Executive Summary -
Health inequities are pervasive across the country, with the health and well-being of Americans too often diverging along racial and ethnic lines. While recent studies have identified many factors...more
In December 2022, the U.S. Congress took a step to address churn—where enrollees lose Medicaid coverage, often for procedural reasons, and later reenroll after a gap in coverage—in the Consolidated Appropriations Act, 2023...more
On May 18, 2023, the CMS, in consultation with the DOE, released new guidance to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies (SMAs), state education agencies (SEAs), and local education...more
Editor’s Note: In a new issue brief prepared with the support of Arnold Ventures, Manatt Health shares an array of best practice strategies in place across the nation to serve as an actionable road map for states that might...more
Given its role as a critical source of health care coverage for low-income individuals in the United States, including 13 million women of reproductive age, Medicaid is the primary source of family planning coverage in the...more
The Big Picture -
On January 26, 2023, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to amend the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration. A...more
1/31/2023
/ 1115 Waivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Inmates ,
Medi-Cal ,
Medicaid ,
Prisoners ,
Regulatory Agenda
Overview -
Disruptions in Medicaid coverage, and losing coverage altogether despite remaining eligible, are common occurrences for individuals enrolled in Medicaid. These disruptions and coverage losses result in unmet...more
Editor’s Note: Section 1115 demonstrations (also called waivers) allow states to test new ways to operate their Medicaid programs, typically on matters related to eligibility, benefits and care delivery. Recently, the Centers...more
The Families First Coronavirus Response Act (FFCRA) provides enhanced federal matching funds to states as a condition of maintaining Medicaid enrollment until the conclusion of the COVID-19 public health emergency (PHE).1 As...more
Editor’s Note: Over the course of the COVID-19 public health emergency (PHE), a series of Medicare and Medicaid regulatory flexibilities were implemented to help ensure access to care for older adults and people with chronic...more
3/29/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Infectious Diseases ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Patient Access ,
Relief Measures ,
Telehealth
Editor’s Note: Since the start of the COVID-19 pandemic, federal and state policymakers have acted to preserve access to services for populations that use Medicaid-covered long-term services and supports (LTSS). These...more
3/8/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Infectious Diseases ,
Long-Term Care ,
Medicaid ,
Patient Access ,
Public Health Emergency
Background -
Since the start of the COVID-19 pandemic, federal and state policymakers have acted to preserve access to services for populations that use Medicaid-covered long-term services and supports (LTSS). These...more
3/1/2022
/ Coronavirus/COVID-19 ,
Elder Care ,
Federal Funding ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Infectious Diseases ,
Long Term Care Facilities ,
Long-Term Care ,
Medicaid
President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more
2/16/2022
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Beneficiaries ,
Physicians ,
Public Health Emergency ,
Public Health Insurance Marketplace ,
Surprise Medical Bills ,
Telehealth ,
Webinars
Since 2014, states have had the option to expand Medicaid eligibility to include adults with incomes under 138 percent of the federal poverty level. Under this option, the federal government covers 90 percent of the cost of...more
I. Introduction -
Since 2014, states have had the option to expand Medicaid eligibility to most adults with incomes under 138 percent of the federal poverty level (FPL; approximately $30,300 in annual earnings for a family...more
Medicaid has seen significant increases in enrollment across all states since the outbreak of the COVID-19 pandemic. According to the latest data from the Centers for Medicare and Medicaid Services (CMS), total Medicaid...more
What Actions Can State Medicaid Agencies and Medicaid Managed Care Organizations Take to Support Financial Stability for Pediatric and Other Primary Care Practices During the COVID-19 Pandemic? Find Out in a New Webinar From...more
11/25/2020
/ Child Care ,
Children's Hospital ,
Coronavirus/COVID-19 ,
Health Care Providers ,
Health Insurance ,
Incentives ,
Managed Care Contracts ,
MCOs ,
Medicaid ,
Pediatrics ,
Physicians ,
Provider Payments ,
Reimbursements ,
State Agencies ,
State Contracts ,
Webinars
Editor’s Note: In a new report, Manatt explores how states are using two key tools—Medicaid managed care contracts and 1115 waivers—to address the unmet social needs of people with Medicaid coverage. The findings have...more
The Trump administration recently invited states to apply for the new Healthy Adult Opportunity Medicaid demonstration initiative, which lets states opt in to a block grant funding model for a portion of their Medicaid...more
The Center for Medicare and Medicaid Innovation (CMMI) will fund a model of care, Integrated Care for Kids (InCK), that will test whether alternative payment models can promote closer integration across children’s physical...more
Across the country, policymakers, healthcare stakeholders and consumer advocates are motivated to expand affordable coverage, with the overarching goals of lowering the uninsured rate, addressing affordability and access to...more
The Senate is poised to vote today, July 25, 2017, on a motion to proceed (MTP) to debate on repealing and possibly replacing the Affordable Care Act (ACA). The MTP allows the Senate to consider the House repeal and replace...more
Congressional action on repeal and replace took a number of significant turns in the past few days, and next steps still remain uncertain. On Monday evening, Senators Mike Lee (R-UT) and Jerry Moran (R-KS) joined Senators...more
The State of Wisconsin recently proposed a Medicaid waiver that includes a number of precedent-setting features, including a 48-month time limit on enrollment (with the limit paused for periods of employment or job training),...more
Editor’s Note: While the American Health Care Act (AHCA)—the bill that would replace the Affordable Care Act—does not include explicit changes to Medicare, it could have a profound impact on the 11 million Medicare...more