Weekly Medicaid Update

Mar 16, 2022 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AR: FY2023 budget signed into law FL: Passes Legislation that will impact 2025 MCO procurement NY: Assembly and Senate release FY2022-23 budget proposals Click to read more.

CBO Analysis of Commercial Rates

Mar 15, 2022 | Legislation/ Budgets/ Macro

CBO Analysis of Commercial Rate Premium Compared to Medicare FFS: CBO examined potential reasons that the prices paid by commercial health insurers for hospitals’ and physicians’ services are higher, rise more quickly, and vary more by area than the prices paid by the Medicare fee-for-service program. Read our summary of highlights from the CBO publication here.

TX Surprise Billing Dispute Resolution

Mar 15, 2022 | Legislation/ Budgets/ Macro

Federal Court Rules Surprise Billing Dispute Resolution Process Will Continue Without QPA Presumption: A federal court has struck provisions of the independent dispute resolution rule that required arbitrators to presume the offer closest to the payer-driven qualifying payment amount was the correct offer. Providers will now be able to have arbitrators consider additional factors outlined in the No Surprises Act, like patient acuity and complexity of the procedure. Click to read more.

Managed Care Friday

Mar 11, 2022 | Managed Care Friday

38%: Reduction in pediatric hospitalizations due to Cincinnati Children’s Hospital and the Legal Aid Society of Greater Cincinnati partnering to connect children to social services, including three primary clinics in schools. The partners manage about 900 referrals a year, connecting families with resources for housing insecurity, poverty-related issues, and educational concerns. Fundraising and grants are the primary sources to fund the program but reimbursement through insurance could help long term. Self-Insured Coupe? BCBS Minnesota began offering a new product, Coupe Health, to...

Weekly Medicaid Update

Mar 9, 2022 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AL: Budget is expected to contain funding to extend Medicaid postpartum coverage NV: Implementing short-term quarterly supplemental payments for HCBS providers MI: Genetic counselors will now be eligible to enroll as Medicaid providers SC: Proposed rates increases for several HCBS waivers Click to read more.