HHS Announces Health Care Innovation Awards

 

The U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (CMMI), announced a new batch of “round two” health care innovation awards on July 9, 2014. These are grants to applicants who have set forth compelling new ideas to improve care and control costs for persons enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). [More]

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Kaiser Commission Releases Report on Successful SBEs

 

The Kaiser Commission on Medicaid and the Uninsured released an excellent report on July 20, 2014 about the successful state-based health insurance Exchanges (SBEs) and Medicaid expansions in Colorado, Connecticut, Kentucky, and the State of Washington. The report, “What Worked and What’s Next? Strategies in Four States Leading ACA Enrollment Efforts,” includes interviews with stakeholders in each state about exemplary marketing, outreach and enrollment, consumer assistance, and systems/operations strategies, with insights on 2014 and lessons for 2015. It shows that each of the states marketed the coverage expansions as state-based initiatives; conducted statewide marketing via a wide range of methods, including social media and promotional materials; and emphasized the enrollment deadline in their marketing efforts. [More]

 

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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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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