Weekly Medicaid Update

Mar 30, 2022 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: CA: State to extend Medi-Cal benefits to undocumented seniors in May CO: Medicaid partners with state health insurance exchange to implement redetermination NY: Prior authorization no longer required for MAT drugs Click to read more.

Managed Care Friday

Mar 25, 2022 | Managed Care Friday

135M: The amount the Dr. Lorna Breen Health Care Protection Act, which was signed into law last week, will provide to support the mental health of healthcare workers. The bill was named in honor of Dr. Lorna Breen, the ER Director at NY-Presbyterian Hospital who died by suicide in April 2020. She was one of many frontline healthcare workers who struggled with their mental health during the COVID pandemic. “Physicians are at a significantly increased risk of suicide compared to the general population, with suicide rates 40% higher in males and 130% higher in females,” Dr. Madara, CEO of the...

Weekly Medicaid Update

Mar 23, 2022 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: IN: New law increases Medicaid income eligibility threshold for pregnant women MA: Supplemental payments for adult day health providers SC: Rate increase for home delivered meals Click to read more.

CMS Releases Data On The Use Of SUD Services

Mar 22, 2022 | Substance Abuse

A recent review of Medicaid data presented to Congress by the Department of Health and Human Services shows which beneficiaries receive care for substance use disorder (SUD) and the types of services they are receiving. While acute care remains the most common service that beneficiaries receive, data showed a slight decrease in percentage points of individuals with an SUD receiving those services, while there was a large increase in use of MAT services between 2018 and 2019. Click to read more.

Managed Care Friday

Mar 18, 2022 | Uncategorized

1,300: Number of hospitals, payers and students who weighed in on the nursing shortage in our special report. Like Arleth Flores, the 24-year-old nursing grad who wants to work at a local school and urgent care center but is waiting due to delays in administering the board test.  Nurse staffing challenges are likely here to stay over the next few years but lawmakers, health systems and even educators are trying to create solutions in real-time, like Evolve Health’s new hospital alliance that shares HR best practices on employee well-being, diversity and inclusion program implementation, and...

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.