One in five American children has a chronic health condition, with even higher rates among those enrolled in Medicaid and the Children’s Health Insurance Program. The trend raises questions about how to address underlying systemic drivers and whether value-based care models can help improve outcomes for children and youth.
The...National News
CMS is launching a new Healthcare Advisory Committee to provide non-binding recommendations on federal policy and program administration, with a focus on improving care delivery and system performance.
As promoted by the Health & Human Services and the Centers for Medicare & Medicaid Services (CMS), the committee will...CMS Rules
This week, the Centers for Medicare and Medicaid Services (CMS) announced a new payment model that aims to bolster comprehensive health coverage for children with complex medical and behavioral health needs. The Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model is a state-based model that will serve...National News
This week, the Centers for Medicare and Medicaid Services (CMS) announced plans to crack down on double-enrollment in Medicaid and end demonstration waivers for continuous enrollment in Medicaid.
CMS sent letters to states notifying them that it will end 1115 demonstration waivers that allow people to continuously enroll in Medicaid...National News
Congressional Republicans have reached a tentative agreement on the shape that a budget reconciliation bill could take, and it includes significant changes to healthcare funding with Medicaid cuts at the center of the plan. The House Energy and Commerce Committee released a legislative text that includes work and reporting requirements...National News
A new report from Georgetown University looks into the role played by Medicaid in rural healthcare delivery and finds that rural medical services rely on Medicaid funding.
The report found that non-Medicare eligible adults and children in rural areas were more likely than those in metro areas to use Medicaid or CHIP for their health...Arizona News
Although the topic of Medicaid was largely left out of both campaigns this election cycle, the incoming Trump administration is expected to make some major policy changes to the safety net health program now covering 69 million Americans.
Medicaid and the Children's Health Insurance Program (CHIP) are likely bargaining chips to make...Arizona News
Medicaid and Children’s Health Insurance Program (CHIP) will now cover traditional healthcare practices provided by Indian Health Service (IHS) facilities, Tribal facilities, and urban Indian organizations in Arizona, California, New Mexico and Oregon after approving the four states' section 1115 demonstration waivers. Since 2015 the...National News
Last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) held its annual meeting where the draft of the annual March Report to Congress on Medicaid and the Children's Health Insurance Program (CHIP) was presented.
In the meeting, the commission discussed and voted on seven recommendations to change the mechanism for...National Reports & Surveys
The annual report published this month can serve as an essential reference when compiling and analyzing Medicaid & CHIP data including enrollment, expenditures, state spending, beneficiary demographics, income and health status, and more.
In 2022, more than 30% of the U.S. population was enrolled in Medicaid or the State...National News
Governors in Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota and Texas received a letter his week urging them to adopt additional federal strategies and flexibilities to help prevent children and their families from losing coverage due to red tape. All nine states account for about 60% of the decline in...Arizona News
The Arizona Health Care Cost Containment System (AHCCCS) is asking the Centers for Medicare and Medicaid Services (CMS) to obtain approval to increase the income limit for KidsCare eligibility to 225% of the federal poverty level (FPL).
The request is expected in increase enrollment in KidsCare by about 10,000 and is in alignment with...CMS Rules
States will now be required to report health quality measures for Medicaid beneficiaries including children's health, adult behavioral health and health home data to the Centers for Medicare and Medicaid Services (CMS).
The Core Set of Children's Health Care Quality Measures for Medicaid and the Children's Health Insurance Program...
On June 15, 2023, the Medicaid and CHIP Payment and Access Commission (MACPAC) issued its June Report to Congress which includes recommendations for DSH payments, delivering on the promise of dual integration and access to Medicaid coverage for released prisoners. MACPAC is an independent, non-partisan commission composed of experts in...
Last week, the Centers for Medicare and Medicaid Services (CMS) proposed two new rules that would require private entities that manage Medicaid and Children's Health Insurance Plan (CHIP) plans to enforce national maximum standards for appointment wait times and will require managed care organizations (MCOs) to monitor compliance.
The...
On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that includes revisions to network adequacy standards for Marketplace plans and paths to transitioning Medicaid members to the Marketplace. The proposed rule adds behavioral healthcare, including substance use disorder facilities and providers, to the...
The Centers for Medicare and Medicaid Services (CMS) published a proposed rule which would require Medicare Advantage, Medicaid managed care organizations, Affordable Care Act (ACA) plans, and state Medicaid agencies to implement electronic prior authorization systems by 2026.
The proposed rule updates requirements for certain payers...
There will likely be a winter surge of COVID-19 in the next few months, but Americans aren't receiving the bivalent booster shot that targets Omicron variants.
The daily global COVID-19 infection rate is expected to rise by two million daily cases by February, according to an analysis from the University of Washington. Reuters notes...
Last Wednesday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would streamline the application and renewal process for enrollees in Medicaid and the Children's Health Insurance Program (CHIP).
The overhaul aims to "reduce red tape" and simplify the application and verification process for children,...
The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (APSE) published a report late last week that projects that 15 million people could lose health coverage once states resume checking Medicaid enrollees for eligibility at the conclusion of the COVID-19 public health...
