Archive for Medicaid disproportionate share

 

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The October 2020 MACPAC meeting opened with a panel discussion on restarting Medicaid eligibility redeterminations when the public health emergency ends.  It included Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities; René Mollow, deputy director for health care benefits and eligibility at the California Department of Health Care Services; and Lee Guice, director of policy and operations at the Department for Medicaid Services, Kentucky Cabinet for Health and Family Services.

After a break, Commissioners heard a panel discussion with Kevin Prindiville, executive director at Justice in Aging; Mark Miller, executive vice president of healthcare at Arnold Ventures; and Charlene Frizzera, senior advisor at Leavitt Partners, on creating a new program for dually eligible beneficiaries. Later, staff presented preliminary findings from a mandated report on non-emergency medical transportation. The day concluded with a report on nursing facility acuity adjustment methods.

On Friday, the day began with a session on access to mental health services for adults in Medicaid. It was followed by a related panel discussion on

Congress Gives Hospitals Medicaid DSH Relief

Medicaid DSH allocations to states will not be reduced right away thanks to a new continuing resolution to fund the federal government through December 11.

The Medicare disproportionate share allocation cuts to the states, mandated by the Affordable Care Act but delayed by Congress several times, were delayed again earlier this year but scheduled to take effect on November 11.  With the latest continuing resolution, the cuts will be delayed yet another month.

Learn more about the delay of Medicaid DSH cuts and other aspects of the continuing resolution that affect hospitals in the Healthcare Dive article “Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law.”…

Coronavirus Update for Wednesday, September 23

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Wednesday, September 23.

Continuing Resolution to Fund the Federal Government

The House has passed, and the Senate is expected to take up and pass as soon as this week, a continuing resolution to fund the federal government from the beginning of the new fiscal year, on October 1, through December 11; the president is expected to sign the measure.  Key health care provisions in this continuing resolution include:

  • Changes in the Medicare Accelerated and Advance Payment Program that extend the period before repayment begins and the period before the balance must be repaid in full; reduce the recoupment percentage; and lower the interest rates for this and comparable programs.
  • A delay in the Affordable Care Act-mandated reduction of Medicaid disproportionate share (Medicaid DSH) allotments to the states through December 11.
  • Extended funding for Community Health Centers, the National Health Services Corps, and the Teaching Health Centers Graduate Medical Education Program through December 11.
  • Extended funding for the Special Diabetes Program through December 11.
  • Extended authorization for the certified community behavioral health clinics demonstration program through December 11.
  • Clarification that drugs and biologicals used for medication-assisted

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services.

In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy.

In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017.  Learn more from this Medicaid notice and from its accompanying CMS informational bulletin “Treatment of Third Party Payers (TPP) in Calculating Uncompensated Care Costs (UCC).”

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The Medicaid and CHIP Payment and Access Commission kicked off its December meeting with highlights from its forthcoming issue of MACStats: Medicaid and CHIP Data Book, due out December 18, 2019. MACStats brings together statistics on Medicaid and State Children’s Health Insurance Program (CHIP) enrollment and spending, federal matching rates, eligibility levels, and access to care measures, which come from multiple sources.

Later the Commission discussed a proposed rule that the Centers for Medicare & Medicaid Services issued in November, which—among other changes—would increase federal oversight of Medicaid supplemental payments. The final morning session addressed payment error rates in Medicaid, with a briefing on the annual Department of Health and Human Services Agency Financial Report (AFR). Fiscal year 2019 was the first time that the AFR incorporated eligibility errors since the Patient Protection and Affordable Care Act’s Medicaid eligibility and enrollment changes took effect in 2014.

After lunch, MACPAC staff summarized themes from expert roundtables convened in November, one to explore Medicaid policy on high-cost specialty drugs and another on the need for more