Feds Seek to Regulate Narrow Networks
Amid concerns that low-cost health plans are reducing their provider networks to contain costs at the expense of access to care for their members, the Centers for Medicare & Medicaid Services (CMS) is proposing new guidelines to limit how much [...]
OIG Reveals 2016 Plans
The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) has published its work plan for the 2016 fiscal year. In 2016, the OIG will continue to examine all aspects of HHS endeavor, including Medicare, Medicaid, [...]
Feds OK Medicaid Money for Housing
The Obama administration has informed state Medicaid programs that they may use federal Medicaid money to help the chronically homeless obtain housing. While a June bulletin to state Medicaid directors technically only clarified existing policy, it signaled states that the [...]
Study Looks at Social Determinants of Health
A new issue brief from the Kaiser Family Foundation looks at the social determinants of health and health outcomes. The issue brief “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity” reports that Social determinants [...]
Study: Medicaid Denying Expensive Hepatitis C Drugs
A new study has found that state Medicaid programs are rejecting nearly 50 percent of requests to administer expensive hepatitis C drugs to patients. According to a review of prescription data for Delaware, Maryland, New Jersey, and Pennsylvania, 46 percent [...]
House Committee Forms New Medicaid Task Force
The House Energy & Commerce Committee has created a new task force “to strengthen and sustain the critical program for the nation’s most vulnerable citizens.” According to a committee news release, the task force “…will examine the program to determine [...]
CMS Requires States to Monitor Medicaid Access
A new federal regulation requires states to monitor access to Medicaid services. According to a new regulation issued by the Centers for Medicare & Medicaid Services (CMS), states must submit to CMS plans for monitoring Medicaid beneficiary access to care [...]
GAO: More Information Needed About Supplemental Medicaid Payments
More data is needed about the supplemental Medicaid payments states make to hospitals and how those payments are financed, according to a new report from the U.S. Government Accountability Office (GAO). According to the GAO, states are increasingly funding non-disproportionate [...]
MedPAC Meets
Last week the members of the Medicare Payment Advisory Commission (MedPAC) met in Washington, D.C. to talk about how Medicare pays for a variety of services needed by the nation’s 50 million Medicare beneficiaries. Among the issues addressed by MedPAC [...]
Serving Patients With Complex Needs
Patients with complex medical needs account for a significant proportion of overall health care spending, and many efforts in recent years, including some mandated by the Affordable Care Act, have sought to identify the best ways to serve such patients [...]
