New Study Measures Importance of Health Coverage


The Annals of Internal Medicine, a distinguished publication of the American College of Physicians, issued a study on May 5, 2014 showing that Massachusetts health care reform was associated with a statistically significant reduction in all-cause mortality (- 2.9 percent, p = 0.003, equivalent to a decrease of 8.2 deaths/100,000 adults) and an even more robust reduction in mortality from causes amenable to health care interventions such as infections, cancer, cardiovascular disease, diabetes, and kidney disease (- 4.5 percent, p < 0.001). [More]


CMS Report Shows Continuing Growth in Medicaid/CHIP Enrollments


The Centers for Medicare and Medicaid Services (CMS) released on May 1, 2014 a report showing that 25 states which implemented Medicaid expansion under the Affordable Care Act (ACA) by March 2014 saw on average a 12.9 percent increase in Medicaid/CHIP enrollment for March 2014, as compared to those states’ average monthly enrollments in a July – September 2013 baseline period (Michigan, which implemented Medicaid expansion in April 2014, and New Hampshire, expected to implement Medicaid expansion in July 2014, are not included in this calculation). [More]

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HHS Releases Report on Exchange Enrollments


The U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE), released on May 1, 2014 a health insurance Exchange enrollment report for the October 1, 2013 – March 31, 2014 open enrollment period and a subsequent special enrollment period through April 19, 2014. It shows that 8,019,763 Exchange eligible individuals selected a qualified health plan (QHP) through Exchanges and that another 6,724,660 individuals have been determined/assessed eligible for Medicaid/CHIP through Exchanges. [More]

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Bipartisan Support for Preventing Sex Trafficking and Improving Opportunities for Youth in Foster Care Act


Legislation that Congressman Dave Reichert (R-WA), Chairman of the Subcommittee on Human Resources of the Committee on Ways and Means introduced on February 14, 2014 provides significant provisions for youth in and out of the foster care system who might fall prey to sex traffickers. On April 29, 2014, the committee did a bill markup with significant bipartisan support and leadership. The legislation has a companion bill in the Senate, introduced by Senator Orrin Hatch (R-UT) in September 2013. [More]


The Affordable Care Act and Foster Youth


The need for foster youth to have continued Medicaid after leaving the foster care system is tremendous. The Congressional Research Service reported that between 35 and 60 percent of the youth have at least one chronic or acute health condition that requires treatment, 50 to 75 percent have behavioral or social competency issues that require monitoring, and as many as 57 percent of foster care youth have a mental disorder. On average, about 26,000 foster adults ages 18 to 22 leave the foster care system every year with few tools and supports to help them maneuver their lives. [More]


CMS Finalizes FQHC Prospective Payment Rule


The Centers for Medicare and Medicaid Services (CMS) released a final rule on April 29, 2014 on a new Medicare Part B prospective payment system (PPS) for federally qualified health centers (FQHCs). These are 1,240 public and private non-profit organizations that deliver primary and preventive care services at 3,830 sites serving 21 million persons in medically underserved urban, rural, and tribal communities throughout the United States. The rule implements section 10501 of the Affordable Care Act, which authorizes nation-wide encounter-based rates derived from aggregated FQHC cost report data. [More]

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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]