Archive for Medicaid managed care

 

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15.  Some of the language used below is taken directly from government documents.

White House

  • The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans.  Learn more about the plan from this White House fact sheet and go here for a transcript of the White House press briefing about the plan.

Congress

  • Yesterday the House passed a one-week continuing resolution (CR) that will prevent the federal government from shutting down when the current CR ends tomorrow, December 16; the Senate will take up that bill although some senators have expressed their objection to a short-term CR.  Appropriators have agreed on the spending limits for FY 2023 spending bills and hope to pass an omnibus spending bill encompassing all 12 appropriations bills before next Friday, December 23.  House minority leader Kevin McCarthy, backed by other House Republicans, objects to passing an omnibus spending bill before the end of

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 December 2022 MACPAC meeting began with a Commission discussion on two potential recommendations for improving Medicaid race and ethnicity data reporting. As part of its commitment to prioritizing health equity in all of its work, the Commission is focused on how to improve Medicaid race and ethnicity data collection and reporting. In October, staff presented findings from a literature review and key stakeholder interviews, as well as possible approaches for improving the collection and reporting of these data. In this presentation, staff reviewed the state data collection and reporting processes, data quality priorities, and barriers to improvement. Staff also presented two potential recommendations for the Commission’s consideration, with the goal of making recommendations in MACPAC’s March report to Congress. The Commission will vote on these recommendations in January 2023.

Next, the Commission discussed two potential recommendations to improve the transparency of nursing facility payment data. The Commission has undertaken long-term work to examine the extent to which Medicaid nursing facility payment policies are consistent with the statutory goals of efficiency, economy, quality,

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 …