Archive for: Medicaid

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Payment Innovation: Innovation Center

Innovation Center Holds Second Webinar on InCK Funding Opportunity

The Innovation Center is holding its second webinar on the InCK Model Notice of Funding Opportunity.

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Insurance Coverage: Regulation

Utah Medicaid 1115 Waiver Summary

On June 22, 2018, Utah submitted an 1115 waiver amendment to CMS seeking to implement a partial and capped Medicaid expansion, as well as Medicaid work requirements for certain populations. Following that waiver amendment, on February 6, 2019, Utah submitted an additional 1115 waiver amendment lifting the Medicaid Institution for Mental Disease (IMD) exclusion for…

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Payment Innovation: Innovation Center

Innovation Center Hosts Webinar on MOM Model Application Process

The Innovation Center will hold a webinar on the MOM Model application process on April 4, 2019.

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Insurance Coverage: Original Analysis

Ohio Section 1115 Waiver Approval

On March 15, 2019, CMS approved Ohio’s Medicaid 1115 waiver, allowing the state to implement work requirements for certain Medicaid recipients.

ORIGINAL ANALYSIS

Payment Innovation: Other

CMS Publishes Guidance on 1115 Waiver Evaluations

CMS published guidance for states on 1115 waiver evaluations.

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Payment Innovation: Other

CMS Updates Drug Spending Dashboards

CMS updated its drug spending dashboards with 2017 data.

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Insurance Coverage: Stakeholder Engagement

Actuaries Weigh in on Expanding Public Insurance

An American Academy of Actuaries report out today breaks down criteria and implications for “Medicare for All” and less sweeping approaches, including Medicare and Medicaid buy-ins.

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Payment Innovation: Other

CMS Approves Drug Price Negotiations for Colorado Medicaid

Colorado has become the latest state to receive approval from CMS for negotiating drug prices for Medicaid recipients using value-based contracting arrangements.

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Payment Innovation: Innovation Center

Innovation Center Hosts Webinar on MOM Model Application Process

CMMI is holding a webinar on February 21 from 2:00 to 3:15 pm ET to review the Maternal Opioid Misuse (MOM) model Notice of Funding Opportunity and Grants.gov application process.

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Insurance Coverage: Legislation

Medicaid Expansion Bill Introduced

On February 14, 2019, Senator Brian Schatz (D-HI) introduced the State Public Option Act (S. 489) which allows states to provide a public option through Medicaid for individuals not otherwise covered under Medicaid or enrolled in other insurance.

EXTERNAL LINK

Payment Innovation: Innovation Center

InCK Model: Notice of Funding Opportunity and Webinar on February 19

The CMS Innovation Center has announced a funding opportunity for the Integrated Care for Kids model and a webinar on Feb. 19.

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Payment Innovation: Innovation Center

Maternal Opioid Misuse Model Funding Opportunity Announced

The CMS Innovation Center will execute up to 12 cooperative agreements with states whose Medicaid agencies will implement the Maternal Opioid Misuse model with one or more “care-delivery partners” in their communities. The Notice of Funding Opportunity is now available.

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Payment Innovation: Other

HHS and OIG Releases Proposal Targeting PBMs

HHS and OIG release proposed rule targeting pharmacy benefits managers.

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Payment Innovation: Innovation Center

McDermottPlus Launches 2019 CMS/CMMI Payment Model Tracker

This handy CMMI payment model tracker will allow you to easily follow changes and help you better understand the evolution of value-based payment in the Medicare and Medicaid program.

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Insurance Coverage: Legislation

Medicaid Extenders Act of 2019

On January 24, 2019, the Medicaid Extenders Act of 2019 (H.R. 259) was signed into law. This law extends the Money Follows the Person program, among other things.

EXTERNAL LINK

Payment Innovation: Other

Institute for Medicaid Innovation Survey Finds Medicaid MCOs Are Increasingly Using Value-based Payment Models

Survey results released by the Institute for Medicaid Innovation find that around half of Medicaid managed care organizations launched population-specific value-based purchasing models last year, and around 10 percent of plans had extensive value-based purchasing arrangements in place.

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Payment Innovation: Innovation Center

CMS Announces MOM Model

CMS announces the Material Opioid Misuse (MOM) model as part of the agency’s strategy for combating the opioid crisis.

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Payment Innovation: Other

LAN Releases Updated Report on APM Adoption

Health Care Payment Learning and Action Network released a new report on alternative payment model adoption.

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Payment Innovation: Innovation Center

CMS Announces Integrated Care for Kids Model to Address the Opioid Crisis

On August 23, 2018, CMS announced a new model that is intended to address the opioid crisis for children.

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Insurance Coverage: Budget Information

House GOP Proposes 2019 Budget Plan

The Republican House Budget Committee released a FY 2019 budget roadmap, The Budget for A Brighter American Future, on June 19.

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Insurance Coverage: Stakeholder Engagement

Republican Governors Criticize American Health Care Act

On March 16, 2017, four Republican governors (John Kasich of Ohio, Rick Snyder of Michigan, Brian Sandoval of Nevada and Asa Hutchison of Arkansas) sent congressional leaders a letter criticizing the American Health Care Act and proposing an alternative framework for reforming the Medicaid program. The four governors endorse per capita caps and block grants,…

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Insurance Coverage: Stakeholder Engagement

The Commonwealth Fund: Medicaid’s Future: What Might ACA Repeal Mean?

January 12, 2017 report examining how repeal legislation could affect Medicaid.

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Insurance Coverage: Congress

Senate Finance Committee Letter to RGA on Jan 2017 Medicaid Roundtable

In a letter to the Republican Governors Association dated December 13, 2016, the Senate Finance Committee announced that it will convene a Governor Roundtable in January 2017 to discuss the sustainability and future of the Medicaid program.

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Insurance Coverage: Stakeholder Engagement

What Would Block Grants or Limits on Per Capita Spending Mean for Medicaid?

November 18, 2016 report from the Commonwealth Fund examining the President-elect Trump and some congressional leaders’ calls for absolute limits on the federal government’s spending on Medicaid.  This report explores the two most common proposals for reengineering federal funding of Medicaid: block grants that set limits on total annual spending, regardless of enrollment; and caps…

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