Medicaid

On December 14, the Center for Medicaid and CHIP Services (CMCS) issued an Informational Bulletin to advise state Medicaid agencies that starting January 1, 2024, Medicare will begin covering and making payments for marriage and family therapists (MFT) and mental health counselors (MHC), and intensive outpatient program (IOP) services provided to dually eligible beneficiaries, or individuals enrolled in Medicare and Medicaid. These provisions were implemented as part of the Calendar Year (CY) 2024 Physician Fee Schedule final rule (Centers for Medicare & Medicaid Services (CMS)-1784-F, “Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2024”)...

The U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Office of Refugee Resettlement have jointly released a report aimed at enhancing the data infrastructure of agencies managing refugees and Medicaid services. This report, funded by the Patient-Centered Outcomes Research Trust Fund, addresses data gaps in understanding the health and well-being of refugees. By linking data from two HHS administrative systems, the Refugee Arrivals Data System (RADS) and the Transformed Medicaid Statistical Information System Analytic Files (TAF), the report provides insights into Medicaid enrollment trends and service utilization among refugees...

KFF released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on February 1. This tracker provides state-level data on Medicaid/CHIP enrollment, unwinding, renewals, and other measures. Please note that while the tool includes national data reported by CMS, it has a lag of several months and may not reflect the most current Medicaid enrollment status.

A recent analysis by KFF explores the unwinding of the pandemic continuous enrollment provision in Medicaid, with a focus on its impact on different racial and ethnic groups. This analysis was based on data from the nine states reporting data that allowed for analysis of disenrollment patterns by race and ethnicity as of September 2023: Arizona, California, Indiana, Minnesota, Oregon, Nevada, Oklahoma, Virginia, and Washington. The analysis found that across these states, the racial and ethnic composition of people losing coverage generally mirrors that of the overall Medicaid population. While available data on Medicaid disenrollments by race/ethnicity suggest people of color are not at greater risk of being disenrolled, the data...

On July 25, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid and CHIP Mental Health (MH) and Substance Use Disorder (SUD) Action Plan Overview and Guide, outlining the agency's strategies for enhancing treatment and support for enrollees with these conditions. Key areas of focus include enhancing coverage and integration to expand access to prevention and treatment services, promoting engagement in care through increased availability of home and community-based services, and extending coverage to non-traditional services and settings. Additionally, the plan aims to improve the quality of care for individuals with MH conditions and SUDs.

On July 25, The Centers for Medicare & Medicaid Services (CMS) released the 2021 data on Medicaid Managed Care enrollments, program characteristics, and data tables. This national data is broken down by program and population, as well as by individual state. The enrollment data provides an accurate snapshot of Medicaid managed care enrollment for a particular year as of July 1st of each year.

On July 13th, CMS published several proposed CY 2024 physician and hospital Medicare payment rules with comments due on September 11, 2023. The proposed rules are: CY 2024 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS 1786-P). CMS proposes updating OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.8%....

The Kaiser Family Foundation (KFF) released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on July 20th. This tracker provides state-level data on Medicaid/CHIP enrollment, unwinding, renewals, and other measures. Please note that while the tool includes national data reported by CMS, it has a lag of several months and may not reflect the most current Medicaid enrollment status.

Justice in Aging has published a fact sheet providing guidance for advocates working with older adults who are dually eligible for Medicare and Medicaid. It emphasizes two important features of the Medicare Part D Low-Income Subsidy (LIS): Medicaid termination does not immediately end LIS enrollment, and LIS eligibility is often more generous than Medicaid and Medicare Savings Program (MSP) eligibility rules. The fact sheet offers practice tips to help advocates ensure that older adults understand their LIS enrollment during the Medicaid unwinding period and their options for continuing their LIS coverage...

On June 15th, MedPAC released its June 2023 “Report to the Congress: Medicare and the Health Care Delivery System”. Each June, as part of its mandate from the Congress, MedPAC reports on issues affecting the Medicare program as well as broader changes in health care delivery and the market for health care services. The report includes ten chapters. Examples of information addressed in the report includes the following: High prices of drugs and biologics covered under Medicare Part B. Due to an increase in Medicare Part B drug spending between 2009 and 2021, the Commission recommends three policies designed to improve Medicare's Part B drug payment system and reduce spending growth for Part B drugs....