Medicaid

In this Health Affairs blog post, Nancy Archibald, MHA, MBA, CHCS’ Associate Director for Federal Integrated Care Programs, outlines perspectives from state Medicaid officials on the federal policies that have advanced Medicare-Medicaid integration, and areas where they believe additional federal policy actions are needed.

This brief outlines lessons from the Center for Health Care Strategies’ MassHealth Care Planning Learning Collaborative, where Massachusetts Accountable Care Organizations and Community Partners integrated care planning across their organizations to improve care for Medicaid members with complex needs. This brief can inform providers, payers, and community partners in other states seeking to improve care for people with complex health and social needs.

CMS has released a new proposed rule with several provisions related to dual eligible individuals and would impact states. The proposed rule includes provisions to: Limit retroactive Medicare Part B premium liability for states to 36 months, Retire the old stand-alone buy-in agreements and specify that the provisions of a state buy-in agreement shall be set forth in the state’s Medicaid state plan, Extend the Medicare Savings Programs (MSPs) to cover premiums and cost sharing for individuals enrolling in the new Medicare immunosuppressive drug benefit. CMS is currently requesting comments on the proposed rule.

When the federal declaration of a public health emergency (PHE) expires, many of the flexibilities initiated during COVID-19 will need to be rolled back, including changes in Medicaid enrollment and eligibility. ACL has developed a fact sheet to help grantees prepare for these changes ahead and continue to support older adults and people with disabilities who currently rely on Medicaid Coverage.

The COVID-19 pandemic has forced many providers to transition to telehealth when it became the only way patients could access health services. Medicaid agencies now have an opportunity to support phone-based telemedicine in primary care beyond the pandemic, and many are already doing so. This blog post explores strategies that Medicaid agencies can use to suport audio-only telehealth moving forward, including extending payment parity for telehealth visits and using value-based payment models.

This brief shares data on state policy choices about Medicaid HCBS, including target populations, functional eligibility criteria, financial eligibility criteria, waiver waiting lists, benefit packages, out-of-pocket costs, use of capitated managed care, self-direction opportunities, covered provider types, electronic visit verification systems, and provider reimbursement rates.

The brief from the KKF shares state-level data on HCBS spending and the number of people receiving Medicaid in FY 2020. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC.

On Thursday, February 24, 2022, CMS released a CMCS Informational Bulletin with the updated 2022 Federal Poverty Level Standards. The 2022 guidelines reflect the 4.7 percent price increase between calendar years 2020 and 2021. After this inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family and household sizes. The informational bulletin also includes a 2022 Dual Eligible Standards chart that displays the new standards for the Medicare Savings Program categories.

On Thursday, February 17, 2022 CMS released a request for information (RFI) regarding access to Medicaid and CHIP Services. The RFI is broad and extends beyond prior CMS access inquiries, which largely focused on eligible beneficiaries ability to receive covered Medicaid services. This RFI includes topics such as how beneficiaries enroll in and maintain access to coverage, access to the actual services, and payment rates.

Many states are directing focus toward achieving racial health equity as a key priority within their Medicaid programs and managed care contracts. This blog post discusses the importance of equitable access to high-quality and comprehensive primary care and the structural and interpersonal racism that creates barriers within health systems. The post explores how states can advance more equitable primary care by building on the patient-centered medical home (PCMH) framework.