DHHS Providing $100 Million in Collaborative Effort with States to Reform Medicaid Systems

 

On July 14, 2014, US Department of Health and Human Services (DHHS) Secretary Sylvia M. Burwell announced a new innovative collaboration with states to improve care for Medicaid beneficiaries by accelerating efforts to reform health care systems. The new initiative, entitled the Medicaid Innovation Accelerator Program, follows recommendations by the National Governors Association (NGA) that The Centers for Medicare & Medicaid Services (CMS) identify opportunities for care improvement and address high-priority areas, such as mental health and emergency department utilization. [More]

 

HHS Launches Medicaid Innovation Accelerator Program

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), announced the Medicaid Innovation Accelerator Program (IAP) on July 14, 2014. The IAP’s goals are to improve health care delivery and patient outcomes while controlling costs through accelerated payment and service delivery reform in state Medicaid programs. It incorporates many recommendations from states, the National Governors Association (NGA), and the National Association of Medicaid Directors (NAMD), such as improvements in: Medicaid data analytics; quality metric development; service delivery model development; rapid cycle model evaluation; and coordination among various HHS components (the Center for Medicare, the Center for Medicaid and CHIP Services (CMCS), the Center for Medicare and Medicaid Innovation (CMMI), the Medicare-Medicaid Coordination Office (MMCO), etc.). [More]

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Categories:Health and Human Services

 

HHS/CMS Releases Proposed Rules on Exchange Eligibility Redeterminations

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published proposed rules in the July 1, 2014 Federal Register on health insurance Exchange/Marketplace eligibility redeterminations and re-enrollments in health plans for 2015 and beyond. The new proposed rules would modify final rules published in 2012. They would allow more flexibility in Federal Exchanges, at HHS’ discretion, and would also allow State-based Exchanges (SBEs) to devise alternative procedures, subject to HHS approval. [More]

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CMS Announces Availability of Funding to Support Navigators in Federally-Facilitated and State Partnership Marketplaces

 

On June 10, 2014, CMS announced the opportunity to apply for Navigator grants in federally-facilitated and State Partnership Marketplaces. A total of $60 million will be available in 2014-2015. Navigators are intended to provide unbiased information to consumers about health insurance coverage, the Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program (CHIP). [More]

 

Reports Show Emerging ACA Impact on Medicaid Enrollments, Hospital Charges, and Payer Mix

 

The Centers for Medicare and Medicaid Services (CMS) released on June 4, 2014 a report showing that the 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by April 2014 saw on average a 15.3 percent increase in Medicaid/CHIP enrollments for April 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. States which had not implemented Medicaid expansion by April 2014 saw on average a 3.3 percent increase as compared to their 2013 baselines. Total reported Medicaid/CHIP enrollments nation-wide as of April 2014 reached 65,016,775, an increase of 6,050,059 (10.3 percent) as compared to 2013 baselines. [More]

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CMMI Begins Round Two for SIM Grants

 

The Centers for Medicare and Medicaid Innovation (CMMI) released a funding opportunity announcement (FOA) on May 22, 2014 for grant awards under round two of the State Innovation Models (SIM) program. The FOA outlines opportunities for states to obtain model design awards for January 1, 2015 - December 31, 2015 as well as model testing awards for January 1, 2015 - December 31, 2018. CMMI expects that it will approve up to 15 model design awards, limited to $3 million per state, and up to 12 model testing awards, ranging from $20 million to $100 million per state. [More]

 

CMS Broadens Medicare Payment Policies for Certain Skilled Care Treatments

 

In accordance with a 2013 Settlement Agreement in the case of Jimmo v. Sebelius, (see Fact Sheet here), the Centers for Medicare & Medicaid Services (CMS) recently issued revised portions of the relevant program manuals used by Medicare contractors. [More]

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HHS Addresses Medicare DME Program Integrity

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), proposed rules in the May 28, 2014 Federal Register which would require prior authorization of certain durable medical equipment (DME), prosthetics, orthotics, and medical supplies that CMS considers frequently subject to unnecessary utilization. [More]

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HHS Updates Exchange and Insurance Market Standards for 2015 and Beyond

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), issued draft final rules on May 16, 2014 to update and clarify a wide range of health insurance rules under the Affordable Care Act (ACA). The final rules take into account public comments submitted by April 21, 2014 on proposed rules published in the Federal Register on March 21, 2014. The final rules address standards for health insurance issuers, including but not limited to issuers offering qualified health plans (QHPs) through Exchanges and the Small Business Health Options Program (SHOP); requirements on health care quality, medical loss ratios (MLRs), and rebates to consumers from issuers that do not meet MLRs; and requirements under the ACA reinsurance, risk corridor, and risk adjustment programs. [More]

 

HHS Proposes More Flexibility in Electronic Health Records Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued draft proposed rules on May 20, 2014 to offer greater flexibility under requirements governing Medicare and Medicaid incentive payments to promote the meaningful use of electronic health records. [More]