06 Apr MARCH MEDICAID NEWS RECAP
Syrtis Solution’s March 2020 Medicaid News Recap: A roundup of Medicaid news, legislation, and industry developments relating to Medicaid integrity, cost avoidance, improper payments, fraud, waste, and abuse.
Medicare And Medicaid Administrator Addresses U.S. Health Care Response To COVID-19 npr, March 31
NPR’s Mary Louise Kelly speaks with Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, about the administration’s ongoing response to the coronavirus outbreak. MARY LOUISE KELLY, HOST: What counts as a hospital bed? We now look to New York City, where emergency hospital beds are multiplying in tents in Central Park, on a hospital ship docked on Manhattan’s West Side and 10 blocks south in the Javits Convention Center, which now houses a thousand beds. read more
NPR’s Mary Louise Kelly speaks with Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, about the administration’s ongoing response to the coronavirus outbreak. MARY LOUISE KELLY, HOST: What counts as a hospital bed? We now look to New York City, where emergency hospital beds are multiplying in tents in Central Park, on a hospital ship docked on Manhattan’s West Side and 10 blocks south in the Javits Convention Center, which now houses a thousand beds. read more
US territories show why Tennessee should reject block grant Medicaid funding | Opinion Tennessean, March 31
Since 1965, the federal and state governments have successfully partnered to provide health care insurance to people with disabilities and to poor Americans who meet eligibility requirements through the Medicaid program. “A wide body of research demonstrates that Medicaid provides critical access to comprehensive, cost-effective care for tens of millions of children and families, seniors, people with disabilities, and other adults,” says the Center on Budget and Policy Priorities, a nonpartisan research and policy institute that analyzes federal budget priorities. read more
Since 1965, the federal and state governments have successfully partnered to provide health care insurance to people with disabilities and to poor Americans who meet eligibility requirements through the Medicaid program. “A wide body of research demonstrates that Medicaid provides critical access to comprehensive, cost-effective care for tens of millions of children and families, seniors, people with disabilities, and other adults,” says the Center on Budget and Policy Priorities, a nonpartisan research and policy institute that analyzes federal budget priorities. read more
Syrtis Solutions Blog, March 30
After COVID-19 was declared a national emergency on March 13th, the Centers for Medicare and Medicaid Services (CMS) was able to waive stipulations in federally funded programs to help States respond to the pandemic. To date, CMS has approved Medicaid Section 1135 Waivers for 23 States that grant them the authority to suspend pre-admission screening for nursing facilities. read more
After COVID-19 was declared a national emergency on March 13th, the Centers for Medicare and Medicaid Services (CMS) was able to waive stipulations in federally funded programs to help States respond to the pandemic. To date, CMS has approved Medicaid Section 1135 Waivers for 23 States that grant them the authority to suspend pre-admission screening for nursing facilities. read more
Caller Times, March 30
Since the passage of the Affordable Care Act, Gov. Greg Abbott and the Texas Legislature have rejected Medicaid expansion even though Texas has the highest rate of uninsured residents in the nation. With the spread of COVID-19 and the threat of health care systems being overwhelmed by this pandemic, the governor should call a special session of the Legislature to expand Medicaid. Medicaid expansion has been an overwhelmingly successful program.
Since the passage of the Affordable Care Act, Gov. Greg Abbott and the Texas Legislature have rejected Medicaid expansion even though Texas has the highest rate of uninsured residents in the nation. With the spread of COVID-19 and the threat of health care systems being overwhelmed by this pandemic, the governor should call a special session of the Legislature to expand Medicaid. Medicaid expansion has been an overwhelmingly successful program.
KFVS12, March 28
Governor JB Pritzker announced the “Care Comes First” action plan. It is a series of efforts led by the Illinois Department of Healthcare and Family Services to expand medical coverage for residents across the state. “My team is doing everything in our power to make sure all of our residents can access the health care they need in these trying times,” said Governor JB Pritzker. “That is why we’ve applied for waivers with the federal government to expand Medicaid availability during this period.” read more
Governor JB Pritzker announced the “Care Comes First” action plan. It is a series of efforts led by the Illinois Department of Healthcare and Family Services to expand medical coverage for residents across the state. “My team is doing everything in our power to make sure all of our residents can access the health care they need in these trying times,” said Governor JB Pritzker. “That is why we’ve applied for waivers with the federal government to expand Medicaid availability during this period.” read more
Managed Healthcare Executive, March 27
With reports of large spikes in unemployment, economists believe a global recession is unavoidable amidst the Coronavirus crisis. Since the health insurance of many Americans is tied to their employment, the U.S. is likely to also see large increases in uninsured people with newly lower incomes, according to a report by the Urban Insitute. However, states in the U.S. have expanded Medicade eligibility under the Affordable Care Act (ACA). read more
With reports of large spikes in unemployment, economists believe a global recession is unavoidable amidst the Coronavirus crisis. Since the health insurance of many Americans is tied to their employment, the U.S. is likely to also see large increases in uninsured people with newly lower incomes, according to a report by the Urban Insitute. However, states in the U.S. have expanded Medicade eligibility under the Affordable Care Act (ACA). read more
KFF, March 26
As the COVID-19 pandemic expands, needs for health insurance coverage through Medicaid and CHIP will increase for people who get sick and who lose private coverage due to the declining economy. Increasing enrollment for the 6.7 million uninsured individuals who are eligible for Medicaid and facilitating enrollment for the growing numbers of individuals who will become eligible for Medicaid as they lose jobs and incomes decrease will help expand access to care for COVID-19-related needs and health care needs and more broadly. read more
As the COVID-19 pandemic expands, needs for health insurance coverage through Medicaid and CHIP will increase for people who get sick and who lose private coverage due to the declining economy. Increasing enrollment for the 6.7 million uninsured individuals who are eligible for Medicaid and facilitating enrollment for the growing numbers of individuals who will become eligible for Medicaid as they lose jobs and incomes decrease will help expand access to care for COVID-19-related needs and health care needs and more broadly. read more
Texas cancels controversial Medicaid contracts after complaints of subjective scoring The Texas Tribune, March 25
Texas health officials announced Wednesday that they are starting over on a years long process to pick health insurance companies to operate a $10 billion portion of the state’s privatized Medicaid program. More than half a dozen health insurers had protested the Texas Health and Human Services Commission’s awarding of contracts in Medicaid’s STAR+PLUS program on the grounds that the scoring process was arbitrary and inconsistent. The health commission, with recently appointed acting Executive Commissioner Phil Wilson now in charge, appears to agree. read more
Texas health officials announced Wednesday that they are starting over on a years long process to pick health insurance companies to operate a $10 billion portion of the state’s privatized Medicaid program. More than half a dozen health insurers had protested the Texas Health and Human Services Commission’s awarding of contracts in Medicaid’s STAR+PLUS program on the grounds that the scoring process was arbitrary and inconsistent. The health commission, with recently appointed acting Executive Commissioner Phil Wilson now in charge, appears to agree. read more
KFF, March 17
As a source of coverage for 1 in 5 Americans, Medicaid can play a key role in connecting individuals to testing and treatment for COVID-19. Through Medicaid, states can provide enrollees access to comprehensive benefits with limited out-of-pocket cost and receive federal funding with no pre-set limit to support coverage. States have options available under existing rules to expand access to coverage and facilitate enrollment in coverage for eligible individuals. read more
As a source of coverage for 1 in 5 Americans, Medicaid can play a key role in connecting individuals to testing and treatment for COVID-19. Through Medicaid, states can provide enrollees access to comprehensive benefits with limited out-of-pocket cost and receive federal funding with no pre-set limit to support coverage. States have options available under existing rules to expand access to coverage and facilitate enrollment in coverage for eligible individuals. read more
Health Payer Intelligence, March 17
Medicaid expansion is key to securing national access to care for the new coronavirus and the federal government can and should support state programs for increasing COVID-19 coverage, Samantha Artiga and Robin Rudowitz wrote in a recent Kaiser Family Foundation brief. States can expand coronavirus care in three main ways: States can expand coronavirus care in three main ways: Broaden eligibility, Ensure that eligible residents are enrolled or do enroll in Medicaid, Submit additional waivers to CMS seeking greater flexibility in coverage and care access. read more
Medicaid expansion is key to securing national access to care for the new coronavirus and the federal government can and should support state programs for increasing COVID-19 coverage, Samantha Artiga and Robin Rudowitz wrote in a recent Kaiser Family Foundation brief. States can expand coronavirus care in three main ways: States can expand coronavirus care in three main ways: Broaden eligibility, Ensure that eligible residents are enrolled or do enroll in Medicaid, Submit additional waivers to CMS seeking greater flexibility in coverage and care access. read more
Health Payer Intelligence, March 16
On March 13, the Trump Administration declared the spreading coronavirus (COVID-19) a national emergency. CMS immediately followed with various resources, including a factsheet from March 5 about COVID-19 Medicaid and CHIP coverage and benefits, as well as clear support for states considering Medicaid expansion or further expansion. “The spread of COVID-19 within our Nation’s communities threatens to strain our Nation’s healthcare systems,” the president’s proclamation read. read more
On March 13, the Trump Administration declared the spreading coronavirus (COVID-19) a national emergency. CMS immediately followed with various resources, including a factsheet from March 5 about COVID-19 Medicaid and CHIP coverage and benefits, as well as clear support for states considering Medicaid expansion or further expansion. “The spread of COVID-19 within our Nation’s communities threatens to strain our Nation’s healthcare systems,” the president’s proclamation read. read more
Syrtis Solutions Blog, March 11
Back in September, Michigan proposed policy 1936-Pharmacy to carve-out the State’s Managed Medicaid outpatient pharmacy drug coverage and transition to a Fee-for-Service (FFS) model. However, plans to carve-out pharmacy benefits have recently been updated. After considering the policy, the State has decided to instead implement a single Medicaid Preferred Drug List (PDL). The single PDL was a recommendation in the Governor’s Executive Budget and works to maximize manufacturer rebates in order to increase savings. read more
Back in September, Michigan proposed policy 1936-Pharmacy to carve-out the State’s Managed Medicaid outpatient pharmacy drug coverage and transition to a Fee-for-Service (FFS) model. However, plans to carve-out pharmacy benefits have recently been updated. After considering the policy, the State has decided to instead implement a single Medicaid Preferred Drug List (PDL). The single PDL was a recommendation in the Governor’s Executive Budget and works to maximize manufacturer rebates in order to increase savings. read more
CalMatters, March 5
The old adage about tiny acorns growing into mighty oak trees is not confined to dendrology. It applies as well to governmental programs and there’s no better example than Medi-Cal, California’s program of health care for the poor. An addendum to the landmark federal legislation creating Medicare coverage for the elderly 55 years ago offered federal subsidies to states for caring for the poor — dubbed Medicaid in most states, but Medi-Cal in California. read more
The old adage about tiny acorns growing into mighty oak trees is not confined to dendrology. It applies as well to governmental programs and there’s no better example than Medi-Cal, California’s program of health care for the poor. An addendum to the landmark federal legislation creating Medicare coverage for the elderly 55 years ago offered federal subsidies to states for caring for the poor — dubbed Medicaid in most states, but Medi-Cal in California. read more