HHS Selects 10 States to Participate in Medicaid Behavioral Health Clinic Demonstration

Today, the U.S. Department of Health and Human Services (HHS) announced 10 new states have been selected to participate in the Certified Community Behavioral Health Clinic Medicaid Demonstration – Alabama, Illinois, Indiana, Iowa, Kansas, Maine, New Hampshire, New Mexico, Rhode Island and Vermont. The Certified Community Behavioral Health Clinic (CCBHC) Medicaid Demonstration was created in […]

Strengthened Tool to Address Health-Related Social Needs: The New Medicaid Managed Care Regulation’s “In Lieu of Services” Explained

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 […]

New Rule Seeks to Improve Transparency of State Medicaid Provider Payment Rates

CMS recently finalized two key regulations: “Ensuring Access to Medicaid Services” (Access Rule) and “Medicaid, CHIP Managed Care Access, Finance, and Quality” (Managed Care Rule), aimed at improving access to care in Medicaid across delivery systems (fee-for-service and managed care) and authorities (state plan and waiver services). The rules are long and complex; we’ve summarized […]

Delaware and Tennessee Become First States to Cover Diapers for Young Children in Medicaid through Section 1115 Demonstrations

Last week, CMS announced the approval of section 1115 demonstration project requests from Delaware and Tennessee to provide diapers to young children covered by Medicaid. These approvals mark the first time a state has been authorized to cover diapers for infants in Medicaid regardless of medical necessity due to incontinence issues. Under federal statute, section […]