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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its latest Health Law News.
Included in the November edition are articles about:

  • a proposal to impose a work requirement on Pennsylvania Medicaid recipients
  • the CHIP program
  • leadership changes in health care-related state agencies
  • the rollout of the Community HealthChoices program of managed long-term services and supports
  • HealthChoices managed care contracts
  • changes in several state waiver programs

Find these stories here in the latest edition of Health Law News.

2017-11-20T06:00:01+00:00November 20th, 2017|HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

Feds Propose New Medicaid Managed Care Regs

The Centers for Medicare & Medicaid Services (CMS) has proposed its first major changes in regulations governing Medicaid managed care in more than a decade.
In a 653-page draft regulation published on Monday, CMS proposes imposing a medical-loss ratio on Medicaid managed care plans; establishing new standards for adequate provider networks; partially lifting the ban on payments to institutions for mental diseases; pursuing greater transparency in rate-setting; and new quality initiatives that mirror those of Medicare and the federal marketplace.
In addition, the proposed regulation calls for new marketing guidelines for Medicaid managed care plans, improved access to information for Medicaid beneficiaries, and new program integrity measures.  It also proposes better aligning the governance of CHIP with Medicaid, new requirements for managed long-term services and supports, and new tools for fostering delivery system reform at the state level.
Bookshelf with law booksWith virtually all Medicaid recipients in Pennsylvania now enrolled in managed care plans, this regulation will be significant for the state’s safety-net hospitals.
Interested parties have until July 27 to submit comments to CMS about the proposals.
To learn more about this major regulatory proposal, see this Kaiser Health News article; find the regulation here;  and see this CMS fact sheet on the draft regulation.

2015-05-28T06:00:35+00:00May 28th, 2015|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off on Feds Propose New Medicaid Managed Care Regs

GAO Reports on CHIP Extension

As a House-approved bill that would extend authorization for the Children’s Health Insurance Program (CHIP) for two years awaits Senate consideration, the U.S. Government Accountability Office (GAO) has issued a mandated evaluation of the program.
Among the GAO’s findings, it concluded that children enrolled in the program

… (1) had substantially better access to care, service use, and preventive care when compared with uninsured children; and (2) experienced comparable access and service use when compared with privately insured children.

It also found that nearly all children between the age of one and two enrolled in CHIP or Medicaid made at least one visit to a primary care physician in 2013; that the program’s costs for families were almost always less than states’ benchmark plans established under the Affordable Care Act; and that its benefits were generally comparable to those offered by benchmark plans.
For a closer look at the GAO report Children’s Health Insurance Program:  Effects on Coverage and Access, and Considerations for Extending Fund, find links to a summary and the full report here, on the GAO web site.

2015-04-02T06:00:52+00:00April 2nd, 2015|Uncategorized|Comments Off on GAO Reports on CHIP Extension

MACPAC Recommends Steps to Ensure Continuity of Care

Citing income volatility among low-income Americans, the federal agency charged with analyzing Medicaid and the Children’s Health Insurance Program (CHIP) has recommended that Congress adopt measures to ensure that low-income Americans retain health insurance as their income fluctuates above and below the federal poverty level.
In its March report to Congress, MACPAC (the Medicaid and CHIP Payment and Access Commission) recommends that Congress empower states to extend coverage to eligible adults for an entire year to ensure that as those adults become eligible for Medicaid, lose Medicaid eligibility as their income rises, and then become eligible again because of unemployment or illness, they can maintain continuity of coverage and care.
MACPAC also recommends that Congress extend the current transitional medical assistance program so low-income parents who move into the workforce do not immediately lose their Medicaid coverage and that it eliminate the waiting period for CHIP eligibility and prohibit CHIP premiums for children from families whose income is less than 150 percent of the federal poverty level.
MACPAC is a non-partisan federal agency charged with providing policy and data analysis to Congress on Medicaid and CHIP and making recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide range of issues affecting these programs.
For more information about MACPAC’s March 2014 report and recommendations, see this MACPAC news release or find the entire report here.

2014-03-21T06:00:49+00:00March 21st, 2014|Uncategorized|Comments Off on MACPAC Recommends Steps to Ensure Continuity of Care

Delay in Switch From CHIP to Medicaid

The federal government is permitting Pennsylvania to delay shifting children currently enrolled in the state’s Children’s Health Insurance Program (CHIP) into Medicaid.
The state has objected to such a transition, which is mandated by the Affordable Care Act, and is in the process of attempting to negotiate a compromise with federal officials.  Those federal officials have agreed to delay the required transition until they have an opportunity to review the state’s new proposal, which should be delivered later this week.
Learn more about this issue in this article in The (Cumberland County) Sentinel.

2013-12-10T06:00:51+00:00December 10th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Delay in Switch From CHIP to Medicaid

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Features include articles about the state budget and the possible expansion of Medicaid eligibility in Pennsylvania; upcoming changes facing CHIP and PA Fair Care participants; an upcoming study on serving dual eligibles in the state; a new state Medicaid waiver application; and more.
Find the latest Pennsylvania Health Law Project newsletter here.
 

2013-08-15T06:00:04+00:00August 15th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on New Pennsylvania Health Law Project Newsletter

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has issued its March 2013 report to Congress.
The agency, created to advise Congress on Medicaid and Children’s Health Insurance Program (CHIP) issues, offered two recommendations in its report.
First, it recommended that Congress authorize states to implement 12-month eligibility for adults enrolled in Medicaid and children enrolled in CHIP, in much the same manner as they now do for children enrolled in Medicaid.
And second, MACPAC urged Congress to fund permanently Transitional Medical Assistance (TMA), which enables families that become ineligible for Medicaid because they now earn more money than the program’s limit to retain their Medicaid eligibility for several additional months.
The MACPAC report also includes analyses of several issues involving services for dually eligible (Medicare and Medicaid) individuals.
Because Pennsylvania’s safety-net hospitals serve so many Medicaid, CHIP, and dually eligible patients, MACPAC’s recommendations and analyses can be especially important to them.
Find the MACPAC March 2013 report here.

2013-03-25T06:00:01+00:00March 25th, 2013|Uncategorized|Comments Off on MACPAC Reports to Congress

The Proposed FY 2014 State Budget: Part 6 of 7

The Children’s Health Insurance Program

Pennsylvania Governor Tom Corbett recently unveiled his proposed state FY 2014 budget.  The day he did, members of the Safety-Net Association of Pennsylvania (SNAP) immediately received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals.   Today, SNAP takes a look at what the proposed budget says about the Children’s Health Insurance Program.
The governor’s proposed FY 2014 budget includes $24 million in new money for the Children’s Health Insurance Program (CHIP).  This additional funding will support the addition of more than 9300 children to the program.
Tomorrow:  Department of Health
Safety-Net Association of Pennsylvania logo

2013-02-19T06:00:46+00:00February 19th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget|Comments Off on The Proposed FY 2014 State Budget: Part 6 of 7
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