CMS Finalizes Changes to Prior Authorization Requirements

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The Centers for Medicare & Medicaid Services (CMS) has issued the final rule: Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children’s Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified […]

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CMS Sends Medicaid Access Rule to OMB

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On Friday, January 26, 2024, the Centers for Medicare & Medicaid Services (CMS) sent the final Medicaid Access Rule (CMS-2442-F) to the Office of Management and Budget (OMB) for review and clearance. OMB review is the last step in the process prior to release of a regulation in the Federal Register. Although the rule is […]

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CMS Releases Data on American Rescue Plan Spending

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On December 12, 2023, the Centers for Medicare and Medicaid Services (CMS) released information on how State Medicaid Agencies have used the enhanced funding for home and community-based services (HCBS) provided by the American Rescue Plan Act (ARPA). According to the CMS data: The full dataset is available online at: https://www.medicaid.gov/sites/default/files/2023-12/arp-sec9817-overview-infographic_0.pdf.

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KFF Releases Updated Medicaid Waiver Waiting List Data

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On November 29th, the Kaiser Family Foundation (KFF) released a report detailing state waiting lists for Medicaid home and community-based services (HCBS) waivers. Unlike other parts of the Medicaid program, states are able to limit enrollment and establish waiting, or interest, lists for HCBS waiver services. According to the KFF data: Importantly, KFF questions whether […]

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Update on 2023-2024 Medicaid Enrollment and Spending Trends

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The Kaiser Family Foundation issue brief focusing on Medicaid enrollment and spending trends contains a significant amount of interesting and useful information, derived from a survey of Medicaid agencies that collected data on actual FY2023 expenditures and projected FY2024 spending. Importantly, the survey results predict that the state share of Medicaid financing increased by 13% […]

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TODAY! Home Health and Home Care Regulatory Update

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NAHC President Bill Dombi and Director of Medicaid Advocacy Damon Terzaghi will discuss current issues in the Home Health and Medicaid HCBS industry. The webinar with Farragut Square Consulting will provide updates and information on: Interested parties can learn more and register at https://mwe.zoom.us/webinar/register/WN_k6mhlsA8RxC75esbQ9d_-g#/registration.

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NAHC Releases White Paper on EVV and Home Health Services

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The requirement for State Medicaid agencies to implement EVV for Medicaid-funded home health services is in less than a month, with a January 1, 2024 deadline. Some states are already operational while others will not be able to implement on time. However, the majority of states will move forward with the requirements in January. This […]

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CMS Updates Spousal Impoverishment Standards and Medicaid Savings Program Resource Levels

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On November 14th, the Centers for Medicare & Medicaid Services (CMS) released an information bulletin that provided information about annual updates to the income standards for certain eligibility groups. A number of eligibility criteria for older adults and people with disabilities are based on the Supplemental Security Income (SSI) program’s Federal Benefit Rate (FBR). In […]

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CMS Expands Medicaid Eligibility Flexibilities in 2025 Marketplace Benefit and Payment Parameters Proposed Rule

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On November 15th, CMS released the HHS Notice of Benefit and Payment Parameters (Payment Notice) for 2025. While this rule is primarily focused on the Affordable Care Act’s Marketplace plans, there are other policies included as well. One such policy provides additional flexibility for states to target various eligibility disregards to more nuanced groups of […]

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CMS Releases Guidance on Medicaid and CHIP Health-Related Social Needs Expenditures

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On November 16th, the Centers for Medicare & Medicaid Services (CMS) released an informational bulletin that provided additional information and guidance regarding Medicaid coverage of “Health Related Social Needs Expenditures” (HSRNs), which are services provided to address the social determinants of health. The letter outlines the various ways that states may cover different HSRNs, including […]

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House Subcommittee Holds Hearing on LTSS Workforce

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On Wednesday, October 25th, in the U.S. House of Representatives, the Health Subcommittee of the Energy and Commerce Committee in the House of Representatives held a hearing titled, “Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care.” The hearing specifically looked at two recent regulations from the […]

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