CHIP

Medicaid final rules improve care access for managed care, FFS beneficiaries

April 23, 2024 - CMS has finalized policies to improve access to Medicaid and the Children’s Health Insurance Program (CHIP) managed care and boost coverage quality. The Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality Final Rule and the Ensuring Access to Medicaid Services Final Rule address state payments,...

Read More


More Articles

PHE unwinding work may aid Medicaid, CHIP final rule compliance

by Victoria Bailey

The eligibility and enrollment processes for Medicaid and the Children’s Health Insurance Program (CHIP) have been riddled with inefficiencies. Policies like annual coverage limits and waiting periods have created barriers for...

CMS final rule aims to simplify Medicaid, CHIP enrollment, coverage

by Kelsey Waddill

A new CMS final rule, the “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal...

How Do Payers Cover COVID-19 Vaccines, Treatments, and Tests Post-PHE?

by Victoria Bailey

After the public health emergency (PHE) ended, many federal regulations that facilitated access to COVID-19 vaccines, treatments, and tests expired. While some policies may still apply, coverage...

HHS Urges States to Reduce Medicaid, CHIP Child Disenrollments

by Victoria Bailey

The Department of Health and Human Services (HHS) is urging states to employ federal strategies to help reduce child disenrollments from Medicaid and the Children’s Health Insurance Program...

CMS Orders States to Provide Continuous Coverage for Kids in Medicaid, CHIP

by Victoria Bailey

CMS is reminding state health officials of the upcoming continuous coverage requirements for children in Medicaid and the Children’s Health Insurance Program (CHIP). Provisions in the...

CMS: Ex Parte Systems May Disenroll Eligible Medicaid, CHIP Enrollees

by Kelsey Waddill

CMS has identified system errors that may unnecessarily disenroll eligible Medicaid and Children’s Health Insurance Program (CHIP) enrollees during the redetermination process and is calling on...

Unnecessary Utilization in CO Leads to $134M in Healthcare Spending

by Kelsey Waddill

Updated 8/24/2023: This article has been updated to reflect that the share of healthcare spending on low value care was highest in commercial health plans. Previously, the article framed...

How Medicaid Network Adequacy Rules Affect Children with Special Needs

by Kelsey Waddill

Children with special health care needs (CSHCN) may experience access to care barriers as a result of new quantitative Medicaid network adequacy standards, a study published in Health Affairs...

Employer Sponsored Health Plan Enrollment Will Hit 159M in 2033

by Kelsey Waddill

Employer-sponsored health plan enrollment among nonelderly Americans will grow after 2025, accompanied by higher private payer premiums, a Health Affairs study found. The study used Congressional...

How to Increase Access to Prenatal Vaccines for Medicaid Beneficiaries

by Victoria Bailey

Solidifying access to prenatal vaccines can help minimize maternal health disparities for pregnant people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). A white paper...

HHS Proposal Could Boost Health Insurance Coverage for DACA Recipients

by Victoria Bailey

The US Department of Health and Human Services (HHS) has released a proposal that would expand access to health insurance coverage for Deferred Action for Childhood Arrivals (DACA) recipients. The...

CMS Approval Expands School-Based Health Services in Illinois

by Victoria Bailey

The Centers for Medicare and Medicaid Services (CMS) has approved a state plan amendment (SPA) in Illinois to expand school-based health services for children with Medicaid. The SPA will allow...

DACA Recipients Might Gain Access to ACA, Public Payer Coverage

by Kelsey Waddill

The US Department of Health and Human Services (HHS) has announced plans to improve health insurance coverage for Deferred Action for Childhood Arrivals (DACA) recipients, offering access to Affordable...

States Plan Various Continuity of Coverage Strategies Post-PHE

by Kelsey Waddill

States are responding to the public health emergency unwinding in a variety of ways, with some states placing greater emphasis on continuity of coverage than others, a Kaiser Family Foundation (KFF)...

Enrollment in Medicaid, CHIP Has Grown 28% During the Pandemic

by Victoria Bailey

Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) has increased by 20.2 million beneficiaries since the start of the COVID-19 pandemic, according to an analysis from the...

Aetna Funding Improves Healthcare Access for Domestic Violence Survivors

by Victoria Bailey

Aetna’s Children’s Health Insurance Program (CHIP) organization, Aetna Better Health Kids, has contributed $50,000 to help increase access to trauma-informed, affordable healthcare for...

65% of Beneficiaries Were Uninsured After Medicaid, CHIP Disenrollment

by Victoria Bailey

Almost two-thirds of beneficiaries were uninsured for part or all of the year following disenrollment from Medicaid or the Children’s Health Insurance Program (CHIP), an issue brief from the...

HHS, CMS Guidance Boosts Access to Specialty Behavioral Healthcare

by Victoria Bailey

The US Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), has expanded access to specialty behavioral healthcare for Medicaid and...

156M Beneficiaries Receive Health Insurance Through Public Programs

by Victoria Bailey

More than 150 million people receive health insurance through public programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), according to the latest enrollment...

Recent Articles