Weekly Medicaid Update

Aug 18, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: OH: State to increase HCBS rates; Buckeye awarded MCO contract following lawsuit SC: Proposal seeks to expand eligibility for Medically Complex Children's waiver TN: Court puts Medicaid block grant waiver lawsuit on hold WI: State to implement hub and spoke model for SUD services Click to read more.

CMS Published FY2022 IPPS & LTCH Final Rule

Aug 17, 2021 | Hospitals, Inpatient, Payers

CMS published the final rules for the FY 2022 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospitals (LTCH) Prospective Payment System (PPS). The IPPS applies to approximately 3,200 acute care hospitals. The finalized increase in IPPS operating payment rates is +2.5% or ~$3.2 billion. The LTCH PPS rule applies to approximately 360 LTCHs. The finalized increase to LTCH payments is +1.1% or $52 million. Click to read more.

Managed Care Friday

Aug 13, 2021 | Managed Care Friday

5: The number of new states where Aetna is entering the ACA marketplace in 2022, including Nevada, Missouri, Texas, Florida, and North Carolina. Meanwhile, HCSC will expand its Medicare Advantage (MA) footprint to an additional 90 counties next year, which the company says is its largest MA expansion ever. Per Member Per Month, And Then Some:  A Medicaid managed care plan in Kansas is playing Oz by setting up a series of multi-level payment per month models for youth behavioral health care. In one design, you can get a $1 PMPM for doing follow up calls within 7 days of IP discharge, $20 for...

Weekly Medicaid Update

Aug 11, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AZ: State releases RFP for Regional Behavioral Health Agreements (RBHAs) IN:  State expands provider types qualified to provide MAT services MA: MassHealth to cover preventive behavioral health services for children regardless of diagnosis Click to read more.