Health and well-being require far more than medical care. Research shows that personal behaviors, physical environments and socioeconomic factors—commonly referred to as social drivers of health (SDOH)—are responsible for 80...more
The authors are grateful for insights provided by state Medicaid agency staff from the Arizona Health Care Cost Containment System, MassHealth, New York State Department of Health, Oregon Health Authority, Rhode Island...more
In a new webinar based on their soon-to-be-released resource, Integrating Community Care Hubs into Efforts to Address Social Drivers of Health: A Playbook for State Medicaid Agencies, Manatt Health and the Partnership to...more
Issue 1 -
The Issue -
Medicaid is woven into the fabric of states’ health care systems and economies: it covers one in five Americans; is the single largest insurer in every state; and is the largest source of funding...more
On October 24, 2018, North Carolina received approval from the federal Centers for Medicare & Medicaid Services (CMS) of its 1115 waiver for a five-year demonstration period. The waiver provides the North Carolina Department...more
Medicaid has entered a period of volatile change, unprecedented in its 51-year history.
With 74 million members nationwide,1 Medicaid provides health coverage to more than one in four Americans, ensuring access to...more
On November 20, 2017, North Carolina submitted an amended 1115 waiver application to the Centers for Medicare & Medicaid Services (CMS) seeking authority to invest $1.2 billion over five years in a range of targeted...more
Editor’s Note: The Affordable Care Act (ACA) brought sweeping changes to the Medicaid program that have had profound implications for family planning coverage, services and providers. In particular, in the 17 states with...more
Maryland becomes the first State to mandate over-the-counter contraceptive coverage; Missouri plans to increase Medicaid asset limitations by 500% by 2021; and HHS' final rule extends protections against sex discrimination to...more
5/18/2016
/ Affordable Care Act ,
Contraceptive Coverage Mandate ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Health Insurance Exchanges ,
Medicaid ,
Opioid ,
Religious Accommodation ,
SCOTUS ,
Sex Discrimination ,
Zubik v Burwell
CMS encourages access to Medicaid for eligible inmates transitioning to their communities, while New York seeks to extend Medicaid coverage to eligible inmates in the days prior to release; Pennsylvania seeks to shift $6...more
CMS's sweeping final rule aligns Medicaid and CHIP managed care with QHP and Medicare Advantage regulations; New York's DSRIP is enabling change in the State's Medicaid delivery system; and Medicaid expansion reduces...more
California's Marketplace revises its QHP contract to improve care quality and value, and announces its support for a 1332 waiver to allow undocumented immigrants to purchase Marketplace plans; Wisconsin proposes transitioning...more
Rhode Island's Medicaid reforms will save the State $75 million this year; HHS finds that Medicaid expansion improves behavioral healthcare; and California's Marketplace may exclude poor performing hospitals from its QHP...more
3/30/2016
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Budget Office ,
Department of Health and Human Services (HHS) ,
GAO ,
Governor Vetoes ,
Healthcare.gov ,
Hospitals ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Public Health Insurance Marketplace
Oklahoma seeks federal approval for premium assistance program targeted to American Indians/Alaska Natives; Louisiana estimates $100 million in net savings from Medicaid expansion; and Vermont becomes the first state to...more
3/23/2016
/ 1332 Waiver ,
Co-Op ,
Department of Health and Human Services (HHS) ,
Drug & Alcohol Abuse ,
GAO ,
Health Insurance ,
Medicaid ,
Medicaid Expansion ,
Mental Health ,
Native American Issues ,
Premium Assistance ,
Public Health Insurance Marketplace ,
SHOP Program
The IRS releases guidance on resolving Form 1095 conflicts; New Hampshire's Medicaid expansion renewal clears a hurdle in the State; and New York providers get $1.5 billion in long-awaited DSRIP capital and infrastructure...more
3/16/2016
/ Centers for Medicare & Medicaid Services (CMS) ,
DSRIP ,
Health Insurance ,
Healthcare Reform ,
IRS ,
Legislative Agendas ,
Medicaid ,
Medicaid Expansion ,
Prescription Drugs ,
Public Health Insurance Marketplace ,
State and Local Government
HHS approves waiver extending Medicaid coverage to Flint residents impacted by the water crisis; SCOTUS rules that states cannot require self-insured health plans to provide claims data; and seven insurers sign on to...more
STATE STAFFING UPDATES:
Nevada: New Insurance Commissioner Appointed -
The Director of Nevada's Department and Industry announced Barbara Richardson as the Commissioner of the Division of Insurance. Richardson...more
3/2/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
GAO ,
Healthcare Reform ,
Healthcare.gov ,
Managed Care Contracts ,
Medicaid ,
Medicaid Expansion ,
Native American Issues ,
OIG ,
State Health Insurance Exchanges
Medicaid expansion cuts the number of low-income adults without health insurance in Kentucky by nearly 70%; the Georgia legislature considers a "Private Option" coverage expansion bill; and CMS and AHIP collaborate on quality...more
Alabama receives federal approval for its Medicaid transformation waiver, while Michigan's Governor submits a Medicaid waiver on behalf of Flint residents; CMS announces $7.7 billion in reinsurance payments; and Vermont seeks...more
2/18/2016
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicaid Expansion ,
Public Health Insurance Marketplace ,
Qualified Health Plans ,
Reinsurance ,
SHOP Program ,
State Medicaid Programs ,
Waivers
CMS details requirements for Kentucky's transition to HealthCare.gov; a new special enrollment period is established for subsidy-eligible individuals who failed to file their 2014 taxes; and President Obama sends his final...more
Louisiana's Governor pushes ahead on Medicaid expansion, while expansion is blocked by Wyoming's Legislature; Massachusetts plans to submit a 1332 waiver application to preserve its merged markets; and CBO lowers its 2016...more
1/28/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Healthcare Reform ,
Healthcare.gov ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Prescription Drugs ,
State Budgets ,
State Health Insurance Exchanges ,
Tax Credits
Louisiana's Governor signs an executive order on his first day in office to expand Medicaid; Kentucky's Governor opts to replace, rather than repeal, its Medicaid expansion program; and New York and Missouri make it easier...more
HealthCare.gov enrolls 8.2 million; Manatt and RWJF release an open access dataset on Marketplace plans nationwide; Montana names administrator for its Medicaid expansion; and Michigan gets the green light in the nick of time...more
A flurry of support for Medicaid expansion this week…with Virginia hospitals backing a provider assessment, Wyoming's Governor putting forth a budget initiative, and Arkansas announcing plans to extend its waiver. Meanwhile,...more
12/10/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Conflicts of Interest ,
Enrollment ,
Governor Pence ,
Healthcare Costs ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
State Budgets ,
Waivers
With the election of a new Governor, the future of Kentucky’s Marketplace and Medicaid expansion is uncertain; CMS questions Iowa on its Medicaid managed care transition timeline; and the Supreme Court agrees to hear a case...more
11/11/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Co-Op ,
Contraceptive Coverage Mandate ,
Hepatitis C ,
Medicaid ,
Medicaid Expansion ,
Medicaid Reform ,
Pharmaceutical Industry ,
SCOTUS ,
State Health Insurance Exchanges