Medicaid
CMS Finalizes Changes to Prior Authorization Requirements
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 […]
Read MoreCMS Sends Medicaid Access Rule to OMB
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 […]
Read MoreCMS Releases Data on American Rescue Plan Spending
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.
Read MoreKFF Releases Updated Medicaid Waiver Waiting List Data
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 […]
Read MoreUpdate on 2023-2024 Medicaid Enrollment and Spending Trends
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% […]
Read MoreTODAY! Home Health and Home Care Regulatory Update
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.
Read MoreNAHC Releases White Paper on EVV and Home Health Services
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 […]
Read MoreCMS Updates Spousal Impoverishment Standards and Medicaid Savings Program Resource Levels
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 […]
Read MoreCMS Expands Medicaid Eligibility Flexibilities in 2025 Marketplace Benefit and Payment Parameters Proposed Rule
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 […]
Read MoreCMS Releases Guidance on Medicaid and CHIP Health-Related Social Needs Expenditures
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 […]
Read MoreHouse Subcommittee Holds Hearing on LTSS Workforce
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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