Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: IL: Non-emergency ground ambulance services carved out of managed care IN: +4% rate increase for “COVID-19 Ready” nursing facilities OH: Proposed rules increase PDN and home health rates by +6.1% MN, MO, SC: Rate increases for certain HCBS waivers Click to read more.

Managed Care Friday

24601: Les Miserable fans know this number too well as the mark symbolizing Jean Valjean’s bread stealing moment during the end of the French Revolution, and in a symbolic way this is exactly the number a Medicaid managed care plan’s medical director is advocating the insurer pay per beneficiary per year (well, $24,600 to be exact, but what’s an extra dollar for effect?) to cover housing, health and wellness, transportation, job support and food as part of a social family support concept targeting underserved, typically refugee, populations. Dose E Doh! Several insurers are looking to reduce...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AL:  State submits IMD waiver for Medicaid patients with serious mental illness CO: State to implement prior authorization requirements for certain physician-administered drugs MA: Pending legislation seeks to improve MassHealth behavioral health access and quality MD: Task Force on Oral Health begins studying access to dental services across the state Click to read more.

2021 Medicare Trustees Report Projects 2026 Shortfall

The 2021 Medicare Trustees report projects a shortfall for the Medicare Hospital Insurance (Part A) trust fund in CY 2026. At that time, Medicare expenditure for Part A services, inpatient hospital, SNF, hospice, post-discharge home health, would be limited to the amount of Medicare payroll tax revenue. Projected expenditures are about 15% to 20% above projected payroll revenue. Click to read more.