Medicaid Retroactive Eligibility: A Dying Policy?
A growing number of states are ending or limiting retroactive eligibility for Medicaid: the practice of Medicaid reimbursing providers for the care they deliver to Medicaid-eligible patients for up to three months even if those patients had not previously enrolled [...]
Administration Moving Away From Value Pay?
First, new Medicare programs for lump-sums payments for cardiac care and joint replacements were scaled back. Then, additional doctors were exempted from a new payment system that would have paid them more for the results they produce than for the [...]
GAO Urges Medicare Action on Opioids
The Centers for Medicare & Medicaid Services is not doing enough to oversee the prescribing of opioids to Medicare beneficiaries. Or so concludes the U.S. Government Accountability Office. According to the GAO, CMS provides guidance to Medicare drug plans “…but [...]
Hospitals Improving on Medicare Value-Based Measures
U.S. hospitals continue to improve their performance under Medicare’s value-based purchasing program. In FY 2018, 57 percent of hospitals will receive Medicare bonuses from the program, up from 55 percent in FY 2017. Bonuses are generally small but for some [...]
CMS Shares Vision for Medicaid
Medicaid is about to undergo major changes, CMS administrator Seema Verma outlined in a news release yesterday and in a speech to state Medicaid directors. According to the news release, those changes include: re-establishing a state-federal partnership that Verma believes [...]
CMS Offers States New Medicaid Path for Opioid Treatment
The Centers for Medicare & Medicaid Services (CMS) has issued new guidance to states advising them on how they can use section 1115 Medicaid waivers to improve access to treatment for Medicaid recipients struggling with opioid abuse problems. According to [...]
NAUH Asks House to Renew CHIP and Delay Medicaid DSH Cuts
In a message sent to every member of the House of Representatives, NAUH conveyed its support for key provisions in HR 3922, the Championing Healthy Kids Act. Those provisions include renewal of the Children’s Health Insurance Program (CHIP) and a [...]
CMS Announces Drive to Reduce Paperwork
The Centers for Medicare & Medicaid Services is launching a new “Meaningful Measures” initiative that will seek to reduce the regulatory burden on health care providers. According to a CMS news release, Meaningful Measures …will involve only assessing those core [...]
New Rules Facilitate Integration of Physical, Behavioral Care
New federal regulations are facilitating better integration of physical and behavioral health services for the Medicaid population. Two developments, in particular, are advancing this integration: the 2016 Medicare managed care rule and a 2016 rule implementing the Mental Health Parity [...]
AMA: Health Insurance Concentration in Urban Areas Threatens Competition
Too much market share by insurers in urban areas can inhibit competition, and according to the American Medical Association, there is too little competition among insurers in too many urban markets today. According to a new AMA study, 69 percent [...]
