Medicaid

On July 25, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid and CHIP Mental Health (MH) and Substance Use Disorder (SUD) Action Plan Overview and Guide, outlining the agency's strategies for enhancing treatment and support for enrollees with these conditions. Key areas of focus include enhancing coverage and integration to expand access to prevention and treatment services, promoting engagement in care through increased availability of home and community-based services, and extending coverage to non-traditional services and settings. Additionally, the plan aims to improve the quality of care for individuals with MH conditions and SUDs.

On July 25, The Centers for Medicare & Medicaid Services (CMS) released the 2021 data on Medicaid Managed Care enrollments, program characteristics, and data tables. This national data is broken down by program and population, as well as by individual state. The enrollment data provides an accurate snapshot of Medicaid managed care enrollment for a particular year as of July 1st of each year.

On July 13th, CMS published several proposed CY 2024 physician and hospital Medicare payment rules with comments due on September 11, 2023. The proposed rules are: CY 2024 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS 1786-P). CMS proposes updating OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.8%....

The Kaiser Family Foundation (KFF) released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on July 20th. This tracker provides state-level data on Medicaid/CHIP enrollment, unwinding, renewals, and other measures. Please note that while the tool includes national data reported by CMS, it has a lag of several months and may not reflect the most current Medicaid enrollment status.

Justice in Aging has published a fact sheet providing guidance for advocates working with older adults who are dually eligible for Medicare and Medicaid. It emphasizes two important features of the Medicare Part D Low-Income Subsidy (LIS): Medicaid termination does not immediately end LIS enrollment, and LIS eligibility is often more generous than Medicaid and Medicare Savings Program (MSP) eligibility rules. The fact sheet offers practice tips to help advocates ensure that older adults understand their LIS enrollment during the Medicaid unwinding period and their options for continuing their LIS coverage...

On June 15th, MedPAC released its June 2023 “Report to the Congress: Medicare and the Health Care Delivery System”. Each June, as part of its mandate from the Congress, MedPAC reports on issues affecting the Medicare program as well as broader changes in health care delivery and the market for health care services. The report includes ten chapters. Examples of information addressed in the report includes the following: High prices of drugs and biologics covered under Medicare Part B. Due to an increase in Medicare Part B drug spending between 2009 and 2021, the Commission recommends three policies designed to improve Medicare's Part B drug payment system and reduce spending growth for Part B drugs....

The Kaiser Family Foundation (KFF) released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on June 20th. This tracker provides state-level data on Medicaid/CHIP enrollment, unwinding, renewals, and other measures. Please note that while the tool includes national data reported by CMS, it has a lag of several months and may not reflect the most current Medicaid enrollment status.

On June 12, the U.S. Department of Health and Human Services (HHS) announced new flexibilities to help keep individuals covered as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter Secretary Becerra sent to the nation’s governors encouraging them to adopt available flexibilities to minimize coverage losses. Building on flexibilities HHS offered to states before renewals resumed, some of the new flexibilities announced include: Allowing managed care plans to assist people with Medicaid with completing their renewal forms, including completing certain parts of the renewal forms on their behalf....

MACPAC, the non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP), released its June 2023 Report to Congress on Medicaid and CHIP. The report features the agency’s recommendations in four areas: payment policy for safety net hospitals, integrated care for people who are dually eligible for Medicaid and Medicare, coverage for adults leaving incarceration, and access to Medicaid home- and community-based services (HCBS)...

On June 7, Justice in Aging published an issue brief titled “An Equity Framework for Evaluating and Improving Medicaid Home and Community Based Services.” In recent decades, long-term care has shifted from institutional settings to home and community-integrated settings. While access to HCBS has been steadily increasing over time, systemic inequalities due to racism, sexism, ageism, classism, etc. have led to large disparities in HCBS for diverse communities. This issue brief evaluates several ways in which the current setup of HCBS can cause inequities to arise. This includes program design, provider availability, awareness of HCBS, implicit bias in services, and provision of HCBS...