Medicaid

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

March 27, 2024 - A new CMS final rule, the “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” rule, aims to modernize and optimize the Medicaid enrollment process, according to a press release from CMS. The rule was proposed in...


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Medicaid disenrollments surpass 18M, exceeding HHS projections

by Victoria Bailey

The Families First Coronavirus Response Act required Medicaid to provide continuous coverage for beneficiaries throughout the COVID-19 pandemic. With disenrollments paused, Medicaid and the...

Medicaid Health Plan Will Reimburse Health Equity Certification

by Kelsey Waddill

Meridian Health Plan of Illinois, Inc.—a wholly-owned subsidiary of Centene Corporation that offers Medicaid coverage—announced that it will cover part of the fee hospitals must pay to...

Continuous Medicaid eligibility during PHE improved postpartum coverage

by Victoria Bailey

The continuous Medicaid eligibility requirement during the COVID-19 public health emergency was associated with increased postpartum Medicaid enrollment and reduced uninsurance, according to a study...

Few Physicians Participate in Both Medicaid and Marketplace Plans

by Victoria Bailey

Less than three in ten primary care physicians participating in Medicaid also participated in an average marketplace network, raising concerns about continuity of care for beneficiaries disenrolled...

HHS Will Provide Technical Assistance to States Addressing Homelessness

by Victoria Bailey

The Department of Health and Human Services (HHS) and the Department of Housing and Urban Development (HUD) are increasing access to federal programs and resources that address homelessness in eight...

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...

States Leverage Waivers To Support Medicaid Redetermination

by Kelsey Waddill

States flocked toward ex parte renewals and contact information update waivers to support Medicaid redetermination processes after the coronavirus public health emergency ended, a KFF brief found. For...

NY Medicaid Section 1115 Waiver Amendment Improves Access to Care

by Victoria Bailey

CMS has approved an amendment to New York State’s Medicaid section 1115 waiver that will address health disparities and improve access to primary and behavioral healthcare, Governor Kathy Hochul...

Does Integrating Medicare and Medicaid Improve Care for Dual Eligibles?

by Victoria Bailey

Integrating Medicare and Medicaid coverage for dual eligible beneficiaries was associated with higher use of home- and community-based services (HCBS) but did not reduce hospitalization or improve care...

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...

What Health Plans Are Available For People With Disabilities?

by Victoria Bailey

Public and private payers alike offer a multitude of benefits for people living with disabilities. According to the CDC, up to 27 percent of adults in the United States have some type of disability, including mobility, cognition,...

How Do Payers Cover Prenatal, Postpartum Care for Pregnant People?

by Victoria Bailey

Prenatal, perinatal, and postpartum care help ensure healthier pregnancies and better birth outcomes for pregnant people. Access to this essential care comes easier with adequate health insurance. Pregnant people are almost guaranteed...

Quality Outcomes Are Better When Medicaid MCOs Administer Pharmacy Benefits

by Victoria Bailey

Pharmacy-related quality outcomes were better in states where Medicaid managed care organizations administered health plans’ pharmacy benefits, according to a report from Elevance Health. The...

Cardiovascular Disease Utilization Grew After Medicaid Expansion

by Kelsey Waddill

Adults with cardiovascular disease are more likely to utilize outpatient cardiovascular services in Medicaid expansion states than in nonexpansion states, a study published in Health Affairs...

An Overview of 2024 Coverage for Veterans Beyond Veterans Affairs

by Kelsey Waddill

Although US veterans have many coverage options, including Veterans Affairs (VA), Medicaid, and the Affordable Care Act (ACA) marketplace, many are projected to remain uninsured in 2024, according to a...

7 Elements of Successful Community Health Worker Integration

by Kelsey Waddill

Medicaid programs are leveraging community health workers (CHWs) to improve patient navigation, quality of care, and cultural competency, a Manatt Health newsletter found. “The use of CHWs...