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.
view more »Medicaid and CHIP coverage of interprofessional consultation is permissible as long as the consultation is for the beneficiary's direct benefit.
view more »CMS Report on Access to Coverage and Care in Medicaid and CHIP
Jan. 3, 2023 ||The report summarizes responses to a 2022 request for information, which focus on eligibility and enrollment, access to hospital services, and payment.
view more »CMS Proposes 2024 Notice of Benefit and Payment Parameters
Dec. 21, 2022 ||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.
view more »Statement on Omnibus Agreement
Dec. 20, 2022 ||We thank congressional negotiators for supporting essential hospitals and their communities by agreeing to shore up the health care workforce, expand access to mental health and substance use disorder services, and extend flexibility for alternative care settings.
view more »Association Comments on Proposed Updates to Medicaid Eligibility, Enrollment Policies
Nov. 8, 2022 ||The association urges CMS to educate and provide funding for essential hospital staff to conduct Medicaid and CHIP eligibility and enrollment activities.
view more »Currently, 26 states have extended Medicaid and Children's Health Insurance Program coverage from 60 days to 12 months postpartum.
view more »Proposed Rule Streamlines Medicaid, CHIP Enrollment
Sept. 1, 2022 ||An Aug. 31 CMS proposed rule aims to streamline Medicaid and CHIP enrollment and ensure continuous coverage throughout the renewal process.
view more »CMS Launches New Medicaid, CHIP Renewal Webpage
May 24, 2022 ||The webpage includes renewal instructions for eligible beneficiaries and guidance for ineligible beneficiaries to secure insurance through the marketplaces.
view more »Association Comments on Medicaid Access
April 19, 2022 ||The association made recommendations on payment rates, workforce development, eligibility and enrollment policies, and measuring access to hospital services.
view more »CMS Seeks Information on Medicaid, CHIP Access to Care and Coverage
Feb. 18, 2022 ||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.
view more »CMS to Award $49M to Increase CHIP, Medicaid Enrollment
Jan. 31, 2022 ||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.
view more »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.
view more »Medicaid Required to Cover COVID-19 Treatment
Oct. 25, 2021 ||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.
view more »Administration Advises States on Change to Public Charge Rule
July 27, 2021 ||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.
view more »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.
view more »CMS Encourages States to Address Social Determinants
Jan. 15, 2021 ||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.
view more »CMS Launches Next Phase of Maternal, Infant Health Initiative
Jan. 5, 2021 ||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.
view more »CMS Releases Final Medicaid Managed Care Regulation
Nov. 17, 2020 ||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.
view more »CMS Expands List of Reimbursable Telehealth Services
Oct. 20, 2020 ||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.
view more »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.
view more »CMS Releases Additional COVID-19 Medicaid FAQs
April 20, 2020 ||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.
view more »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.
view more »MACPAC Issues Annual DSH Analysis
March 16, 2020 ||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.
view more »COVID-19 State Funding; Medicaid and CHIP Resources
March 16, 2020 ||The Centers for Disease Control and Prevention will use existing networks to award more than $560 million to states, localities, territories, and tribes to accelerate planning and operational readiness. The agency has issued a list of funding actions and a frequently asked questions document.
view more »CMS Updates Medicaid and CHIP Scorecard
Nov. 8, 2019 ||This year’s update contains new quality and accountability measures and new national context data.
view more »CMS Increases Public Access to Medicaid, CHIP Data
Nov. 8, 2019 ||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.
view more »States Restrategize to Enroll Children in Medicaid, CHIP
Aug. 27, 2019 ||For the first time since 2007, the number of children enrolled in Medicaid and the Children’s Health Insurance Program declined in 2018.
view more »CMS Issues Guidance on Enforcement of Immigrant Benefit Rules
Aug. 26, 2019 ||The guidance follows a May 23 presidential memorandum calling for increased enforcement of laws related to individuals sponsoring immigration applicants.
view more »Association Comments on Consumer Inflation Measure Updates
June 14, 2019 ||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.
view more »GAO Appoints New MACPAC Leaders, Commissioners
May 21, 2019 ||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.
view more »Association Comments on Medicaid Managed Care Proposed Rule
Jan. 15, 2019 ||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.
view more »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.
view more »CMS Proposes to Streamline Medicaid Managed Care Regulations
Nov. 13, 2018 ||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.
view more »CMS Responds to Hurricane Michael Public Health Emergency
Oct. 15, 2018 ||The Centers for Medicare & Medicaid Services is waiving program requirements and suspending enforcement activities in Florida and Georgia.
view more »On the Hill: House to Vote on Health Care Tax Measures
July 24, 2018 ||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.
view more »CMS Outlines Expanded Access for Children in Psychiatric Care
June 28, 2018 ||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.
view more »MACPAC Releases June Report to Congress
June 25, 2018 ||This year's Medicaid and CHIP Payment and Access Commission report focuses on the high cost of prescription drugs and the opioid epidemic.
view more »CMS Releases New Medicaid and CHIP Scorecard
June 4, 2018 ||The first Medicaid and Children’s Health Insurance Program scorecard is intended to increase public transparency and accountability in the two programs.
view more »On the Hill: Administration Releases FY 2019 Budget Plan
Feb. 13, 2018 ||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.
view more »On the Hill: Medicaid DSH Cut Delay in Latest Funding Bill
Feb. 5, 2018 ||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.
view more »The groups called for swift action on seven programs and policies lawmakers left out of a Jan. 19 continuing resolution that funds the government through Feb. 8 and that extended the Children’s Health Insurance Program by six years.
view more »On the Hill: Federal Shutdown Ends, CHIP Extended
Jan. 23, 2018 ||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.
view more »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.
view more »On the Hill: Funding Deadline, Medicaid Work Requirements
Jan. 16, 2018 ||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.
view more »On the Hill: Working to Stop 340B, Medicaid DSH Cuts
Jan. 3, 2018 ||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.
view more »CMS Approves Waiver Extensions for Texas, Mississippi
Jan. 2, 2018 ||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.
view more »On the Hill: Congress To Vote on Tax Bill, Continuing Resolution
Dec. 19, 2017 ||The final tax deal includes the repeal of the Affordable Care Act's individual mandate, Advance Refunding Bonds and Private Activity Bonds.
view more »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.
view more »On the Hill: Senate Tax Bill Would Repeal Individual Mandate
Nov. 21, 2017 ||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.
view more »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.
view more »CMS to Streamline Medicaid Demonstration, Waiver Policies
Nov. 14, 2017 ||In a speech to the National Association of Medicaid Directors, Administrator Verma also announced an initiative to create scorecards for Medicaid and CHIP outcomes.
view more »On the Hill: House Passes Bill Funding CHIP, Delaying DSH Cuts
Nov. 7, 2017 ||The bill delays disproportionate share hospital payment cuts for two years; House Republicans consider repealing the individual mandate through tax reform.
view more »The vote moves us a step closer to protecting funding for hospitals that care for uninsured and underinsured patients and to preserving access to care for our nation’s children. America's Essential Hospitals now calls on the Senate to act in bipartisan fashion to do the same.
view more »On the Hill: House Bill Funds CHIP, Delays DSH Cuts
Oct. 31, 2017 ||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.
view more »A bipartisan Senate bill would fund cost-sharing reduction payments; Congress has yet to renew funding for the Children's Health Insurance Program.
view more »FAQs Clarify Effect of Parity Rule on Medicaid, CHIP
Oct. 16, 2017 ||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.
view more »On the Hill: Congress Works to Fund CHIP
Oct. 10, 2017 ||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.
view more »Statement on Energy and Commerce Mark-Up of the HEALTHY KIDS Act
Oct. 3, 2017 ||America’s Essential Hospitals applauds the HEALTHY KIDS Act for extending the Children’s Health Insurance Program but remains concerned the bill's disproportionate share hospital provision will make it harder to find a sustainable solution to uncompensated care.
view more »On the Hill: Congress Shifts Focus with New Fiscal Year
Oct. 3, 2017 ||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.
view more »On the Hill: Senate Considers New ACA Repeal Bill
Sept. 19, 2017 ||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.
view more »On the Hill: ACA Marketplace Stabilization, 340B Inquiry
Sept. 12, 2017 ||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.
view more »On the Hill: Congress Considers Health Program Reauthorizations
Sept. 5, 2017 ||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.
view more »On the Hill: Senate Prepares Fall Health Care Agenda
Aug. 7, 2017 ||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.
view more »GAO Appoints New MACPAC Chair, Commissioners
May 9, 2017 ||Penny Thompson, principal at Penny Thompson Consulting and former deputy director of CMS' Center for Medicaid and CHIP Services, was named MACPAC chair.
view more »MACPAC Releases Annual DSH Report
March 16, 2017 ||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.
view more »MACPAC Recommends 5-Year CHIP Extension, Discusses Medicaid DSH
Dec. 20, 2016 ||MACPAC's recommendation is part of a larger package of suggestions meant to improve coverage for children in low- and moderate-income families.
view more »HHS Announces FY 2018 Federal Medical Assistance Percentages
Nov. 22, 2016 ||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.
view more »CMS Issues FAQ on Medicaid Managed Care Final Rule
Nov. 15, 2016 ||The FAQ provides clarification on managed care contracts, rating periods, and external quality reviews, among other things.
view more »CMS Issues Final Rule for Medicaid Managed Care
April 27, 2016 ||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.
view more »Mental Health Coverage Parity for Medicaid, CHIP Now Final
March 30, 2016 ||Regulation provides more robust mental health, substance use care options for those in Medicaid alternative benefit plans, CHIP, and Medicaid managed care.
view more »Bill to Cut Medicaid, CHIP, Prevention and Public Health Fund Advances
March 16, 2016 ||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.
view more »On the Hill: GOP Budget Faces Delay, Senate Combats Opioid Abuse
March 15, 2016 ||Conservative Freedom Caucus opposes GOP budget plan; Senate-passed bill would combat opioid abuse; health committees work on mental health, Medicare improvement.
view more »AHRQ Offers Assistance for Child Health Care Projects
Jan. 20, 2016 ||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.
view more »GAO Appoints New MACPAC Commissioners
Dec. 18, 2015 ||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.
view more »HHS Says No Marketplace Qualified Plan Comparable to CHIP
Dec. 9, 2015 ||Out-of-pocket expenses higher in ACA marketplaces and coverage worse for children, especially those with special needs, HHS reports.
view more »$32 Million Available to Help Connect Kids to Coverage
Nov. 17, 2015 ||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.
view more »Marketplaces Now Open for Coverage Enrollment
Nov. 3, 2015 ||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.
view more »CMS Will Fast-Track Certain Section 1115 Waiver Renewals
July 29, 2015 ||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.
view more »Association Supports Parity for Mental Health Services
June 9, 2015 ||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.
view more »CMS Proposes Mental Health Coverage Parity for Medicaid and CHIP
April 7, 2015 ||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.
view more »MACPAC Report to Congress Examines CHIP, Premium Assistance Waivers
March 17, 2015 ||Report includes potential impact if CHIP was to expire, Section 1115 waivers used to expand Medicaid coverage, and other aspects of Medicaid payment policy.
view more »Marketplaces Enroll More Than 11.4 Million in Coverage
Feb. 18, 2015 ||Plus, more than 3.3 million people who submitted marketplace applications are eligible for Medicaid or CHIP.
view more »On the Hill: Omnibus, Immigration, CHIP, Election Results
Dec. 9, 2014 ||Congress must past spending legislation before Dec. 11, governors request CHIP funding extension, Cassidy defeats Landrieu.
view more »On the Hill: Lame Duck Continues, Appropriations, CHIP
Dec. 2, 2014 ||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.
view more »On the Hill: CR, Medical Device Tax, Veteran and Children’s Health
Sept. 16, 2014 ||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.
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