Health Policy News has devoted significant attention to State and Federal efforts to contain drug costs, including recently issuing a report and legislative tracking tool entitled “ Rising Prescription Drug Costs: A report on state and federal efforts to contain costs”. As we head into the summer we offer readers a few short updates on some of the issues we have been closely following and will continue to track...

On May 7, 2018, Illinois Governor Bruce Rauner announced that Illinois has won federal approval to launch a 5 year, $2 billion Medicaid behavioral health services initiative.  The initiative will be implemented by the Illinois Department of Healthcare and Family Services in collaboration with the Governor’s office and eleven other Illinois state health and human services agencies.  Objectives of Illinois’ initiative include...

In December 2017, the federal administration’s tax bill – the Tax Cuts and Jobs Act, phased out the individual mandate requirements, with the penalty for failing to have qualified insurance eliminated starting in 2019. For 2018, the mandate remains, with the penalty set at $695 per adult or 2.5% of household income, whichever is higher.  The individual mandate is cited as one of the tenants of the success of the Affordable Care Act. In order to ensure a healthy risk pool, participation of as many individuals as possible was key.

On March 23rd, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would exempt states from requirements to analyze and monitor access to care in the Medicaid program under certain circumstances. The proposal seeks to amend 42 CFR 447.203(b), which sets forth the process for states to document whether Medicaid payments in fee-for-service (FFS) delivery systems are sufficient to ensure appropriate access to services.