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policy

Medicaid and CHIP coverage of interprofessional consultation is permissible as long as the consultation is for the beneficiary's direct benefit.

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policy

Each awardee will receive up to $1.5 million for a three-year period to reduce the number of uninsured children by advancing Medicaid and Children's Health Insurance Program enrollment and retention. Grant applications are due March 28.

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policy

President Joe Biden last week announced a $1.75 trillion framework for "human infrastructure" reconciliation legislation; the House subsequently released updated legislative text for its human infrastructure bill that aims to close the Medicaid coverage gap.

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policy

The waiver makes Illinois the first state to provide continuity of full Medicaid benefit coverage for mothers by extending eligibility during the entire first year after delivery.

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policy

In an annual report to Congress, the Medicaid and CHIP Payment and Access Commission finds an increase from 2018 to 2019 in the number of uninsured and in charity care and bad debt. The report includes state-specific projections of the Medicaid disproportionate share hospital allotment.

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policy

In its first letter to President-elect Joseph Biden and his transition team, America's Essential Hospitals noted a desire to work together to stabilize the nation's health care safety net and described several administrative policy priorities and paths of partnership.

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state-action

A Kaiser Family Foundation annual survey finds states expect to see Medicaid enrollment spike more than 8 percent in fiscal year 2021 due to the COVID-19 public health crisis.

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state-action

As the country works to expand COVID-19 through testing, every state has submitted a testing strategy to the federal government. Most state plans prioritize vulnerable populations and offer testing for uninsured individuals.

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policy

In a letter to state Medicaid directors, CMS outlines lessons learned from previous initiatives, offers a comprehensive toolkit and examples of value-based care models, and highlights changes to existing flexibility.

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policy

The proposed rule, issued by CMS, aims to advance Medicaid prescription drug value-based purchasing arrangements between states and manufacturers, set standards to promote safe opioid prescribing, and amend regulations related to the Medicaid drug rebate program.

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state-action

The report, requested by Republican representatives, details challenges states face in administering Medicaid programs, including with coverage exclusions and care coordination, coverage benefits and eligibility, and Medicare and Medicaid alignment.

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state-action

Several states, including Missouri and Oklahoma, will vote this year on whether to expand Medicaid. However, the topic of expansion will remain unaddressed in several states this year; for example, plans to include expansion on the 2020 ballot in Florida now have been pushed to 2022.

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policy

In a letter, America's Essential Hospitals urged the agency to reopen the comment period for the Medicaid Fiscal Accountability Regulation to allow stakeholders to address the proposed rule's impact, as the COVID-19 pandemic has fundamentally altered the health care and economic landscapes.

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state-action

Virginia and Washington have paused proposals to extend Medicaid postpartum coverage for low-income women, due to budget constraints resulting from the pandemic. States are engaged in contact tracing to curb the spread of COVID-19, and 24 states enacted budgetary measures related to the emergency.

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state-action

In addition to efforts targeting surprise medical bills, governors are asking the administration to allow Medicaid retainer payments during the COVID-19 pandemic. Meanwhile, the administration has approved Section 1135 waivers for 47 states, the District of Columbia, and the U.S. Virgin Islands.

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policy

In its March report to Congress, the Medicaid and CHIP Payment and Access Commission included chapters analyzing Medicaid disproportionate share hospital payments, state readiness to report on core quality measure sets, and Section 1115 waiver evaluations.

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policy

In a new Modern Healthcare commentary, association President and CEO Bruce Siegel explains that the proposed Medicaid Fiscal Accountability Regulation would do more to shrink Medicaid than to contribute to program integrity and transparency.

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policy

Administrator Verma writes that provisions of the Medicaid Fiscal Accountability Regulation are meant to ensure transparent and lawful use of taxpayer resources to fund Medicaid. She contends that nothing in the proposal is meant to reduce Medicaid funding or prohibit supplemental payments.

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policy

CMS issued guidance outlining how states can receive a block grant or per-capita cap in exchange for additional administrative flexibility. Through a Section 1115 demonstration waiver, these new financing arrangements would apply to coverage of optional Medicaid patient populations.

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policy

In its submitted comments, the association outlines overarching and specific problems that necessitate withdrawal of the rule to protect the stability and viability of the Medicaid program.

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policy

America's Essential Hospitals encourages members to share their concerns about the Medicaid Fiscal Accountability Regulation with Congress and CMS. Meanwhile, the House returns to health care business after a one-week recess, and the Senate impeachment trial continues.

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policy

CMS issued a request for information seeking input on coordinating care from out-of-state providers for medically complex children who are eligible for Medicaid coverage. The agency will use the information collected to produce guidance to state Medicaid directors.

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policy

The statutorily required report reviews rules and oversight for institutions for mental disease in seven states. Meanwhile, CMS announced it will integrate the psychiatric hospital program survey into its larger survey to determine compliance with Medicare conditions of participation.

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policy

America's Essential Hospitals warns the Centers for Medicare & Medicaid Services that its proposal will weaken federal oversight of Medicaid payment rates and undermine beneficiary access to care.

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policy

The final rule revises the criteria that determines whether an individual seeking to enter the country or become a lawful permanent resident could become a public charge.

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policy

To facilitate multi-payer alignment for ambulance services, the Center for Medicare and Medicaid Innovation will provide an interactive learning system with targeted learning opportunities for state Medicaid programs.

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policy

Two informational bulletins outline information on services for infants via residential pediatric recovery centers and a limited exception to the institutions for mental disease exclusion for pregnant and postpartum women with substance use disorder.

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state-action

The Centers for Medicare & Medicaid Services has refreshed data for the Medicaid and Children’s Health Insurance Program Scorecard, which reflects states’ progress in strengthening their reporting of patient health outcomes.

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state-action

The expansion, which takes effect in 2020, applies to low-income residents ages 19 to 25, regardless of immigration status. The state estimates more than 100,000 undocumented young adults will be eligible for the expanded coverage.

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policy

The agency proposes to rescind the requirement due to states' concerns regarding undue administrative burden.

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state-action

A Commonwealth Fund report reviews 36 state Medicaid quality strategies for advancing primary care, a key factor in achieving a high-performing health system.

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policy

In a new request for information, the agency seeks ideas for innovative programs and waiver concepts states could consider in developing Section 1332 waivers. The request follows October 2018 guidance aimed at increasing state flexibility.

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policy

The legislation allows states to establish Medicaid health homes to coordinate complex care for children and provides $20 million in additional funding for the "Money Follows the Person" demonstration program, among other provisions.

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policy

As the partial government shutdown continues, the House this week will consider the Pandemic and All-Hazards Preparedness and Advancing Innovations Act and a bill to extend funding for the "Money Follows the Person" demonstration program.

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policy

House and Senate Democratic leaders vowed to pursue legislation to intervene after a judge ruled the Affordable Care Act unconstitutional; negotiations continue on a spending package to fund portions of the federal government before current funding expires on Dec. 21.

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policy

The proposed rule reflects the agency’s broader strategy to relieve regulatory burden, support state flexibility, and promote transparency and innovation in the delivery of care.

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Essential Insights

Government Relations Academy alumnae Elisa Hernández and Amy Carta share their experiences in the program and the value of applying new advocacy tools.

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policy

CMS approved Oklahoma's proposal to advance Medicaid value-based arrangements with drugmakers in negotiating supplemental rebate agreements; The agency rejected Massachusetts' request to institute a closed formulary for Medicaid outpatient prescription drugs.

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policy

A change brought by passage of the 21st Century Cures Act will ensure coverage for early and periodic screening, diagnostic, and treatment services for children under age 21 receiving inpatient psychiatric hospital services.

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policy

In this new policy brief, America's Essential Hospitals examines Section 1115 waivers that use a market-based approach to expanding Medicaid.

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policy

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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policy

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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policy

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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policy

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

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policy

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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policy

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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Essential Insights

As we mark 50 years of Medicaid and Medicare, we reflect on the experiences of others within and beyond the four walls of essential hospitals.

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Essential Insights

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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policy

Topics include Medicare Advantage, the ACA's medical device tax, Medicaid fraud and abuse, and the Medicare appeals process.

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policy

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

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policy

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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Essential Insights

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

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policy

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

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policy

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

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policy

Congress considers Veteran Affairs, Medicare, and immigration bills as August recess nears; House holds hearing on state Medicaid funding.

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webinar

Government relations staff will share their experiences with Medicaid expansion, including challenges and best practices

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policy

Association develops entitlement reform principles to guide possible future discussions around changes to the Medicare and Medicaid programs.

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