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 […]
Download the Full Explainer (PDF) On April 2, 2024, the Centers for Medicare & Medicaid Services 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).1 The rule eliminates certain access barriers for children enrolled […]
On February 1, the State of Florida filed a lawsuit in federal court in Tampa against the Centers for Medicare & Medicaid Services in an effort to prevent the agency from enforcing 12-month continuous eligibility in the state’s CHIP program. As loyal readers of Say Ahhh! know, the Consolidated Appropriations Act of 2023 required that […]
Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new state opportunity to test approaches for addressing behavioral, physical, and health-related social needs of individuals covered by Medicaid and Medicare. Structured as a new “Innovation in Behavioral Health” (IBH) model to be tested by the CMS Innovation Center, the state-based model is […]
Just over 25 years ago, Congress enacted a major change in federal policy on Medicaid managed care. It eliminated the 75/25 rule—the requirement that no more than 75 percent of the enrollees in a Medicaid managed care organization (MCO) could be Medicaid or Medicare beneficiaries. The logic of the rule was that if an MCO […]
CMS has released long awaited guidance to states on implementing 12-month continuous eligibility (CE) for all children in Medicaid and the Children’s Insurance Program (CHIP) under the age of 19 as enacted by Congress in the Consolidated Appropriations Act. As of January 2023, 26 states cover some or all children in Medicaid for a full […]
