Syrtis Solutions distributes a monthly Medicaid news summary to help you stay up-to-date. The monthly roundup focuses on developments, research, and legislation that relates to Medicaid program integrity, cost avoidance, coordination of benefits, improper payments, fraud, waste, and abuse. Below is a summary of last month’s noteworthy Medicaid news.

Enrollment in the Oregon Health Plan just keeps growing. The number of Oregonians in the taxpayer-funded system topped 1.28 million as of late March, up more than 200,000 since the start of the COVID-19 pandemic a year ago, PDF icon the newest numbers show. For the time being, the federal government, under emergency legislation, is sending enough extra Medicaid money Oregon’s way to cover the added cost of those new members, the state says. But for the coming state biennium, starting July 1, the flow of federal cash may not be sufficient to cover the added burden.  read more


Arkansas Democrat-Gazette, March 24
A retooling of Arkansas’ private-option Medicaid expansion program was sent by a committee to the House floor Tuesday, setting the legislation up for a potential final vote as early as next week. Senate Bill 410, dubbed the “Arkansas Health and Opportunity for Me Act,” proposes to scrap the work requirement established by Gov. Asa Hutchinson and lawmakers in 2017, and replace it with a new system that incentivizes work and education with access to government-subsidized private health plans.  read more


If the Supreme Court ultimately decides to hear the dispute over work requirements for Medicaid beneficiaries, the Biden administration wants a ruling that gives the government broad authority to test new policies for the program in the future. The court should clarify in any ruling on the merits that the Health and Human Services Secretary can allow states to try out new measures—like alternative ways to deliver care—that indirectly advance Medicaid’s main goal of providing low-income people health insurance, the Justice Department said in a brief Monday.  read more


Democrats’ nearly $2 trillion coronavirus relief package includes a big financial incentive for the states that have opted against expanding Medicaid to provide health coverage for more low-income Americans. It’s proving to be a tough sell. The Associated Press surveyed top Republican elected officials in the dozen states that have resisted expanding coverage under a key provision of former President Barack Obama’s heath care law.  read more


Fierce Healthcare, March 15
Medicaid, the federal and state program that provides health coverage to low-income and elderly adults, children, pregnant women and people with disabilities, is countercyclical by nature. During an economic downturn, reliance on the safety net rises, driving increased spending at times when state and federal budgets are stretched thin. We saw this over a decade ago when the 2007–2009 financial crisis drove more than 10 million additional people to enroll in Medicaid, according to the Center on Budget and Policy Priorities.  read more


Congress passed a $1.9 trillion relief package to support the nation’s coronavirus pandemic response efforts and the law could have particular significance for Medicaid and CHIP programs. The bill passed in the Senate by a vote of 50 to 49. While it still resembled the American Rescue Plan put forth by the Biden administration to expand COBRA and Affordable Care Act marketplace subsidies, the bill sustained several changes in the Senate, American Hospital Association reported in a special bulletin on the policy.  read more


Bass, Berry & Sims attorney Angela Humphreys—Chair of the Healthcare Practice and Co-Chair of the Healthcare Private Equity Team—sat down virtually with Paul Keckley—a healthcare policy analyst, industry expert and Managing Editor of The Keckley Report —to discuss the anticipated healthcare policy changes under the Biden administration and what impact these changes could have on the healthcare industry. 


KFF, March 8
During the coronavirus pandemic, Medicaid has played a key role in providing coverage to millions of people who have lost their jobs or their health coverage. In addition, provisions included in the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Security (CARES) Act require states to maintain eligibility standards and provide continuous enrollment in Medicaid until the end of the public health emergency (PHE) in order to qualify for enhanced federal Medicaid funding.  read more


To the editors: The debate to move Oklahoma to a Medicaid managed care system is complex. It requires all decision makers to focus only on facts in order for the citizens of Oklahoma to be well informed when the Oklahoma Legislature determines where to allocate funds for the approximately 200,000 new Medicaid recipients that will be added to the system this fall because of Medicaid expansion. As the executive director of an Oklahoma nonprofit organization that supports Oklahomans with disabilities, I believe a managed care model is the best choice. read more


Every session since the U.S. Supreme Court’s landmark ruling in NFIB v. Sebelius that the federal government could not require states to expand their respective Medicaid programs, Texas has passed on expanding its own. The expansion would increase both the number of people eligible under the government insurance program and the federal government’s share of financing. Rep. Lyle Larson (R-San Antonio) has picked up that baton this session, arguing for Medicaid expansion in the San Antonio Express-News.  read more


Kansas Medicaid expansion was dealt another setback Wednesday in its first formal debate this year, as lawmakers signaled that the proposal, long a Democratic priority, was unlikely to go anywhere this session. Senate Minority Leader Dinah Sykes, a Lenexa Democrat, introduced expansion as an amendment to a bill that sought to create a certification and funding process for community mental health clinics. It also authorized out-of-state physicians to treat Kansans via telemedicine.  read more


Mark Farrah Associates, March 3
With the impact of Medicaid Expansion coupled with a lackluster economy, Medicaid and Children’s Health Insurance Program (CHIP) membership grew rapidly from 2014 until peaking at 75 million members in January 2017. Medicaid and CHIP membership began to retreat in 2017 due to improving economic conditions, dropping to 71 million by the end of 2019. The COVID-19 pandemic severely impacted the economy in 2020, swiftly reversing the enrollment declines experienced between 2017 and 2019.  read more


Former U.S. Supreme Court Justice Louis Brandeis popularized the phrase “laboratories of democracy” to describe how a “state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.” Within the federalist framework, state and local governments have some degree of autonomy to act as social “laboratories,” where policies can be created and tested at the state or local level.  read more


Highmark Inc. has finalized an affiliation agreement with Buffalo, New York-based HealthNow New York Inc., the parent company of BlueCross BlueShield of Western New York and BlueShield of Northeastern New York, giving the Downtown-based health insurer about one million new members and opportunity to expand its third-party benefits administration business. The newly affiliated organization will be rebranded Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York.  read more