Medicaid

A recent report by the U.S. Department of Health and Human Services used Medicare data to identifiy certain characteristics or risk factors that placed nursing home residents at an increased risk of discharge. Characteristics included residents with severe behavioral symptoms, residents with psychiatric and mood disorders, residents with impairments that required more staff time, residents transitioning to Medicaid.

On Friday, November 11, 2022 HHS announced that it will again extend the COVID-19 Public Health Emergency (PHE). Based on commitments to provide at least 60 days’ notice prior to allowing the PHE to lapse, HHS had until Saturday, November 12, to provide states with notice that the PHE would either be extended or end in January. This means that unwinding protocol will not yet begin, and that the PHE policies such as Medicaid FMAP increases; continuous eligibility; and the 1135, Appendix K, and Emergency SPAs will remain in effect.

This brief includes a checklist of eight key questions that can help state purchasers and other payers develop a robust payment and spending strategy focused on advancing health equity. Each question includes concrete state examples for adopting health equity-focused payment methods. This brief is a product of Advancing Health Equity, a national initiative supported by the Robert Wood Johnson Foundation that is working with states to pursue payment innovations that support health equity.

Late yesterday CMS released a State Medicaid Director Letter (SMDL 22-003) providing guidance for the first-ever HCBS Quality Measure Set, the first of two planned guidance documents from CMS. The HCBS Quality Measure Set is included in the SMD, starting on page 14. The list of measures includes the NQF number (if applicable), measure steward, and data collection method, as well as information on whether each measure addresses section 1915(c) waiver assurances and/or can be used to assess access, LTSS rebalancing, and/or community integration and HCBS settings requirements.

This KFF issue brief describes the anticipated enrollment changes in pathways based on old age or disability (“non-MAGI”) after the Public Health Emergency (PHE) ends, state enrollment and renewal policies for non-MAGI groups as of January 1, 2022, and state plans for resuming normal operations when the PHE ends.

On Thursday, February 24, 2022, CMS released a CMCS Informational Bulletin with the updated 2022 Federal Poverty Level Standards. The 2022 guidelines reflect the 4.7 percent price increase between calendar years 2020 and 2021. After this inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family and household sizes. The informational bulletin also includes a 2022 Dual Eligible Standards chart that displays the new standards for the Medicare Savings Program categories.

This brief outlines key recommendations to further Medicaid and public health opportunities and cross-agency partnerships that advance health equity. These cross-agency efforts can use three broad strategies to promote health equity: (1) advance internal-facing health equity work; (2) leverage data to drive health equity efforts; and (3) engage community members authentically.

NCOA, in partnership with the Medicare Rights Center, recently expanded the resources in their toolkit that help explain integrated care coverage options for dual eligibles. New items in the toolkit include a video tutorial explaining integrated care, an infographic for counselors, and comparison charts highlighting the differences between Original Medicare, PACE, Duals Special Needs Plans (D-SNPs) and integrated D-SNPs.

CHCS senior program officer, Diana Crumley, JD, MPAff, has helped state Medicaid agencies, health plans, and community-based organizations think through issues regarding health-related social needs and social care integration over the last four years. This blog post outlines four lessons from her experience supporting health care stakeholders address health-related social needs and health inequities, while focusing on advanced primary care and Medicaid managed care.

The Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities to protect themselves and patients from the COVID-19 Delta variant. On Thursday, September 9, 2021, CMS, in collaboration with the CDC, announced that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others.