Public Payers News

1.7M Beneficiaries May Lose Coverage Under Medicaid Work Requirements

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Around 1.7 million Medicaid beneficiaries could potentially lose coverage and $10.3 billion in spending would shift from federal to state governments if Medicaid work requirements were implemented, an...

4 Barriers to Coverage Among Uninsured Individuals in Massachusetts

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Uninsured individuals in the state of Massachusetts face a variety of barriers to healthcare coverage, including real and perceived eligibility gaps and a complex health insurance landscape, a report...

Medicare Advantage Provider Directories Are Inaccurate, Study Finds

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Medicare Advantage provider directories are inaccurate, hindering beneficiaries’ access to mental healthcare, according to a secret shopper survey conducted by the Senate Finance Committee. When...

Potential Outcomes of Basic Health Programs for States, Consumers

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Basic Health Programs (BHPs) can streamline coverage and increase coverage continuity for certain populations, but the cost to states will vary, a report from the Urban Institute shared. “The...

Half of Medicare Beneficiaries Are Enrolled in Medicare Advantage

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Half of all Medicare beneficiaries are enrolled in Medicare Advantage, according to the most recent enrollment data from CMS. The CMS data found that, as of January 2023, 30.19 million of the 59.82...

How to Protect Integration Progress As Medicare-Medicaid Plans Sunset

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As CMS sunsets the Medicare-Medicaid plan model, Congress and the agency will need to take steps to expand the Medicare-Medicaid Coordination Office (MMCO) oversight capabilities and protect the...

Report: Public Insurance Option Would Not Exacerbate Racial Disparities

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Implementing a public insurance option would not significantly impact hospital spending, nor would it exacerbate racial disparities in care access for Black and Hispanic populations, an Urban Institute...

States Use Managed Care, PACE, FAIs to Boost Dual Eligible Care Coordination

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Updated 5/2/2023: This article's title has been updated to say "States Use Managed Care, PACE, FAIs to Boost Dual Eligible Care Coordination." A previous version misspelled the acronym FAI as...

Medicare Advantage, Part D Premiums Increased Slightly in 2023

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Average monthly premiums for Medicare Advantage and Part D plans have increased in 2023, and fewer beneficiaries selected zero-dollar premium plans, a report from eHealth, Inc. found. eHealth’s...

CMS Proposes Transparency, Access Standards for Medicaid Managed Care

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The Centers for Medicare and Medicaid Services (CMS) has released two proposed rules that would establish national access standards for Medicaid managed care plans and increase transparency of Medicaid...

Medicaid Work Requirements Could Disrupt Coverage Access for 21M People

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Around 21 million Americans could face barriers to health insurance coverage if Congress passes the debt ceiling bill that includes Medicaid work requirements, according to an analysis from the US...

The Range for Projected, Post-PHE Medicaid Disenrollment Is Broad

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Depending on the Medicaid disenrollment rate after the public health emergency, the public payer program could lose anywhere from 8 million to over 24 million Medicaid enrollees, a Kaiser Family...

50% of MN Adults Were Uninsured Following Medicaid Disenrollment

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Half of adults who experienced Medicaid disenrollment in Minnesota were uninsured six months after losing coverage, raising concerns about eligibility redeterminations that recently resumed. The...

Medicaid Supplemental Payments Are Inefficient, Demand Change

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Medicaid supplemental payments are not need-based and often leave certain states with excess funds, demonstrating that the processes involved in these payments need to change, according to an issue...

HHS Proposal Could Boost Health Insurance Coverage for DACA Recipients

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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

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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...

Adjusting Medicare Drug Price Negotiation Criteria May Increase Savings

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Adjusting eligibility criteria for Medicare prescription drug price negotiation under the Inflation Reduction Act to include drugs with biosimilars and allow for drug selection based on net spending...

HHS Guidance Increases Care Access for Incarcerated Medicaid Beneficiaries

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The US Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), has released guidance to help states boost access to healthcare for incarcerated...

DACA Recipients Might Gain Access to ACA, Public Payer Coverage

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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...

Younger Medicare Beneficiaries Report More Issues with Care Access, Costs

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Medicare beneficiaries under age 65 reported more cost concerns, worse access to care, and lower care satisfaction compared to older beneficiaries, indicating that the program may not successfully meet...