Virgina Governor Signs Mental Health Reform Legislation into Law

 

On April 28, 2014, Virginia Governor Terry McAuliffe signed SB260 providing for mental health reform. The General Assembly apparently reacted collectively to the unfortunate stabbing of Senator R. Creigh Deeds by a son, afflicted with mental illness, who subsequently committed suicide. The son was supposed to receive institutional care, but no bed was deemed to be available under state requirements. The same General Assembly remains deadlocked over the issue of Medicaid expansion under the Affordable Care Act. [More]

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Commonwealth Fund Releases Case Studies on Regional Health Improvement

 

The Commonwealth Fund has released an April 17, 2014 report entitled, “Opportunities for Regional Health Improvement: Three Case Studies of Local Health Care System Performance.” The Fund has used 43 performance indicators measuring access to care, prevention and treatment, efficient service utilization, and population health outcomes, which it has applied to 306 geographic regions in the United States. The April 17 report examines three regions that ranked in the top quartile on the Fund’s scorecard despite local socioeconomic challenges: western New York, west central Michigan, and southern Arizona. [More]

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NH Medicaid Enhancement Tax Found Unconstitutional

 

On April 10, 2014, Hillsborough North County Superior Court Judge Philip Mangones found unconstitutional New Hampshire’s Medicaid Enhancement Tax (MET). The tax was instituted in 1991 to permit New Hampshire to gain additional federal Medicaid revenue by taxing New Hampshire hospitals in accordance with federal Medicaid reimbursement enhancement regulations. [More]

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CMS Issues Guidance on Medicaid DSH Auditing and Reporting Requirements

 

The Centers for Medicare & Medicaid Services (CMS) issued guidance on auditing and reporting requirements for Medicaid Disproportionate Share Hospital (DSH) payments, which are intended to bring transparency to the use of DSH funds. The guidance, issued on April 4, 2014, is entitled, “Additional Information of the DSH Reporting and Audit Requirements-Part 2.” In the December 19, 2008 Federal Register, CMS issued a final rule establishing new requirements to implement a provision of the Medicare Prescription Drug, Improvement, and Modernization Act. That final rule included a transition period related to audit findings for Medicaid state plan rate years (SPRYs) 2005 through 2010. CMS has stated that this new additional guidance “is designed to ensure proper implementation, consistent practice, and protection for states and hospitals as we approach the end of the regulatory transition period”. [More]

 

New York Wins CMS Approval of Medicaid Redesign Plans

 

The Centers for Medicare and Medicaid Services (CMS) notified the New York Department of Health on April 14, 2014 that CMS has approved New York’s plans to redesign its Medicaid program under section 1115 demonstration waivers. New York’s plans include completing work begun by Governor Andrew Cuomo’s Medicaid Redesign Team (MRT), which developed 79 recommendations after extensive state-wide stakeholder input. The CMS letter officially approves amendments to a current section 1115 demonstration running through December 31, 2014 and establishes parameters for a subsequent, five year renewal period. The CMS letter authorizes $8 billion in Federal Medicaid funding for innovative programs, within a global Medicaid cap, in three major categories. [More]

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Covered California Reports QHP Enrollment Surge in March

 

Covered California, the nation’s largest health insurance Exchange, released enrollment data on April 3, 2014 showing that enrollments in qualified health plans (QHPs) offered through the Exchange surged to 1,221,727 on March 31, 2014, the last day of the six month open enrollment period (versus 868,936 that had been reported through February 28); on the last day, a record number of 117,421 application accounts were set up on the Exchange. [More]

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CMS Report Shows February Growth in Medicaid/CHIP Enrollment

 

The Centers for Medicare and Medicaid Services (CMS) released on April 4, 2014 a report showing that 25 states which implemented Medicaid expansion under the Affordable Care Act (ACA) by February 2014 saw on average an 8.3 percent increase in Medicaid/CHIP enrollment for February 2014, as compared to those states’ average monthly enrollments in a July – September 2013 baseline period. The largest percentage increases were in Oregon (34.8 percent), West Virginia (33.5 percent), Vermont (32.3 percent), Nevada (21.7 percent), and Maryland (20.8 percent). The ACA created as of January 1, 2014 a new Medicaid eligibility category of non-disabled, childless adults with incomes up to 133 percent of the Federal poverty level, but exact data are not yet available from CMS on how many January – February 2014 enrollees are in that new ACA category. [More]

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President Obama Signs H.R. 4302

 

On April 2, President Obama signed into law H.R. 4302, the “Protecting Access to Medicare Act of 2014,” which averts a 24 percent reduction in Medicare Part B physician payment rates until at least March 31, 2015. As in many prior years, Congress set aside Medicare payment reform proposals that would have repealed the “sustainable growth rate” (SGR) formula (in Medicare law since 1997) but postponed for another year the payment reductions that the SGR formula would have imposed. Instead, physician payment rates will increase 0.5 percent as a result of the new legislation. H.R. 4302 also postpones from October 1, 2014 to October 1, 2015 the date upon which the Centers for Medicare and Medicaid Services (CMS) can require health care providers and health plans to transition from ICD-9-CM to ICD-10-CM coding on claims, a five-fold increase in diagnostic coding specificity. [More]

 

New Hampshire Agrees to Medicaid Expansion Plan under ACA

 

On March 26, 2014, New Hampshire Governor Maggie Hassan signed Senate Bill 413 into law, joining 25 other states in expanding Medicaid eligibility under the Affordable Care Act (ACA). The New Hampshire law will provide health insurance to 50,000 low-income adults in a 2 ½-year pilot program paid for with federal Medicaid funding. [More]

 

HHS Finalizes Exchange Rules for 2015

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published final rules in the March 11, 2014 Federal Register as part of the HHS Notice of Benefit and Payment Parameters for 2015 related to the risk adjustment, reinsurance, and risk corridors programs under the Affordable Care Act (ACA). The Notice of Benefit and Payment Parameters for 2015 deals mainly with health insurance issuer contributions into risk pools and disbursements from risk pools to health insurance issuers to maintain stability in the health insurance marketplace as coverage expands as a result of the ACA. [More]

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