Health Reform + Related Health Policy News - December 12, 2012


In This Issue:

- CMS Clarifies ACA's Federal Match Linked to Full Medicaid Expansion

- SCOTUS to Decide Pay-for-Delay Issue

- Two More Lawmakers Introduce Drug Compounding Legislation

- AHRQ Report Finds Teamwork Key to Long-Term Sustainability of Health IT Systems

- Testing Labs Protected From CMS Sanctions Under New Law

- Excerpt from CMS Clarifies ACA's Federal Match Linked to Full Medicaid Expansion:

Under the ACA, the federal government will pay all state costs for expanding Medicaid eligibility to 133 percent of the Federal Poverty Level (FPL) beginning in 2014. The enhanced match will gradually decline to cover 90 percent of the states’ costs by 2020. In the wake of the Supreme Court’s ruling that states are not required to expand their Medicaid programs, there was confusion as to whether states could receive an enhanced federal medical assistance percentage (FMAP) for a partial eligibility expansion (to a level below 133 percent FPL). CMS wrote in guidance that the ACA “does not provide for a phased-in or partial expansion. As such, we will not consider partial expansions for populations eligible for the 100 percent matching.” However, CMS indicated that it will consider demonstration programs using its existing waiver authority to provide coverage to Medicaid recipients under alternative models, but existing Medicaid matching rates would apply. CMS also noted that states that opt to expand their Medicaid programs may decide later to drop the coverage.

Please see full newsletter below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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