Waivers
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Medicaid and CHIP Waiver Transparency Rules Take Effect Today: CMS Unveils New Waiver Website
As regular readers of Say Ahhh! know, CMS has issued final regulations on public input and transparency with respect to Section 1115 Medicaid and CHIP waivers. These rules have been a loooong time coming and much needed since 1115 waivers can be very consequential. And today, April 27th, 2012, the rules become effective. My last…
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Holding Insurers Accountable: Should We Add an MLR to Medicaid?
A hot issue in many states today is whether or not to move more Medicaid beneficiaries, and often very vulnerable beneficiaries, into managed care. Indeed, many managed care companies are interested in getting or keeping a foot in the Medicaid market given the expansion of Medicaid coming in 2014. And many, though not all, states are…
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The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers
Section 1115 Medicaid and CHIP demonstration waivers are intended to allow for research and demonstration projects to test new approaches in program design and administration. The Affordable Care Act required the Department of Health and Human Services to issue regulations designed to ensure that the public has meaningful opportunities to provide input into the Section…
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Keeping Care Affordable: CMS Stands up for California Kids
By Michael Odeh, Children Now Earlier this month the federal Centers for Medicare and Medicaid Services (CMS) made an important ruling that truly embraces the “AFFORDABLE” in the Affordable Care Act (ACA). Health care services and economics research over the past four decades has clearly shown that unaffordable cost-sharing in health care can be a…
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Let the Sun Shine: Section 1115 Medicaid and CHIP Waivers Transparency Rule Finally Issued!
So my children think this is weird, but I was really happy yesterday because CMS issued the final regulations on Section 1115 waivers. CMS also issued final rules on so-called “State Innovation” waivers that will be available through the Affordable Care Act, but since those don’t go into effect until 2017 we will come back…
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Good News for Utah’s Children: CMS Upholds Key Affordability and Benefit Protections
By Lincoln Nehring, Voices for Utah Children In 2011 Utah passed SB 180, Medicaid Reform. As with many Medicaid reform efforts happening across the country, SB 180’s broad theme was good: control costs through improved care management and quality. However, also like many Medicaid reform efforts happening around the country, Utah’s “improved quality” theme came…
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Good News for Florida’s Kids: The State’s Attempt to Charge Unaffordable Medicaid Premiums Won’t Go Forward
Friday was a good day for Florida’s kids. The federal government indicated that the state would not be allowed to proceed with a proposal, passed by the legislature last spring, to charge all Medicaid beneficiaries enrolled in managed care plans $10 a month regardless of income or age. It is important to note that much…
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National Groups Express Concerns About Wisconsin’s Waiver
By Wesley Prater Many thanks to the organizations that joined us in submitting a letter to federal officials in opposition of Wisconsin’s request to waive maintenance of effort provisions. These provisions are so valuable to families because they preserve stability in states’ Medicaid and CHIP programs. Groups such as the AARP, American Heart Association, Center…
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Coming Soon to a State Near You? Wisconsin seeks to preview a slasher triple feature
By Jon Peacock, Wisconsin Council on Children and Families A drama has been slowly unfolding in Wisconsin relating to the shape of the state’s Medicaid program. If it were made into a movie, it would be a slasher film with an unwilling cast of nearly half of the 780,000 people enrolled in Wisconsin’s highly successful…
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Looking Ahead to 2012, What Changes Are In Store for Florida’s Medicaid Program?
Medicaid is a critical part of Florida’s health care system. It covers 3.1 million people in the state, the majority of whom are children. In 2006, a five-year pilot program that replaced traditional Medicaid with an unusual managed-care model and other features that required a Section 1115 waiver from the federal government. In 2012, there…
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National Groups Oppose CA Request to Circumvent Cost-Sharing Protections
Cost-sharing in the private insurance model was intended to encourage consumers to use services prudently, however, the application of increased cost-sharing for those enrolled in Medicaid often simply forces low-income individuals to go without medically necessary care. For that reason, federal legal protections were put in place to protect low-income people from being overburdened with…
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Waiver Watchers Alert: CMS decision protects AZ parents’ coverage; Budget cuts do not a waiver make
Another installment in the ongoing saga regarding Arizona’s efforts to rollback coverage for parents and childless adults occurred on October 7th when CMS sent the state a letter reviewing where things stand with the state’s Section 1115 waiver request. In January, Arizona became the first state in the nation to request a waiver of the…
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Hard Work Pays Off for “Waiver Watchers”
By Wesley Prater A number of states looking to save money in their Medicaid programs are asking the federal government for Section 1115 Research and Demonstration waivers — in some cases asking for federal protection that preserve their coverage for children and families to be loosened. However, recently three states – New Jersey, Texas, and…
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National Children’s Groups Express Concerns About Utah’s Waiver Request
By Joe Touschner We’ve pointed out the flaws in Utah’s request for a Medicaid waiver in a previous blog post But we wanted to call your attention to them once again since today we submitted a letter to federal officials voicing the concerns of many national groups. Thanks to all of you who joined us in…
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Utah’s Waiver Proposal–Join Us in Speaking Up for Kids
By Joe Touschner Like many states, Utah has been working to redesign its Medicaid program in an effort to contain costs–the state submitted a Section 1115 demonstration waiver application to CMS earlier this month. As my colleague Joan Alker has blogged about in the past, waivers are often adopted with little public transparency even though…
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Florida Medicaid Transformation: Bad Policy & Bad Politics
Governor Rick Scott has now officially set in motion an ill-advised transformation of Florida’s Medicaid program that will place the health care of most Florida Medicaid beneficiaries into the hands of for-profit companies. The new law expands a managed care pilot program operating in five counties under a Section 1115 federal waiver. In moving ahead…
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Rhode Island Waiver – Model or Sweetheart Deal?
Proponents of block granting Medicaid have been pointing to Rhode Island’s Section 1115 research and demonstration waiver that includes a global cap on federal spending as evidence of the success of this approach. But as an article that appears in yesterday’s New York Times underscores, this analogy is just another example of the “fact free”…
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CMS Asks Florida ‘Where’s the Beef’? (Do States Need a Waiver to do Managed Care?)
Last week the Centers for Medicare and Medicaid Services sent a letter to the Florida Agency for Health Care Administration in response to the state’s request for waiver authority to expand managed care statewide. CMS responded by saying that their Medicaid waiver extension request cannot be granted because it lacks a specific plan. The state’s…
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Groups Develop Public Comments on Section 1332 Innovation Waiver Regs (aka Wyden Waivers)
A working group consisting of the Center on Budget and Policy Priorities, Georgetown CCF, Families USA, and NHelp, with input from the National Women’s Law Center, NCQA and SEIU have produced comments on the proposed Section 1332 State Innovation waiver public process regulations issued by CMS on March 14, 2011. Take a look at the…
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Transparency in Medicaid/CHIP Waivers is Urgent
Today 34 national groups sent a letter to Secretary Sibelius asking her to finalize the Section 1115 Medicaid and CHIP public process waiver regulations as soon as possible. As the letter notes, state Medicaid waiver activity is a hot topic these days. The Secretary and her colleagues at the U.S. Department of Health and Human…
