HHS outlines multi-pronged strategy to help individuals with substance use disorders

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued a letter to state Medicaid directors on July 27, 2015 encouraging states to pursue demonstration waivers to improve services for individuals with substance use disorders (SUDs). These may include waivers of the longstanding “institution for mental diseases” (IMD) exclusion and other federal Medicaid rules. [More]

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Categories:Health and Human Services

 

Children and families legislative updates

 

Since the beginning of the 114th Congress, many bills have been drafted, a few have been introduced on either the House or Senate floor, and to date, no legislation has been actually passed. The legislation listed below reflect several themes of growing concern but none that have reached the level of attention for a hearing to be held. Continuous monitoring of these bills will be reported. [More]

 

HHS Proposes New Medicare/Medicaid Standards for Long Term Care Facilities

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 16, 2015 which would update Medicare/Medicaid certification requirements for long term care facilities (LTCFs). The proposed rule offers the most comprehensive update in these requirements since 1991. [More]

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Categories:Health and Human Services

 

HHS and USDA Issue Additional Guidance on Eligibility Integration

 

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) issued a joint letter on July 20, 2015 to directors of state health and human services, state Medicaid and Children’s Health Insurance Programs, and health insurance Exchanges, about a limited exception to OMB A-87 cost allocation requirements for integrated eligibility systems serving multiple programs. [More]

 

GAO Report Cites Medicaid Challenges

 

The U.S. Government Accountability Office issued a report to a health care subcommittee in the U.S. House of Representatives on July 8, 2015, entitled, “Medicaid: Overview of Key Issues Facing the Program.” Medicaid serves over 70 million persons and program costs now exceed $508 billion ($304 billion federal, $204 billion state funds in fiscal 2014). The GAO report addresses access to care, transparency and oversight, program integrity, and federal financing issues under the program. [More]

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HHS Proposes Medicare Home Health Value-Based Purchasing Program

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register on July 10, 2015 which would update Medicare payment methods and rates under the home health prospective payment system, update home health quality reporting requirements, and launch the home health value-based purchasing (HH VBP) model beginning in January 2016. [More]

 

CMS has paid out about $1.3 billion to settle Medicare appeals claims

 

On June 11, 2015, the Centers for Medicare & Medicaid Services (CMS) announced that the agency has settled Medicare appeals claims with more than 1900 hospitals. CMS paid out approximately $1.3 billion pursuant to a settlement policy announced in August 2014 to help reduce a backlog of patient status claim denials pending in the appeals process. [More]

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Florida legislature reaches agreement on hospital funding for one year

 

Florida legislators agreed to end a conflict about funding for hospitals for one year by increasing Medicaid reimbursement rates for hospitals. The Low Income Pool program (LIP) funded by a section 1115 project was scheduled to end June 30, but the Center for Medicare and Medicaid Services (CMS) did agree to continue the program at a reduced funding level from $2.2 billion to $1 billion for one year and $600 million thereafter. [More]

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CMS Finalizes New Medicare ACO Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published final rules in the June 9, 2015 Federal Register on accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) under section 3022 of the Affordable Care Act (ACA). Medicare providers and suppliers that participate in a qualifying ACO under the MSSP receive traditional Medicare Part A and Part B fee-for-service payments but the ACO has an opportunity to earn “shared savings” bonus payments if it achieves MSSP savings targets and quality benchmarks. [More]

 

White House Releases Report on Benefits of Medicaid Expansion

 

The White House has released a report entitled, “Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid.” The report estimates that if the 22 states that have not yet expanded Medicaid chose to do so, some 4,299,000 persons in those states would gain coverage; 1,021,000 more persons would report a usual source of care; 491,000 more persons would receive all needed care; hundreds of thousands more persons would receive recommended preventive screenings (626,400 more persons would receive cholesterol screenings, 163,400 more women would receive mammograms, etc.); [More]