GAO Evaluates Federal HCBS Programs

 

The U.S. Government Accountability Office (GAO) released a report on May 20, 2015 entitled, “Federal Strategy Needed to Help Ensure Efficient and Effective Delivery of Home and Community-Based Services and Supports.” The report evaluates a wide range of programs within the U.S. Department of Health and Human Services (HHS), including the Administration on Aging (AOA), Administration for Community Living (ACL), and the Centers for Medicare and Medicaid Services (CMS), as well as programs within the U.S. Department of Housing and Urban Development (HUD), Transportation (DOT), and Agriculture (USDA). [More]

 

RWJF Report Estimates 20 States Could Lose $720 Billion in Federal Health Funds Over Ten Years

 

The Robert Wood Johnson Foundation (RWJF) issued a report on May 18, 2015 estimating that 5,623,000 persons in 20 states that have declined to implement state-based health insurance Exchanges under the Affordable Care Act (ACA) may become uninsured in 2016 if the U.S. Supreme Court rules that advance premium tax credits (APTCs) and cost-sharing reductions (CSRs) are only available through state-based Exchanges, not federally-facilitated Exchanges. A ruling in King v. Burwell on that question is expected by June 30, 2015. [More]

 

GAO Report Finds HHS 1115 Waiver Program Lacks Transparency

 

On Wednesday, May 13, 2015, the Government Accountability Office (GAO) issued a report which concluded that the waiver process for Section 1115 of the Social Security Act, which gives the U.S. Department of Health and Human Services (HHS) authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs, “lacks transparency.” [More]

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Categories:Health and Human Services

 

Medicaid/CHIP Enrollments Exceed 70 Million

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) has released a May 1, 2015 report showing that 29 jurisdictions (28 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by February 2015 saw on average a 26.99 percent increase in Medicaid/CHIP enrollments for February 2015, as compared to their average monthly enrollments in a July – September 2013 baseline period. [More]

 

GAO Evaluates High-Cost Medicaid Recipients

 

The U.S. Government Accountability Office (GAO) issued a report to Congress on May 8, 2015 entitled, “A Small Share of Enrollees Consistently Account for a Large Share of Expenditures.” GAO used the Centers for Medicare and Medicaid Services (CMS) Medicaid Statistical Information System (MSIS) to analyze the distribution of Medicaid expenditures in three years across all states using Medicaid-only beneficiaries’ diagnosis codes and service categories. [More]

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Categories:Health and Human Services

 

Pioneer ACO Model Approved for Potential Expansion

 

The U.S. Department of Health and Human Services (HHS) reported on May 4, 2015 that it has obtained actuarial certification that expansion of the Pioneer ACO model would reduce net Medicare spending. Actuarial certification of this “pay-for-performance” pilot is a prerequisite under the Affordable Care Act for HHS to expand the model to a larger group of Medicare beneficiaries. [More]

 

Florida Sues HHS Over Planned End to Low Income Pool Hospital Funding Program

 

On Tuesday, April 28, 2015, Florida Governor Rick Scott instituted a lawsuit against the U.S. Department of Health and Human Services in an attempt to prevent a threatened end to an optional federal program, providing Florida and eight other states with hospital funds for low income people (LIP). (Rick Scott v. United States Department of Health and Human Services, Case 3:15-cv- 00193-RS-CJK Document 1, filed 4/28/15). [More]

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HHS Proposes New Inpatient Hospital Payment Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued proposed rules on April 17, 2015 to update its Medicare reimbursement methods under inpatient prospective payment systems for 3,400 acute care hospitals and 435 long term care hospitals. [More]

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HHS Proposes New Rules on Medicare Nursing Facility Quality and Reimbursement

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published proposed rules in the Federal Register on April 20, 2015 to update its Medicare skilled nursing facility prospective payment system (SNF PPS) and quality reporting program (SNF QRP). The proposed rules would offer, on average, a 1.4 percent increase in SNF PPS rates for Federal fiscal year 2016 (October 1, 2015 - September 30, 2016), a $500 million aggregate increase in Medicare payments as compared to FFY 2015. [More]

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HHS Releases Funding Opportunity Announcement for Navigator Grants

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued a funding opportunity announcement (FOA) on April 15, 2015 related to grants to support health insurance eligibility and enrollment “navigators” in Federally-facilitated and State Partnership Marketplaces/Exchanges under the Affordable Care Act (ACA). [More]