Medicaid
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Proposed Rule Provides Opportunity to Advance Behavioral Health Quality
As my colleague, Maggie Clark, wrote about on Say Ahhh! earlier this week – we can’t improve what we don’t measure. This is why CMS’s recently proposed rule on reporting of quality measures in Medicaid and CHIP is critical to advancing behavioral health care quality. The proposed rule, open for comment through October 21, requires…
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HHS Secretary Becerra Extends the Public Health Emergency into 2023
HHS Secretary Becerra has declared that the COVID-19 public health emergency is extended for another 90 days through January 11, 2023. This means that February 1, 2023, is the earliest that the Medicaid continuous coverage protection would be lifted and states could begin to disenroll people after completing a full renewal and review of ongoing…
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Unwinding Wednesday #6: Communications Toolkits Offer a Variety of Messages and Materials to Help Mitigate Coverage Losses
This week on Unwinding Wednesday, we are digging into the communications materials and toolkits found on our 50-state Unwinding Tracker – arguably one of the most critical elements of the tracker for ensuring individuals with Medicaid coverage are adequately prepared for the unwinding. The development of comprehensive communications materials by state Medicaid agencies is vital…
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Restoring the Public Charge Policy
The Department of Homeland Security (DHS) issued a final regulation that restores longstanding public charge policy, effective December 23, 2022. This comes after attempts by the Trump Administration to radically expand the scope and nature of the public charge test, making it much harder for some immigrants to adjust their status and discouraging many more…
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Proposed Rule Offers Opportunity to Help Advance Maternal Health Equity
We can’t improve what we don’t measure. That’s why it is important for all who want to improve maternal and child health to take a look at a proposed rule now up for comment that provides an important opportunity to increase transparency and accountability for the quality of care delivered through Medicaid and CHIP. The…
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Medicaid and CHIP Continuous Coverage for Children
States have the option under current law to provide 12 months of continuous health coverage for children in Medicaid and the Children’s Health Insurance Program (CHIP) so that children can maintain coverage throughout the year even as their family income fluctuates from month to month.[note]Twelve-month continuous eligibility was authorized in the 1997 Balanced Budget Act.…
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Comments on Tennessee’s Proposed “Amendment 4” to TennCare III Demonstration
The following organizations joined Georgetown University Center for Children and Families in submitting comments to HHS regarding Tennessee’s proposed “Amendment 4” to its TennCare III Demonstration. ACNM Tennessee Affiliate American College of Obstetricians and Gynecologists (ACOG) American Lung Association Autistic Self Advocacy Network Center for Law and Social Policy Center on Budget and Policy Priorities…
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Medicaid Managed Care: OIG, MLRs, and the Future of Oversight
Last month, the Office of Inspector General (OIG) issued a report that speaks volumes about the oversight of Medicaid managed care organizations (MCOs). As the OIG delicately puts it, CMS has “opportunities” to “strengthen States’ oversight.” An alternative framing would be that CMS and many states have not met minimum standards of stewardship for Medicaid…
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Doula Services in Medicaid: Pathways and Payment Rates (Part 3 in a series)
As awareness around the worsening maternal mortality crisis increases, states continue to look towards covering doula care in Medicaid as a potential strategy to improve birth outcomes, particularly for birthing people of color. More than half the states are working towards Medicaid coverage for doula care. But how can states implement these programs effectively and…
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Unwinding Wednesday #5: Application Processing Times Provide Insight into State Capacity to Manage the Medicaid Workload
In last month’s Unwinding Webinar Part 9, we covered the performance indicator and supplemental unwinding data that will be helpful in monitoring the impact of unwinding the Medicaid continuous coverage protection at the end of the public health emergency (PHE). I often talk about call center statistics being the canary in the coal mine. But…
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Lack of Federal Action Puts Puerto Rico and Other Territories in Peril of Dire Medicaid Fiscal Cliff, Yet Again
With Puerto Rico reeling from the widespread damage caused by Hurricane Fiona, it is critical that Puerto Rico receives all the emergency relief and longer-term assistance it needs to recover from yet another devastating natural disaster. But it is also important to remember that the Medicaid programs in Puerto Rico and the other territories —…
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Unwinding Wednesday #4: PHE Unwinding Related FAQs
Frequently Asked Questions or FAQs are a popular way to provide information based on the types of questions people most frequently ask. But like all types of communications, how well FAQs convey information depends on the audience and how easy the content is to understand. In our 50-State Unwinding Tracker, we have found 28 states…
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Oregon Leads the Nation By Covering Children in Medicaid from Birth to Kindergarten – Which State Will Be Next??
The Biden Administration announced today that it will approve Oregon’s request to provide continuous Medicaid coverage to children from birth through age five and for two years for all Oregonians enrolled in Medicaid age six and up. This use of Section 1115 authority is precisely what Medicaid demonstrations are for — as we and colleagues…
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Assessing the Potential Impact of the Inflation Reduction Act on Federal and State Medicaid Prescription Drug Spending
The Inflation Reduction Act (P.L. 117-169) did not include any drug pricing provisions directly affecting Medicaid. But as I have previously written for the Commonwealth Fund, Medicare drug pricing reforms can interact with the highly effective Medicaid Drug Rebate Program, under which drug manufacturers must pay sizable rebates to state Medicaid programs that significantly lower…
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Congress Could Consider Medicaid and CHIP Drug Pricing Provisions
The Inflation Reduction Act (P.L. 117-169), signed into law on August 16, 2022, includes historic Medicare drug pricing provisions such as a requirement for Medicare to directly negotiate prices with drug manufacturers for certain high-cost drugs and a requirement that drug manufacturers pay rebates to Medicare if their prices rise faster than inflation. Unfortunately, the…
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Unwinding Wednesday #3: State Plans Provide a Glimpse into Unwinding Process
This week in our Unwinding Wednesday blog series, we unpack an element of our 50-state Unwinding Tracker that has been a top issue since discussions about the end of the continuous enrollment protection began: state unwinding plans. In the initial December 2020 guidance, CMS advised states to develop and document a comprehensive plan for eligibility…
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Child Uninsured Rate Declined During the Pandemic Thanks to Medicaid
New data from the American Community Survey (ACS) released today by the U.S. Census Bureau suggests that the continuous coverage provision of the Families First Coronavirus Response Act (which prohibits states from disenrolling anyone involuntarily from Medicaid during the duration of the federal COVID-19 public health emergency), has resulted in the child uninsured rate stabilizing and…
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Unwinding Wednesday #2: Alert to Update Contact Information Most Common Unwinding Information Found on State Medicaid Websites
Last week, we launched our new 50-State Unwinding Tracker, which reflects whether states have posted key information or documents for preparation of the end of the public health emergency and the lifting of the Medicaid continuous coverage protection. In the coming weeks, we plan to lift up additional information that can be gleaned from the…
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Medicaid Managed Care Research: 2022 in Review
As frequent (or even infrequent) readers of Say Ahhh! have heard us say, the world of Medicaid managed care is complex. But because over 70 percent of all Medicaid beneficiaries (and over 80 percent of child beneficiaries) are enrolled in a Managed Care Organization (MCO), those of us who are invested in keeping track of…
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CMS Approves First State for New ARPA Medicaid Mobile Crisis Services Option, Additional States Express Interest
This week, the Centers for Medicare & Medicaid Services announced approval of Oregon’s plan to cover community-based mobile crisis intervention services for individuals experiencing mental health or substance use crises under a new Medicaid state option. As we’ve previously highlighted on Say Ahhh!, the American Rescue Plan Act (ARPA), passed in March 2021, included a…
