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Archive Tag: medicaid

CMS Finalizes 2016 Proposed Updates to PACE Program, Includes Compliance and Quality Requirements

On May 28, 2019, the Centers for Medicare & Medicaid Services (CMS) released the Medicare and Medicaid Programs’ Programs of All-Inclusive Care for the Elderly (PACE) Final Rule which finalizes the policies proposed in the August 2016 PACE proposed rule. Specifically, the final rule addresses application and waiver procedures, sanctions, enforcement actions and termination, administrative [...] Read More

UPCOMING EVENT: LUNCH WITH VIRGINIA MEDICAID DIRECTOR

On April 29th, Dr. Jennifer Lee, Virginia’s state Medicaid Director, will be the Northern Virginia Health Policy Forum's featured speaker. She will discuss how our home state is managing Medicaid expansion, addressing social determinants of health, and dealing with the opioid crisis as well as other topics. As the Director of the Department of Medical [...] Read More

CMS Proposes Exemptions for States with High Medicaid Managed Care Presence

On Thursday, March 23, 2018, the Centers for Medicare and Medicaid Services (CMS) has released a new proposed rule entitled Methods for Assuring Access to Covered Medicaid Services- Exemptions for States with High Managed Care Penetration Rates and Rate Reduction Threshold. In this rule, CMS proposes to exempt states with at least 85 percent of […]

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President Trump’s FY 2019 Budget Proposes Changes and Promises Savings

Today, the White House Office of Management and Budget released An American Budget, the fiscal year 2019 budget for the US Government. Concurrently, the Department of Health and Human Services released its FY 2019 Budget in Brief. Together, these documents propose significant savings while making a number of changes to federal healthcare programs. A brief summary […]

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Council of Economic Advisers Wades into Drug Pricing Conversation

On February 9, 2018, the Council of Economic Advisers released a report looking at drug pricing proposals entitled “Reforming Biopharmaceutical Pricing at Home and Abroad.” The report highlights two goals: reducing the price that Americans pay for biopharmaceutical products and raising innovation incentives as a way to reduce the overall price of health in the […]

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CMS Provides Guidance to States on Medicaid Work Requirements

CMS has sent a letter to state Medicaid directors with additional guidance the agency will use when reviewing waiver applications for states to implement work requirements for some Medicaid beneficiaries. Specifically, several states have expressed interest in some type of work requirements for “non-disabled” adults. Each state will be required to submit a waiver  under […]

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Senate Finance Committee Considers Azar for HHS Secretary

On January 9, 2017, the Senate Finance Committee held a hearing to consider the nomination of Alex Azar II to be the Secretary of Health and Human Services (HHS). This hearing follows the Senate Health, Education, Labor and Pensions (HELP) Committee nomination hearing on November 29, 2017. Mr. Azar has been nominated to replace Tom […]

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Coming in 2018: CMS Limits on Medicaid DME Funding

On December 27, CMS issued a State Medicaid Director letter to explain new limitations on federal financial participation for durable medical equipment (DME) in Medicaid. Beginning on January 1, 2018  (as required by Section 5002  of the 21st Century Cures Act), federal reimbursement to states for DME expenditures in Medicaid will be limited to the […]

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