CMS urges states to review their Medicaid renewal processes to ensure eligible individuals are not disenrolled erroneously through ex parte renewals at the household level.

The letters review the state's May 2023 Medicaid unwinding metrics and compliance with federal requirements in three categories.

The toolkit aims to help states increase postpartum care access, quality, and equity by maximizing existing Medicaid authorities.

CMS will release state Medicaid and Children's Health Insurance Program renewal data on a monthly, two-part basis due to data availability. 

CMS outlines three strategies to improve treatment and support for Medicaid and CHIP enrollees with mental health and substance use disorder conditions.

An August webinar series will provide strategies for reaching out to diverse communities to share information about Medicaid and CHIP renewals.

HHS offers flexible options states can adopt to ensure smooth transitions of coverage during the Medicaid redetermination process.

The new group, comprising two divisions from existing groups, will monitor and provide technical assistance to state and territory managed care programs.

The FAQ guide state Medicaid and Children's Health Insurance Program agencies as they begin terminating enrollment for those who no longer qualify.

The proposed rule changes directed payment policy; access standards and monitoring; in lieu of service and setting requirements; medical loss ratio policy and reporting; and quality strategies, improvements, and reviews.

If CMS finalizes the proposed rule, DACA recipients would be eligible to apply for coverage through the health care marketplaces, Basic Health Programs, and some Medicaid and Children’s Health Insurance Programs.

The six new members will review Medicaid and CHIP access and payment policies and make recommendations to Congress, the administration, and states.

Two proposed rules establish access standards and standardize review and assessment of Medicaid payment rates across states; comments are due to CMS July 3.

The rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those losing Medicaid or CHIP coverage.

The rule would allow DACA recipients to be eligible for health care coverage through the Affordable Care Act marketplace, Medicaid, and the Children's Health Insurance Program.

Qualified individuals and their families who lose Medicaid or CHIP eligibility once the continuous enrollment requirement ends can apply for marketplace coverage between March 31, 2023, and July 31, 2024.

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

The report summarizes responses to a 2022 request for information, which focus on eligibility and enrollment, access to hospital services, and payment.

The proposed rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those disenrolled from Medicaid or CHIP.

The association urges CMS to educate and provide funding for essential hospital staff to conduct Medicaid and CHIP eligibility and enrollment activities.

Currently, 26 states have extended Medicaid and Children's Health Insurance Program coverage from 60 days to 12 months postpartum.

An Aug. 31 CMS proposed rule aims to streamline Medicaid and CHIP enrollment and ensure continuous coverage throughout the renewal process.

The webpage includes renewal instructions for eligible beneficiaries and guidance for ineligible beneficiaries to secure insurance through the marketplaces.

The association made recommendations on payment rates, workforce development, eligibility and enrollment policies, and measuring access to hospital services.

Through a request for information, the Centers for Medicare & Medicaid Services hopes to better understand enrollees' barriers to coverage and access to care to inform future policies and regulatory actions. A 60-day public comment period began Feb. 17.

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.

CMS released guidance to help states maintain Medicaid and Children's Health Insurance Program coverage as they return to normal operations when the COVID-19 public health emergency ends. Many strategies in the documents require support from outside organizations that work with beneficiaries.

CMS will require states to cover COVID-19 treatment with no cost-sharing for Medicaid and Children's Health Insurance Program beneficiaries. Further, states in some circumstances must cover treatments for conditions that might seriously complicate the treatment of COVID-19.

A bulletin from the Center for Medicaid and CHIP Services notes the withdrawal of the 2019 public charge rule and addresses states' role in safeguarding applicant and beneficiary information. The public charge rule was vacated and is no longer in effect, retroactive to March 2, 2021.

In a recent letter to state health officials, CMS outlines opportunities for states to better address social determinants of health. The letter outlines flexibility under current law and includes examples from states already engaging in such initiatives.

A new notice encourages states to improve health outcomes, reduce disparities, and lower costs within Medicaid and the Children's Health Insurance Program. It describes how states might address social determinants of health using flexibility available under current law.

The next phase of the Maternal and Infant Health Initiative (MIHI) includes a new focus on postpartum care visits, well-child visits, and decreasing rates of cesarean-section births in low-risk pregnancies. A work group developed a set of recommendations and a report on next steps for the MIHI.

The Medicaid and Children's Health Insurance Plan managed care final rule includes provisions to help reach Medicaid goals, increase network adequacy for managed care plans, and align quality rating approaches.

The Centers for Medicare & Medicaid Services added 11 new telehealth services to the list of Medicare services reimbursable during the COVID-19 public health emergency. The agency also published resources on Medicaid and Children’s Health Insurance Program coverage of telehealth services.

The Department of Health and Human Services June 9 announced additional, targeted allocations from the Provider Relief Fund for hospitals filling a safety-net role and sole Medicaid and Children’s Health Insurance Program providers.

CMS released new COVID-19 FAQs for state Medicaid and CHIP agencies, providing additional guidance on Medicaid provisions in the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. 

The frequently asked questions document provides guidance on how states can leverage Medicaid flexibilities in response to the novel coronavirus. Key issues for essential hospitals are detailed in our latest Action Update.

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.

This year’s update contains new quality and accountability measures and new national context data.

The move aims to give researchers a better understanding of key Medicaid and Children's Health Insurance Program information, including on utilization and spending under Medicaid managed care.

The guidance follows a May 23 presidential memorandum calling for increased enforcement of laws related to individuals sponsoring immigration applicants.

In a letter to the Office of Management and Budget, America’s Essential Hospitals expressed concern that changes to the consumer inflation index would negatively impact vulnerable populations’ access to Medicaid coverage.

The new chair is Melanie Bella, head of partnerships and policy at Cityblock Health and former founding director of the Centers for Medicare & Medicaid Services' Medicare-Medicaid Coordination Office. The Government Accountability Office also appointed a new vice chair and two new members.

America's Essential Hospitals praised the administration’s efforts to streamline managed care regulations for Medicaid and the Children's Health Insurance Program, reduce regulatory burden, and increase state flexibility.

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. We encourage all members to review the proposed rule, give us feedback, and submit your own comments to CMS.

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.

The Centers for Medicare & Medicaid Services is waiving program requirements and suspending enforcement activities in Florida and Georgia.

Bills to repeal the medical device tax and expand health savings accounts go to a House floor vote; a House committee advanced legislation that would fund the Hospital Preparedness Program at about $265 billion annually.

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.

This year's Medicaid and CHIP Payment and Access Commission report focuses on the high cost of prescription drugs and the opioid epidemic.

The first Medicaid and Children’s Health Insurance Program scorecard is intended to increase public transparency and accountability in the two programs.

The budget plan for fiscal years 2018 and 2019 proposes changes to the distribution of 340B Drug Pricing Program savings and increased funding to fight the opioid crisis.

The measure, which updates a continuing resolution set to expire on Feb. 8, delays cuts to Medicaid disproportionate share hospital payments for fiscal years 2018 and 2019.

The measure passed by Congress and signed by President Trump Monday funds the government through Feb. 8 and extends the Children's Health Insurance Program six years, but leaves unresolved a delay of Medicaid disproportionate share hospital cuts.

The Senate needs 60 votes to avoid a filibuster and pass the continuing resolution. There are only 51 Republicans in the Senate, and several have said they won’t vote for the bill in its current form.

As Congress focuses on Jan. 19 funding deadline, America's Essential Hospitals continues pressure to delay Medicaid disproportionate share hospital cuts. The Trump administration releases guidance on work requirements for Medicaid recipients.

Congress returns from recess to focus on long-term solutions after passing a short-term bill to fund the government through Jan. 19; lawmakers push for delay of 340B Drug Pricing Program cuts.

The waiver extensions fund Texas' uncompensated care pool and delivery system reform incentive payment program and provide family planning services for low-income individuals in Mississippi for 10 years.

The final tax deal includes the repeal of the Affordable Care Act's individual mandate, Advance Refunding Bonds and Private Activity Bonds.

Republican leaders hope to introduce the final tax reform bill early next week; a bill to stop cuts to the 340B Drug Pricing Program has 130 cosponsors.

The House passed the Tax Cuts and Jobs Act; the Senate version of the tax reform bill includes a repeal of the Affordable Care Act's individual mandate.

Final regulations for Medicare physician payments will increase merit-based payments to account for complex patients, allow physicians to participate in virtual groups, adjust the threshold for defining low-volume practices, and make numerous other changes.

In a speech to the National Association of Medicaid Directors, Administrator Verma also announced an initiative to create scorecards for Medicaid and CHIP outcomes.

The bill delays disproportionate share hospital payment cuts for two years; House Republicans consider repealing the individual mandate through tax reform.

The CHAMPIONING HEALTHY KIDS Act extends Children's Health Insurance Program funding for five years and delays cuts to Medicaid disproportionate share hospital payments for two years.

A bipartisan Senate bill would fund cost-sharing reduction payments; Congress has yet to renew funding for the Children's Health Insurance Program.

The Centers for Medicare & Medicaid Services' frequently asked questions document clarifies aspects of the Mental Health and Substance Use Disorder Parity final rule for Medicaid and the Children’s Health Insurance Program.

Senate and House bills to fund the Children's Health Insurance Program are similar, but the House version includes a one-year delay of Medicaid disproportionate share hospital cuts.

The federal fiscal year came to a close Sept. 30, ending a nearly yearlong congressional effort to repeal and replace the Affordable Care Act and bringing tax reform efforts and other health care priorities to the forefront in Congress.

The bill would replace Medicaid expansion funding and private insurance subsidies with $1.2 trillion in block grants to states; the Congressional Budget Office is expected to release a score early next week.

Congress aims to pass legislation by Sept. 30 to stabilize the Affordable Care Act (ACA) insurance markets and reauthorize several health care programs; three senators plan to unveil new ACA repeal legislation.

Lawmakers return from the August recess to consider legislation and policy related to the Children’s Health Insurance Program, market stabilization, and cost-sharing reductions.

Senate committees will focus on market stabilization legislation and Children’s Health Insurance Program (CHIP) reauthorization; the association seeks to attach to the CHIP bill a delay of Medicaid disproportionate share hospital payment cuts.

Penny Thompson, principal at Penny Thompson Consulting and former deputy director of CMS' Center for Medicaid and CHIP Services, was named MACPAC chair.

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.

MACPAC's recommendation is part of a larger package of suggestions meant to improve coverage for children in low- and moderate-income families.

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.

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

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.

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

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.

Conservative Freedom Caucus opposes GOP budget plan; Senate-passed bill would combat opioid abuse; health committees work on mental health, Medicare improvement.

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.

Out-of-pocket expenses higher in ACA marketplaces and coverage worse for children, especially those with special needs, HHS reports.

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.

Open enrollment for ACA marketplaces will last from Nov. 1, 2015, to Jan. 31, 2016, with coverage taking effect as soon as Jan. 1. Previously announced HHS enrollment goals include improving consumer experience, retaining and adding customers.

Proposed renewals must be for demonstrations that are working effectively and have no major or complex policy changes. Certain waivers that use the enhanced FMAP are ineligible.

The association submitted comments to CMS supporting expansion of coverage parity to Medicaid alternative benefit plans, CHIP, and Medicare MCOs for dual eligibles. Association urged CMS to ensure equity of service across states, actuarially sound payment rates.

Beneficiaries of Medicaid alternative benefit plans, CHIP, and Medicaid managed care organizations would stand to benefit from more robust mental health and substance use care options.

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

Plus, more than 3.3 million people who submitted marketplace applications are eligible for Medicaid or CHIP.

Congress must past spending legislation before Dec. 11, governors request CHIP funding extension, Cassidy defeats Landrieu.

Congress works to finalize several measures, including an omnibus spending package to extend federal funding. The House Committee on Energy and Commerce will review CHIP.

Congress meets this week to extend federal funding through Dec. 11. Other legislative considerations include medical device tax, VA authorities, and the Emergency Medical Services for Children Program. Committees will address CHIP, Ebola, and the ACA.