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The letter affirms their desire to improve the Medicaid program and the vulnerable people it serves and to ensure the program provides value to taxpayers.

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MACPAC's March report includes analysis on Medicaid DSH and impacts of the ACA on hospitals, as well as recommendations for the future of CHIP.

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According to reports, draft House reconciliation legislation would cut Medicaid disproportionate share hospital payments starting Oct. 1 and impose per-capita caps on Medicaid funding, resulting in devastating losses for essential hospitals.

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Communities rely on essential hospitals for trauma and other lifesaving care, physician training, emergency response, and other vital services. Essential hospitals, in turn, rely on policymakers for support to keep these services available to all. Learn more about this careful balance.

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In a request for information, CMS seeks input on how to improve the quality and reduce the cost of care for children enrolled in Medicaid and CHIP.

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The House plan to repeal and replace the Affordable Care Act would rescind Medicaid disproportionate share hospital cuts and impose per-capita caps on Medicaid funding.

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On February 16, a policy brief by House Republicans on how they would repeal and replace the Affordable Care Act (ACA) was leaked in Washington. Learn more about what was included.

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Jan. 18 rule finalizes additional restrictions proposed in November 2016 on the ability of states to increase or add new pass-through payments under Medicaid managed care plan contracts.

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In this webinar we looked back at the 2016 advocacy landscape, discussed the progress we have made on key issues affecting essential hospitals, reviewed our interaction with the Trump transition team, and looked forward to 2017. Webinar Recording

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The proposed rule would codify additional restrictions, first outlined in July 2016, on the ability of states to increase or add new pass-through payments under plan contracts.

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The notice contains state-specific FMAPs, used to determine the amount of federal matching funds for state Medicaid programs; and enhanced FMAPs, used to calculate federal funding for the Children’s Health Insurance Program.

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The FAQ provides clarification on managed care contracts, rating periods, and external quality reviews, among other things.

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These long-term HCBS services and supports are critical to ensure people can remain in their homes and communities as they receive treatment.

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The letter was signed by America's Essential Hospital and 20 other national organizations.

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The guide gives states information they need to develop actuarial rate certifications, such as benefit cost projections, pass-through payments, and risk mitigation strategies.

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The notice contains state-specific, final FY 2014 disproportionate share hospital allotments, without reductions that would have been imposed under the ACA.

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A new policy brief by America's Essential Hospitals notes that managed care pathways might be a potential complement to waiver-based delivery system reform.

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Without Medicaid DSH payments, our members would have suffered a 6.21 percent loss in 2014. Congress should postpone DSH cuts until at least FY 2020.

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A per-capita cap would allow the federal government to limit Medicaid spending by allocating a specific amount of funding based on states' enrollees.

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The webinar will introduce AHRQ's updated hospital guide for delivering transitional care to reduce readmissions among adult Medicaid patients.

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The rule would codify the interpretation that the calculation be based on uncompensated care costs for Medicaid beneficiaries not covered by another source.

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As essential hospitals leaders, we all need to stay on top of the evolving landscape for Medicaid Section 1115 waivers. Medicaid waivers offer a key opportunity to make health care delivery more effective and efficient – and to reduce our uncompensated care burden. Consider our experience in Texas. Over the life of the Texas Health

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CMS will issue future rulemaking to further restrict new or increased pass-through payments under Medicaid managed care plan contracts.

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The new CMS rate development guide outlines various provisions of the recent Medicaid managed care final rule that affect the rate-setting process.

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Failure to follow the public notice and process for Medicaid payment changes can result in delay or disapproval of state plan amendments.

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Georgetown University and Kaiser Family Foundation studies suggest Medicaid expansion might be key to improving financial outcomes for essential hospitals.

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The updates aim to reduce incidence of infections, inappropriate use of antibiotics, and discriminatory behavior by health care providers.

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A review of 61 studies found that expansion under the ACA has improved health coverage, access to care, and economic outcomes.

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A CMS bulletin reminds states that Medicaid funds can be used for prevention, diagnosis, and treatment of the Zika virus.

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The complimentary webinar series will focus on key provisions of the April 25 final rule for selected topics.

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CMS stands by its decision to prohibit states from directing payments under managed care, but responds to association concerns by adding flexibility to the policy.

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The rule maintains a prohibition against direct payments by states to providers for services delivered under managed care contracts and explicitly prohibits states from directing plan expenditures.

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Aggregate data collected by the association will help inform advocacy on disproportionate share hospital payments and other funding support.

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Sarah Mutinsky will be covering the rules and challenges of financing non-federal Medicaid payments.

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States now have until Oct. 1 to submit plans. Agency continues to omit hospital services from the list of core services subject to review.

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Regulation provides more robust mental health, substance use care options for those in Medicaid alternative benefit plans, CHIP, and Medicaid managed care.

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House Committee on Energy and Commerce approves legislation that would cut provider taxes, repeal enhanced FMAP for prisoners and CHIP, and end ACA Prevention and Public Health Fund.

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Proposed Medicaid managed care regulations effectively would end supplemental payments that have been in effect for at least a generation to many essential hospitals.

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Changes allow IHS and tribal facilities to enter into care coordination agreements with non-IHS/tribal providers to furnish certain services for AI/AN Medicaid beneficiaries.

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Budget plan would improve Medicaid access and coverage and tackle drug pricing, but make damaging Medicare cuts; lawmakers examine Medicaid housing coverage, FMAP, 21st Century Cures, mental health.

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Agency collaborates with CMS to offer technical assistance to hospitals working on quality improvement projects for children in Medicaid and the Children’s Health Insurance Program.

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America's Essential Hospitals urges CMS to include hospital services among those subject to triennial state reviews to determine whether payments ensure adequate access.

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New members include six who will serve three-year terms and one who will serve the remaining two years of a vacant seat; GW health policy expert Sara Rosenbaum was named chair.

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Guidance builds on 2012 final regulations that outline the process for submission and review of section 1332 waivers, which may begin as early as Jan. 1, 2017.

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National HIV/AIDS Strategy Federal Action Plan directs HHS to issue best practices for hospitals to ensure access to services for patients with HIV.

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Letter from Senate Finance Committee leaders asks America's Essential Hospitals, other stakeholders, for comment on Medicaid transparency, quality, accountability

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Fourth cycle of grants through the Connecting Kids to Coverage program supports work to link eligible children with Medicaid, CHIP coverage; proposals due Jan. 20, 2016.

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Senate plans to expand House reconciliation bill with full ACA repeal; Rep. Brady named Ways and Means chair; Republicans establish Medicaid task force.

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Member leaders attend more than 100 meetings with lawmakers and congressional staff as part of fall Policy Assembly. Event also included insights from policymakers and a Capitol Hill reception honoring 2015 Gage Award recipients.

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Rule for Medicaid FFS omits hospitals from the list of services for which a state must evaluate access. Comments on rule due Jan. 4.

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Changes for hospitals participating in Medicare and Medicaid intended to improve patient communication, outcomes; comments due Jan. 4.

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Federal grants to 24 states will promote better integration of behavioral health and primary care services and improve quality and data reporting systems.

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The briefing included experts serving different Medicaid populations who spoke about strengthening the program and the Medicaid expansion

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Rates must be certified by an actuary, appropriate for the population and services, and developed along generally accepted actuarial practices

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Nearly 200 sign Partnership for Medicaid letter to the president and Congress praising Medicaid on its 50th anniversary

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Articles focus on innovative waivers that support states in transforming delivery systems, also Medicaid coverage for mental health care

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Articles cover Medicaid expansion, shortfalls and community benefit funds, and the impact of recent Supreme Court decisions on Medicaid

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Comments urge CMS for flexibility, the allowance of certain direct payments, and regulations that reflect states' ability to achieve policy goals

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States may apply for a Section 1115 Medicaid waiver to support innovative care delivery for substance abuse disorder

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Proposed renewals must be for demonstrations that are working effectively and have no major or complex policy changes

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Member panel will exchange information, advise association on recent CMS proposal to restrict states' ability to direct supplemental payments; please express interest by July 17.

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Research shows how Medicaid coverage improves health and health care outcomes, and saves money.

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This survey focuses on the first quarter of calendar year 2015. We will use aggregate information only.

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This survey remains especially important in light of recent media coverage that has suggested the need for essential hospitals and the funding to support them may no longer be necessary

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As more and more states turn to Medicaid managed care, these types of data can help us fully understand how beneficiaries are being served

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CBO also found that a full ACA repeal would increase the federal deficit by $137 billion between 2016 and 2025

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Report to Congress touts potential of DSRIPs to transform reimbursement and improve health outcomes, addresses challenges and calls for clearer federal guidance

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Comments to CMS support expansion of coverage parity to Medicaid alternative benefit plans, CHIP, and Medicare MCOs for dual eligibles

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Los Angeles County Department of Health Services is using county health funds to house and care for the homeless. California wants to with Medicaid funds.

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Proposed rule would better align regulations with those for commercial, health insurance marketplace, and Medicare Advantage plans

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Recommendations include the establishment of specific criteria for approval and documentation of how programs will address the health of low-income populations

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GAO found that CMS lacks adequate data to conduct provider-level oversight of Medicaid payments to ensure payments are used for Medicaid patients in an economical and efficient manner

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The study found that 5 percent of Medicaid-only enrollees consistently accounted for almost half of the total expenditures

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Learn more about how states are negotiating alternative Medicaid expansions.

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Recommendations include finalization of equal access rule, targeted supplemental funding, and continuation of DSRIPs

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America's Essential Hospitals is conducting this member survey to capture the impact of the ACA coverage expansion on essential hospitals

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CMS proposes to extend an enhanced matching rate to states to help modernize and update their Medicaid eligibility and enrollment systems

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America's Essential Hospitals President and CEO, other Partnership for Medicaid co-chairs, call partnership proposal the answer to lack of comprehensive, standardized reporting framework

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Beneficiaries of Medicaid alternative benefit plans, CHIP, and Medicaid managed care organizations would stand to benefit

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The survey focuses on uncompensated care and utilization during the last two quarters of CYs 2013 and 2014

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The Supreme Court released its 5-4 decision in Armstrong v. Exceptional Child.

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Today, the U.S. Supreme Court released its opinion on Armstrong v. Exceptional Child, where the court ruled Medicaid providers cannot sue states for low payment rates and what they should do instead

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Report includes potential impact if CHIP was to expire, Section 1115 waivers used to expand Medicaid coverage, and other aspects of Medicaid payment policy

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America's Essential Hospitals reviews Republican plan, which would join two Democratic bills now under consideration

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There is particular interest in mechanisms for greater comprehensiveness in care delivery, care for complex patients, care coordination, and value-driven reimbursement

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Community Health Systems (CHS) and three of its affiliated New Mexico hospitals have settled the federal False Claims Act (FCA) case, United States ex rel. Baker v. Community Health Systems Professional Services Corporation, et al. Per the settlement, CHS and the three hospitals agreed to pay the federal government $75 million. The case was initiated by a

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Justices weigh arguments for allowing providers to sue states over low payment rates - and I was there

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New association policy brief describes how proposed cuts to Medicare, Medicaid funding threaten essential hospitals

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A district court has granted a preliminary injunction restricting HHS and CMS from altering the hospital-specific DSH limit without following notice-and-comment procedures

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The six new members will serve three-year appointments, effective Jan. 1

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America’s Essential Hospitals pressed for four-year CHIP funding extension and marketplace health plan evaluation

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Agency reverts to position recommended by America's Essential Hospitals to define uninsured status at the service level for purposes of calculating DSH payments; sets Dec. 31 as start of new policy

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The pre-2008 definition includes whether a patient is covered for a particular service, among other changes

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The survey aims to capture the impact of ACA coverage expansion and timely information on members' uncompensated care

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States report increased access to care due to payment bump

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modification of the direct pay prohibition to allow states to pursue public policy goals while implementing Medicaid Managed Care

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What impact has section 1202 of the Affordable Care Act, also know as the primary care bump, had on your hospital?

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OIG finds state access to care standards for Medicaid managed care beneficiaries vary widely, recommends stronger CMS oversight

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America's Essential Hospitals asks CMS to finalize a 2011 proposed rule on equal access, addressing the link between provider reimbursement and access

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Plans include evaluating potential data sources, estimating state-level DSH allocations, and consulting with stakeholders

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Members of our policy team discuss our recently released brief on innovative payment models, focused on ways to replace or augment existing models.

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Explore Medicaid alternative payment models, which states have increasingly used to improve health care quality and lower costs.

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GAO found that HHS did not ensure budget neutrality when approving Arkansas' Medicaid expansion waiver

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Pennsylvania expands Medicaid through a private option, includes premiums

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America's Essential Hospitals sends support letter to House for proposed CHIP extension bill.

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The definition would be used for determining Medicaid DSH costs

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It is difficult to find creative ways to describe the thoughtlessness of states’ decisions to opt out of Medicaid expansion under the Affordable Care Act. Here is one involving a stats website and baseball.

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Interactive toolkit and guide aim to address unique characteristics that drive readmissions for Medicaid patients

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Models should use evidence-based social and behavioral insights to increase patient engagement, comments due Sept. 15.

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Resources include a review of Medicaid beneficiaries' ED use, state approaches to payment rates and supplemental payments, and four examples of Medicaid payment and delivery system reform

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Report says funding approaches lack adequate oversight; CMS counters with review of existing safeguards and effect of economic downturn.

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Guidance could subject certain assessments on Medicaid managed care organizations to provider tax rules

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Action, engagement, and the human story of often technical or financial issues is key to driving education and awareness - learn how Medicaid expansion became personal.

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The program is designed to support states as they develop and transition to innovative care and payment models

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GAO found that private payers reimburse at higher rates for office visits, hospital care, and emergency care

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GAO report notes, until data are more comparable, quantifying the impact of factors that drive cost is not possible

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MAP released draft report on the Medicaid adult core set quality measures and is accepting comments until July 30.

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Thirteen states received letters stating that enrollment and eligibility issues must be addressed.

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KFF Study: Medicaid spending per enrollee grew slower than medical care inflation, national health expenditures per capita, and growth in private health insurance per enrollee

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Fact sheets cover the basics of Medicaid and CHIP benefits, enrollment eligibility, and enrollment processes

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Report also describes opportunities missed by non-Medicaid expansion states

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GAO analysis on Medicaid managed care payments and oversight processes

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Association released a policy brief on Medicaid waiver incentive programs

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Funding will expire in FY 2016. Sen. Rockefeller’s bill would extend funding for four years

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Congress should ensure Medicaid pays at least Medicare rates for primary care until at least 2016

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Results will identify measures of health care access, barriers to care, and satisfaction with providers, among others

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Recent study found planned reductions in Medicaid DSH payments and ongoing inflation in health care costs will cause debilitating gaps in funding for essential hospitals

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CMS will not approve state plan amendments that rely on non-bona fide provider-related donations.

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CBO said states will incur $46 billion, about one-third less than CBO's February prediction.

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In an April 28 letter, the Partnership for Medicaid urged Congress to protect otherwise expiring CHIP funding.

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It provides information to help states prepare for the end of the transition period established in 2008.

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In a major victory for essential hospitals, a House committee late last night posted physician payment legislation that includes an additional year delay in Medicaid disproportionate share hospital (DSH) cuts and requires an annual DSH report sought by America’s Essential Hospitals. The changes come in a House Rules Committee bill to extend the current patch

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Included are model agreements between the state and hospitals, a model training template, and FAQs.

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The proposal calls for a common, mandatory set of Medicaid quality measures to be reported by all states

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MACPAC believes this will foster reporting standardization, transparency, and data analysis

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The notice contains state-specific FY 2014 DSH allotments - without the ACA-mandated reductions.

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The OIG and HHS FY 2014 work plan includes several Medicare and Medicaid projects.

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An overview of existing delivery system reform incentive pools and similar models

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The CARE Act would repeal the Affordable Care Act and replace it with market-based reforms.

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In FAQs, CMS clarified that hospitals “may implement presumptive eligibility with the support of third party contractors”

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Penalties will disproportionately fall on hospitals serving a high number of dual eligibles

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ACOs allow hospitals, health care providers to improve quality, slow cost growth through coordinated care while sharing in savings

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Subcommittee considered necessity, effectiveness of temporary extenders

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The report found that all states varied Medicaid provider payment rates for some services

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Brief reviews regulations that update current rules to allow Medicaid hospitals to make presumptive eligibility determinations

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Rule proposes national emergency preparedness requirements for health care facilities

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Budget bill eliminates FY 2014 Medicaid DSH cuts, delays FY 2015 cuts

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House votes to restore some DSH funding. SGR bill directs HHS to monitor DSH need

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MACPAC commissioners voted to increase standardization and transparency around UPL payments.

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States expanding their Medicaid programs saw a 15.5 percent increase in applications

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More than 100 hospital and health system leaders signed on to the letter

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Eligibility notices, benefits in alternative benefit plans, appeals process among rule's provisions

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Section 1115 projects give states additional authority to design, improve Medicaid and CHIP programs

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The Affordable Care Act expanded the RAC program to Medicaid

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Measures are intended for voluntary use by state Medicaid agencies

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Rule implements proposed provisions in the Affordable Care Act

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Proposed rule clarifies costs, payments associated with programs are not federally reimbursable under Medicaid

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Clarifies the Outpatient Clinic and Hospital Facility Services definition, Upper Payment Limit.

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Rule proposes standardized, transparent process for assured access to Medicaid services in states

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This rule clarifies several provisions related to the cost limit for public providers

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The final rule implements the Affordable Care Act's primary care payment bump

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The rule outlines reporting and cost parameters for states and individual hospitals

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Government shutdown prevented DC from making payments to Medicaid providers, managed care organizations

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Held nearly 100 meetings, educated Congress about work to ensure patient access to high quality care

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Proposed rule establishes framework for several program elements

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Siegel, Gremminger highlighted the importance of delaying, reconsidering scheduled Medicaid DSH cuts

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Rule implements the Affordable Care Act's Medicaid DSH cuts for fiscal years 2014 and 2015

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Rule outlines CMS' methodology for annual reductions to DSH payments

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Bill would halt subsidies until applicant coverage requirements, household income can be verified

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Event Oct. 1 and 2 to conclude with full-day of Capitol Hill visits

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Registration open for America’s Essential Hospitals’ Fall Legislative Event, Oct. 1 to 2

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Programs will replace payment error rate measurement reviews, eligibility quality control program

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Starting in 2014, hospitals may make Medicaid eligibility determinations with just a few basic pieces of information

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Tool uses 2011 Medicare cost data aggregated by demographic, spending, utilization, quality indicators

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Analysis from the Kaiser Family Foundation Commission on Medicaid and the Uninsured found that 6.4 million people will miss out on insurance coverage if the 21 states not intending to expand their Medicaid program and the six undecided states do not implement the Medicaid expansion.

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Health Affairs article questions availability of certain services to existing Medicaid enrollees

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Urges CMS to incentivize states to target DSH at hospitals with high levels of uncompensated care and Medicaid patients

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House Energy and Commerce health subcommittee hearing intended to identify weaknesses, possible reforms

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Part of ACA, Children’s Health Insurance Reauthorization Act money for enrollment, renewal outreach

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Rule states mandate for Medicaid coverage in 10 categories of essential health benefits

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Will support demonstration ombudsman programs to provide Medicare-Medicaid enrollees with more person-centered, coordinated care

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States that opt out could lose $8.4 billion in federal funding, Health Affairs study finds

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Calculation will determine reduction to each state's DSH allotment for FYs 2014 and 2015

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Rule proposes implementation of the Affordable Care Act's Medicaid DSH cuts

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Plan outlines options for states to adopt delivery system reforms

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Includes important changes to Medicaid and Medicare of interest to association members

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Agency also releases FAQ on state-supplied premium assistance option

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Letter to state Medicaid directors details federal-state efforts to strengthen program integrity

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Document addresses questions about federal medical assistance percentages

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President and CEO Bruce Siegel moderated sessions on Medicaid, delivery innovations

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Rule continues agency's 2012 efforts to reform hospital conditions of participation

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Administration official announced that the president would not include Medicaid cuts in 2014 budget

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Report concludes that slowing Medicaid enrollment in 2012 reflected economic recovery

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Legislation did not cut Medicaid provider taxes, Medicare E&M, but targeted hospitals in other ways

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Senate passed legislation by a vote of 89-9, sent for vote in the House of Representatives

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

America’s Essential Hospitals was formerly known as the National Association of Public Hospitals and Health Systems (NAPH). Carrying our mission since 1981 into today's health care era

Learn more about the name change »