other transparency requirements that are the focus of this blog, most of which are identical to those […]
Earlier this year, the Center for Medicare & Medicaid Services (CMS) finalized two new regulations aimed at improving access to care for those enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) across delivery systems. CCF experts summarize both rules in “An Explanation of Final Medicaid Managed Care and Access Rules“. Below is a […]
On April 2, 2024, the Centers for Medicare & Medicaid Services (CMS) published the second part of a two-part final rule that simplifies the eligibility and enrollment processes for Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The rule eliminates certain access barriers for children enrolled in CHIP; makes transitions […]
