Archive for Medicaid long-term services and supports

 

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years.  Among the survey’s findings (in language taken directly from the Kaiser report):

  • More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs
  • Some states reported newly implementing or expanding MCO programs
  • States also report continued use of other service delivery and payment system reforms
  • Two-thirds of states are using strategies to improve race, ethnicity, and language data
  • About one-quarter of states are tying MCO financial incentives to health equity
  • States are also leveraging MCO contracts in other ways to promote equity-related goals
  • States report far more benefit expansions than benefit cuts
  • States are most frequently expanding behavioral health and pregnancy/postpartum services
  • Most states allow MCOs to cover “in lieu of” services, especially BH [behavioral health] and SDOH [social determinants of health] services
  • States have seen high telehealth utilization across Medicaid enrollees
  • States are addressing telehealth quality and other challenges
  • Most states are adopting permanent telehealth expansions, though some are considering limits

Other subjects addressed in the report include provider taxes and intergovernmental transfers, supplemental Medicaid payments, health equity, …

MACPAC Meets

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

Supporting the discussion were the following briefing papers:

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department  of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).  Find its web site here.…

Federal Health Policy Update for Wednesday, July 27

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27.  Some of the language used below is taken directly from government documents.

Final Medicare Payment Regulations for FY 2023

  • CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April.  To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself.
  • CMS also has finalized its Medicare inpatient psychiatric facility prospective payment system final rule for FY 2023, including a 2.5 percent rate increase.  Learn more from this CMS fact sheet and the final rule itself.
  • In addition, CMS has published its FY 2023 hospice payment rate update final rule, finalizing a 3.8 percent rate increase.  Learn more from this CMS fact sheet and from the final rule itself.

White House

The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19.  Find a transcript of its latest briefing here.

The White House …

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 March 2022 meeting began with a follow-up discussion on directed payments in managed care. This presentation reviewed a package of five proposed recommendations related to:

improving the transparency of existing directed payment approval documents, rate certifications, and evaluations;

collecting new provider-level data on directed payment spending;

further clarifying directed payment goals and their relationship to network adequacy requirements;

providing guidance for more meaningful, multi-year assessments of directed payments; and

improving the coordination of reviews of directed payments and managed care rate setting.

The Commission is expected to vote on these recommendations at its April 2022 meeting.

The Commission then continued its discussion on how greater adoption of health information technology could facilitate clinical integration for behavioral health. Prior Commission meetings discussed barriers to adopting electronic health records (EHR), including financing and available products that support behavioral health providers. This presentation had two recommendations for the Commission to discuss: (1) creation of voluntary standards for behavioral health-focused EHRs, and (2) Medicaid mechanisms to finance EHR adoption among behavioral health providers. The Commission will vote

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.

MACPAC kicked off its January meeting with a review of a draft chapter for the March 2021 report to Congress and recommendations on a mandatory extension of Medicaid coverage for 12 months postpartum. The Commission received extensive public comment on the recommendations. On Friday, the Commission approved three recommendations as drafted related to postpartum coverage. The Commission recommended that Congress should:

  • extend the postpartum coverage period for individuals who were eligible and enrolled in Medicaid while pregnant to a full year of coverage, regardless of changes in income. Services provided to individuals during the extended postpartum coverage period will receive an enhanced 100 percent federal matching rate;
  • extend the postpartum coverage period for individuals who were eligible and enrolled in the State Children’s Health Insurance Program (CHIP) while pregnant (if the state provides such coverage) to a full year of coverage, regardless of changes in income; and
  • require states to provide full Medicaid benefits to individuals enrolled in all pregnancy-related pathways.

Commissioners then turned their attention to Medicaid estate recovery policies that affect beneficiaries