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Medicaid Section 1115

The state’s waiver initially was approved in May, but required a second approval to extend beyond Dec. 31.

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Medicaid Section 1115

The U.S. District Court for the District of Columbia vacated the previous approval, saying the administration failed to adequately assess the waiver's impact on Medicaid’s core objective: to provide health care coverage for beneficiaries.

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Medicaid Section 1115

A new demonstration opportunity, which can be carried out through Section 1115 waivers, would allow states to receive reimbursement for services at institutions for mental disease for individuals with serious mental illness or serious emotional disturbance.

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Medicaid Section 1115

Wisconsin is the fifth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

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Medicaid Section 1115

The expansion is expected to give up to 400,000 additional Virginians access to the program; the Centers for Medicare & Medicaid Services has not announced a decision on the state's Section 1115 waiver, which includes work requirements.

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Medicaid Section 1115

Several presentations at VITAL2018 focused on a foundational issue for essential hospitals—finance and payment policy—and provided member insights on topics such as Section 1115 Medicaid waivers, state policy trends in the 340B Drug Pricing Program, and digitizing the revenue cycle.

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Medicaid Section 1115

Learn more about the Essential Hospitals Value-Based Care Collaborative and hear how Premier helped NewYork-Presbyterian Queens in the 1115 DSRIP Waiver program to bring additional value to the community.

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Medicaid Section 1115

The letter marks the first time the Centers for Medicare & Medicaid Services has clearly described its budget neutrality calculation and represents its attempts to streamline the waiver process and control costs.

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Medicaid Section 1115

Hear about the state of Medicaid waivers under the Trump administration, and look ahead at the future of waiver innovations.

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Medicaid Section 1115

What comes next after the June 29 court ruling that vacated the U.S. Department of Health and Human Services approval of a Section 1115 waiver that allowed Kentucky to impose community engagement and work requirements on Medicaid beneficiaries.

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Medicaid Section 1115

The decision strikes down the state's overall Section 1115 waiver, which included community engagement and work requirements, but it upholds as a separate waiver a portion allowing Medicaid reimbursement for substance use disorder treatment in institutions for mental disease.

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Medicaid Section 1115

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

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Medicaid Section 1115

New Hampshire is the fourth state to receive approval to incorporate work and community engagement requirements as a condition of Medicaid eligibility.

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Medicaid Section 1115

Reports by the National Academy of State Health Policy and the Medicaid and CHIP Payment and Access Commission point to new trends, including increased focus on reform, new financing mechanisms, and standardized evaluation.

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Medicaid Section 1115

A new policy brief examines Centers for Medicare & Medicaid Services guidance on work and community engagement requirements for Medicaid eligibility and outlines recently approved section 1115 waivers in Kentucky, Indiana, and Arkansas.

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Medicaid Section 1115

The three-pronged approach aims to reduce drug demand, cut off the flow of illicit drugs domestically and internationally, and expand opportunities for proven addiction treatments.

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Medicaid Section 1115

Under the approved waiver, Arkansas Medicaid beneficiaries ages 19 to 49 beginning June 1 must work or participate in community engagement activities for 80 hours per month to maintain their eligibility.

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Medicaid Section 1115

The Centers for Medicare & Medicaid Services announced the community engagement initiative, often referred to as work requirements, in a Jan. 11 letter and a frequently asked questions document.

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Medicaid Section 1115

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.

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Medicaid Section 1115

In response to the request for information, the association encouraged flexibility and a focus on hospitals treating high numbers of complex patients.

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Medicaid Section 1115

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

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Medicaid Section 1115

CMS announced a new streamlined process to encourage state innovation through demonstrations and approved new demonstrations for New Jersey and Utah.

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Medicaid Section 1115

The five-year demonstration project, beginning Jan. 1, 2018, aims to strengthen substance use disorder care for state Medicaid beneficiaries.

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Medicaid Section 1115

Explore Whole Person Care, a pilot initiative through California’s Section 1115 Medicaid waiver that works to improve care for people with complex issues by tackling medical, behavioral, and socioeconomic needs.

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Medicaid Section 1115

The decision extends by five years the state's demonstration of a capitated Medicaid managed care program and a low-income pool to provide support for the safety net.

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Medicaid Section 1115

A publicly released set of slides describes dramatic restrictions to CMS' budget neutrality policy for Section 1115 waivers.

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Medicaid Section 1115

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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Medicaid Section 1115

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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Medicaid Section 1115

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

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Medicaid Section 1115

Articles focus on innovative waivers that support states in transforming delivery systems to improve access and quality of care. Another focus is Medicaid coverage in areas of crucial need, such as mental health care.

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Medicaid Section 1115

States may apply for a Section 1115 Medicaid waiver to support innovative care delivery for substance abuse disorder. SAMHSA, HRSA to also offer funding opportunities.

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Medicaid Section 1115

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.

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Medicaid Section 1115

MACPAC's report to Congress touts potential of DSRIP programs to transform Medicaid reimbursement and improve health outcomes, also addresses the challenge and calls for clear and consistent federal guidance.

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Medicaid Section 1115

Calls for HHS to establish specific criteria for approval, document how programs will address the health of low-income populations, and ensure federal funding is not duplicated.

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Medicaid Section 1115

In an April 28 letter, the association urged CMS to adopt a holistic view of how payment mechanisms impact essential hospitals, including sustainable base payment rates, Medicaid waivers to address uncompensated care, and DSRIP waivers.

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Medicaid Section 1115

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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Medicaid Section 1115

Essential hospitals face barriers in providing care to immigrant populations. They must find unique ways to address the complexity surrounding immigration status for their patients.

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Medicaid Section 1115

The third in a series of waiver-related briefs, this research brief summarizes perspectives from hospital leaders in Massachusetts, California, and Texas.

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Medicaid Section 1115

GAO found that HHS did not ensure budget neutrality when approving Arkansas' Medicaid expansion waiver. Issues include lack of data to corroborate state assumptions and state flexibility to expand spending limits.

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Medicaid Section 1115
Medicaid Section 1115

America’s Essential Hospitals released a policy brief that discusses approaches to extending the reach of health care transformation through Medicaid waiver incentive programs.

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Medicaid Section 1115

CMS will not approve SPAs that include non-bona fide donations as a portion, or all, of the non-federal share of Medicaid payments. Payment methodologies contingent upon the receipt of a non-bona fide donation would also be grounds for disapproval of an SPA.

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Medicaid Section 1115

Learn how delivery system transformation initiatives helped BMC improve quality

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Medicaid Section 1115

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

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Medicaid Section 1115
Medicaid Section 1115

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

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Medicaid Section 1115
Medicaid Section 1115
Medicaid Section 1115