A bipartisan health price transparency bill — The Lower Costs, More Transparency Act (H.R. 5378) — is scheduled to be considered on the House floor “on suspension” this week. The bill includes two sound Medicaid provisions related to “spread pricing” in Medicaid managed care and to Medicaid pharmacy reimbursement, which are similar to those included […]
The Families First Coronavirus Response Act (FFCRA) required states to maintain uninterrupted coverage for all Medicaid beneficiaries in exchange for additional federal funding. This continuous coverage protection also extended to pregnant women in Medicaid beyond the previous 60-day postpartum cutoff that most states have now moved to extend to 12 months postpartum. A new analysis […]
On August 30, CMS revealed that a number of states were incorrectly processing ex parte (automated renewals), an issue that mostly often impacts children although there are circumstances where other eligible members may be affected. In a nutshell, if one person in the family could not be renewed automatically via ex parte, no one is […]
The rapid state adoption of extended postpartum Medicaid coverage from 60 days to 12 months offers an important opportunity to help ensure new parents and their infants get the health care they need during a critical period of family change following a birth. Last month, CMS released a timely resource for states seeking to help […]
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