Archive for Medicaid

 

Feds Give States Direction for Addressing Social Determinants of Health

Federal laws, regulations, and programs offer numerous tools to states seeking to address social determinants of health through their Medicaid and Children’s Health Insurance Program (CHIP).  Now, Centers for Medicare & Medicaid Services has written to state Medicaid directors outlining those tools.

In the 51-page letter, CMS notes that

Many Medicaid and CHIP beneficiaries may face challenges related to SDOH [social determinants of health], including but not limited to access to nutritious food, affordable and accessible housing, convenient and efficient transportation, safe neighborhoods, strong social connections, quality education, and opportunities for meaningful employment.  There is a growing body of evidence that indicates that these challenges can lead to poorer health outcomes for beneficiaries and higher health costs for Medicaid and CHIP programs and can exacerbate health disparities for a broad range of populations…

In the letter, CMS describes:

  • Overarching principles CMS expects states to adhere to in their Medicaid and CHIP programs when offering services and supports that address social determinants of health.
  • Services and supports that are commonly covered in Medicaid and CHIP programs to address social determinants of health.
  • Federal authorities and other opportunities under Medicaid and CHIP that states can use to address social determinants of health.

GAO: CMS Should Pay More Attention to States’ Financing of Medicaid

The federal government does not adequately monitor how states finance their Medicaid programs.

It also lacks a sufficiently clear understanding of how they pay providers of Medicaid-covered services.

These are among the conclusions in a new study on Medicaid financing and payments by the U.S. Government Accountability Office.

According to the GAO report,

GAO estimated that states’ reliance on provider taxes and local government funds decreased states’ share of net Medicaid payments (total state and federal payments) and effectively increased the federal share of net Medicaid payments by 5 percentage points in state fiscal year 2018.  It also resulted in smaller net payments to some providers after the taxes and local government funds they contribute to their payments are taken into account. While net payments are smaller, the federal government’s contribution does not change. This effectively shifts responsibility for a larger portion of Medicaid payments to the federal government and away from states.

To address this challenge, the GAO urged CMS to collect more complete and consistent information about both state financing of their Medicaid programs and the manner in which states pay Medicaid providers.  CMS neither agreed nor disagreed with the GAO’s recommendation.

Learn more about what the GAO …

Recession Taking its Toll on States

State Medicaid programs are feeling the effects of the current recession, according to a new report by the Congressional Research Service.

According to the brief report, state Medicaid enrollment and costs have risen since the COVID-19 pandemic began and states expect them to continue rising into their 2021 fiscal years.  State efforts to reduce spending are limited by provisions in the Families First Coronavirus Response Act, which provided additional federal Medicaid matching funds to the states to assist them with their Medicaid costs during the COVID-19 pandemic but impose maintenance-of-effort requirements in exchange for continued state access to the enhanced federal matching funds.

Learn more about how the COVID-19 public health emergency is affecting state Medicaid programs in the Congressional Research Service report “Impact of the Recession on Medicaid.”

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

Off-Again, On-Again Public Charge Rule is Off Again

A federal rule that would have limited immigration to the U.S. for people who might at some point become dependent on public aid programs has been put on hold again by a federal judge.

Implementation of the rule, delayed by several courts and then authorized by the U.S. Supreme Court until the merits of challenges could be heard, was delayed again by a federal court, which said the rule contained “numerous unexplained flaws” that made it “arbitrary and capricious.”

Health care advocates feared the rule would discourage some immigrants to whom the rule does not even apply from seeking to participate in certain public aid programs and even encourage some to whom the rule does not apply to disenroll from the public aid programs, such as Medicaid, in which they are already legally enrolled.  A recent study published in the journal Health Affairs found that the parents of a projected 260,000 children have disenrolled their children from Medicaid or the Children’s Health Insurance Program (CHIP) because of their fear of the rule’s implications for their families.

Learn more about the rule and this latest court decision in the New York Times article “Trump’s ‘Public Charge’ Immigration Rule Is Vacated