Executive Summary -
Health inequities are pervasive across the country, with the health and well-being of Americans too often diverging along racial and ethnic lines. While recent studies have identified many factors...more
In December 2022, the U.S. Congress took a step to address churn—where enrollees lose Medicaid coverage, often for procedural reasons, and later reenroll after a gap in coverage—in the Consolidated Appropriations Act, 2023...more
On May 18, 2023, the CMS, in consultation with the DOE, released new guidance to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies (SMAs), state education agencies (SEAs), and local education...more
Editor’s Note: In a new issue brief prepared with the support of Arnold Ventures, Manatt Health shares an array of best practice strategies in place across the nation to serve as an actionable road map for states that might...more
Given its role as a critical source of health care coverage for low-income individuals in the United States, including 13 million women of reproductive age, Medicaid is the primary source of family planning coverage in the...more
Medicaid is the primary source of family planning coverage, accounting for 75% of public expenditures for family planning services in the United States. In order to expand the number of people who can access family planning...more
Strong evidence suggests that investing in children’s social needs leads to long-term improvements in health, economic stability and resilience. Despite this growing body of research, stakeholders have historically...more
The Big Picture -
On January 26, 2023, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to amend the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration. A...more
1/31/2023
/ 1115 Waivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Inmates ,
Medi-Cal ,
Medicaid ,
Prisoners ,
Regulatory Agenda
Overview -
Disruptions in Medicaid coverage, and losing coverage altogether despite remaining eligible, are common occurrences for individuals enrolled in Medicaid. These disruptions and coverage losses result in unmet...more
On January 5, the Centers for Medicare & Medicaid Services (CMS) issued guidance for State Health Officials clarifying that Medicaid and CHIP coverage and payment of interprofessional consultations (commonly and hereafter...more
Editor’s Note: Section 1115 demonstrations (also called waivers) allow states to test new ways to operate their Medicaid programs, typically on matters related to eligibility, benefits and care delivery. Recently, the Centers...more
This fall, the Centers for Medicare & Medicaid Services (CMS) approved innovative 1115 waivers for Arizona, Massachusetts and Oregon, authorizing new financing and programmatic flexibilities for delivering services that...more
During the COVID-19 public health emergency (PHE), states implemented numerous Medicaid and Children’s Health Insurance Program (CHIP) policies and operational processes that helped to maintain coverage and support access to...more
The COVID-19 public health emergency (PHE) spurred a seismic shift in the delivery of health care, including services provided to children and adolescents. Pediatric providers rapidly scaled up their telehealth capabilities...more
As a condition of receiving enhanced federal funds under the Families First Coronavirus Response Act, states are maintaining continuous enrollment of all Medicaid enrollees, and many states have also paused Children’s Health...more
The Families First Coronavirus Response Act (FFCRA) provides enhanced federal matching funds to states as a condition of maintaining Medicaid enrollment until the conclusion of the COVID-19 public health emergency (PHE).1 As...more
There is growing momentum among states to develop innovative models to help people involved with the justice system (i.e., justice-involved individuals) receive health care services covered by Medicaid while they are...more
Editor’s Note: Over the course of the COVID-19 public health emergency (PHE), a series of Medicare and Medicaid regulatory flexibilities were implemented to help ensure access to care for older adults and people with chronic...more
3/29/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Infectious Diseases ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Patient Access ,
Relief Measures ,
Telehealth
In recent years, states have sought to leverage Medicaid to address social drivers of health (DoH), relying primarily on waivers for financing. The Center for Medicare & Medicaid Services' (CMS) approval of California’s...more
Editor’s Note: Since the start of the COVID-19 pandemic, federal and state policymakers have acted to preserve access to services for populations that use Medicaid-covered long-term services and supports (LTSS). These...more
3/8/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Infectious Diseases ,
Long-Term Care ,
Medicaid ,
Patient Access ,
Public Health Emergency
Background -
Since the start of the COVID-19 pandemic, federal and state policymakers have acted to preserve access to services for populations that use Medicaid-covered long-term services and supports (LTSS). These...more
3/1/2022
/ Coronavirus/COVID-19 ,
Elder Care ,
Federal Funding ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Infectious Diseases ,
Long Term Care Facilities ,
Long-Term Care ,
Medicaid
President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more
2/16/2022
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Beneficiaries ,
Physicians ,
Public Health Emergency ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth ,
Webinars
Since 2014, states have had the option to expand Medicaid eligibility to include adults with incomes under 138 percent of the federal poverty level. Under this option, the federal government covers 90 percent of the cost of...more
I. Introduction -
Since 2014, states have had the option to expand Medicaid eligibility to most adults with incomes under 138 percent of the federal poverty level (FPL; approximately $30,300 in annual earnings for a family...more
Medicaid has seen significant increases in enrollment across all states since the outbreak of the COVID-19 pandemic. According to the latest data from the Centers for Medicare and Medicaid Services (CMS), total Medicaid...more