Medicaid

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A Quick Guide to Choosing Federal Medicaid Authorities to Address Health-Related Social Needs

On January 11, Mathematica published a blog titled “A Quick Guide to Choosing Federal Medicaid Authorities to Address Health-Related Social Needs.” This blog explores the three most common federal Medicaid authorities that enable states to offer health-related social needs (HRSN) services to Medicaid-enrolled individuals: Section 1915 HCBS waivers, Managed Care In Lieu of Services (ILOS), and Section 1115 demonstrations. It also discusses key factors to contemplate as a state Medicaid official when choosing how to cover HRSN services, emphasizing considerations such as the intended population, types of services, and program features.

Short URL: http://www.advancingstates.org/node/75239

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MACStats: Medicaid and CHIP Data Book

The Medicaid and CHIP Payment and Access Commission (MACPAC) recently released the 2023 edition of their “MACStats: Medicaid and CHIP Data Book,” which presents the most current data available on Medicaid and the State Children’s Health Insurance Program (CHIP). These programs provide a safety net for low-income populations who otherwise would not have access to health care coverage and cover services other payers often do not. This data book compiles the broad range of Medicaid and CHIP statistics that MACPAC regularly updates on macpac.gov into a single, end-of-year publication. MACPAC’s purpose is to bring together in one place federal and state data on Medicaid and CHIP that come from multiple data sources...

Short URL: http://www.advancingstates.org/node/75230

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New Medicaid Unwinding Resource Hub

Last week, the U.S. Department of Health and Human Services (HHS) launched a new online resource hub with Medicaid and CHIP Renewal and Transition Resources for Partners. This virtual hub provides key resources in one centralized location so all partners (e.g., states, beneficiary and provider organizations, and advocates among others) can better assist people with Medicaid or Children’s Health Insurance Program (CHIP) renew their health coverage or find other coverage options that may be a better fit for them. This hub contains the following resources: Resources to help others with coverage Outreach materials by population category Key government actions taken to support Medicaid renewals and transitions...

Short URL: http://www.advancingstates.org/node/75226

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Guidance to State Medicaid Agencies on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist Services, Mental Health Counselor Services, and Intensive Outpatient Services

On December 14, the Center for Medicaid and CHIP Services (CMCS) issued an Informational Bulletin to advise state Medicaid agencies that starting January 1, 2024, Medicare will begin covering and making payments for marriage and family therapists (MFT) and mental health counselors (MHC), and intensive outpatient program (IOP) services provided to dually eligible beneficiaries, or individuals enrolled in Medicare and Medicaid. These provisions were implemented as part of the Calendar Year (CY) 2024 Physician Fee Schedule final rule (Centers for Medicare & Medicaid Services (CMS)-1784-F, “Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2024”)...

Short URL: http://www.advancingstates.org/node/75160

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Refugee and Asylee Data on the Utilization of Medicaid

The U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Office of Refugee Resettlement have jointly released a report aimed at enhancing the data infrastructure of agencies managing refugees and Medicaid services. This report, funded by the Patient-Centered Outcomes Research Trust Fund, addresses data gaps in understanding the health and well-being of refugees. By linking data from two HHS administrative systems, the Refugee Arrivals Data System (RADS) and the Transformed Medicaid Statistical Information System Analytic Files (TAF), the report provides insights into Medicaid enrollment trends and service utilization among refugees...

Short URL: http://www.advancingstates.org/node/75007

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Medicaid Enrollment and Unwinding Tracker

KFF released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on February 1. 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.

Short URL: http://www.advancingstates.org/node/74987

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What Do Medicaid Unwinding Data by Race and Ethnicity Show?

A recent analysis by KFF explores the unwinding of the pandemic continuous enrollment provision in Medicaid, with a focus on its impact on different racial and ethnic groups. This analysis was based on data from the nine states reporting data that allowed for analysis of disenrollment patterns by race and ethnicity as of September 2023: Arizona, California, Indiana, Minnesota, Oregon, Nevada, Oklahoma, Virginia, and Washington. The analysis found that across these states, the racial and ethnic composition of people losing coverage generally mirrors that of the overall Medicaid population. While available data on Medicaid disenrollments by race/ethnicity suggest people of color are not at greater risk of being disenrolled, the data...

Short URL: http://www.advancingstates.org/node/74948

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Medicaid and CHIP Mental Health (MH) and Substance Use Disorder (SUD) Action Plan

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.

Short URL: http://www.advancingstates.org/node/74766

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CMS releases the 2021 Medicaid Managed Care Enrollment and Program Characteristics and Data Tables

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.

Short URL: http://www.advancingstates.org/node/74765

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CMS Releases Calendar Year (CY) 2024 Medicare Proposed Payment Rules

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%....

Short URL: http://www.advancingstates.org/node/74759

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