On August 29, 2024, the Centers for Medicare & Medicaid Services (CMS) released a Center for Medicaid & Children’s Health Insurance Program (CHIP) Services (CMCS) Informational Bulletin (CIB) and an accompanying slide deck to...more
This is an excerpt from a recent Manatt article published on State Health & Value Strategies. Click here to download insight.
On July 23, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health...more
7/30/2024
/ Case Management ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Consolidated Appropriations Act (CAA) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Incarcerated Beneficiaries ,
Medicaid ,
Minor Children ,
Patient Access
On Monday, April 22, the Centers for Medicare & Medicaid Services (CMS) released two highly anticipated final rules. Together, these rules reshape the federal regulatory landscape for Medicaid and the Children’s Health...more
On June 30, 2023, the Centers for Medicare & Medicaid Services (CMS) approved Washington’s five-year Section 1115 demonstration renewal, the Medicaid Transformation Project 2.0 (MTP 2.0 or Demonstration). Through its renewed...more
Editor’s Note: Section 1115 Medicaid demonstrations enable states to develop innovative programs for improving the health and well-being of Medicaid enrollees. Long-standing federal policy requires that 1115 waivers be...more
Editor’s Note: In a new expert perspective prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, reproduced below, Manatt Health outlines the time-limited targeted enrollment...more
6/21/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Continuous Coverage ,
Coronavirus/COVID-19 ,
Enrollment ,
Essential Health Benefits ,
Families First Coronavirus Response Act (FFCRA) ,
Health Insurance ,
Infectious Diseases ,
Medicaid ,
New Guidance ,
Patient Access ,
Public Health Emergency ,
Waivers
Editor’s Note: The current Medicaid continuous coverage requirements enacted by the Families First Coronavirus Act (FFCRA) prohibit states from disenrolling individuals from Medicaid for the duration of the public health...more
6/10/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Continuous Coverage ,
Coronavirus/COVID-19 ,
Enrollment ,
Essential Health Benefits ,
Families First Coronavirus Response Act (FFCRA) ,
Health Insurance ,
Infectious Diseases ,
Medicaid ,
New Guidance ,
Public Health Emergency
Section 1115 of the Social Security Act permits states to waive certain Medicaid statutory requirements through demonstration projects that advance state policy priorities and test innovations in their Medicaid programs....more
On January 30, the Department of Health and Human Services (HHS) released long-anticipated guidance that invites states to pursue capped funding demonstrations for the Affordable Care Act Medicaid expansion population as well...more
The Centers for Medicare & Medicaid Services (CMS) has formalized and strengthened requirements for evaluation of state Section 1115 Medicaid demonstrations, including new demonstration programs being permitted by the current...more
Introduction -
In March 2019, the Centers for Medicare & Medicaid Services (CMS) issued detailed guidance for states on the monitoring and evaluation of “eligibility and coverage” Section 1115 Medicaid demonstrations. The...more
Under Section 1115 of the Social Security Act, the Secretary of Health and Human Services (HHS) is permitted to waive certain federal Medicaid requirements to allow a state to undertake an experimental, pilot or demonstration...more
With a divided Congress that will struggle to reach agreement about major health policy legislation, states will continue to serve as the drivers and testing ground for new healthcare reforms in at least the next two years....more
During the first half of 2018, the Centers for Medicare & Medicaid Services (CMS) granted four states—Arkansas, Indiana, Kentucky and New Hampshire—Section 1115 waivers permitting them to condition Medicaid coverage for...more
In January 2018, the Centers for Medicare & Medicaid Services (CMS) issued guidance to states as to the circumstances under which CMS would approve Section 1115 demonstration waivers making work/community engagement (CE)...more
Since assuming office last January, the Trump administration has signaled a shift in Medicaid policy. In early November, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma made the administration’s...more
On October 6, the Centers for Medicare & Medicaid Services (CMS) approved West Virginia’s “Creating a Continuum of Care for Medicaid Enrollees with Substance Use Disorders” Section 1115 demonstration. West Virginia’s waiver,...more
Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary -
On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its...more
Next steps regarding Congressional action on repeal and replace remain uncertain, with the President again supporting repeal coupled with replace, members attempting to bridge their differences over the Better Care...more
Indiana is seeking a three-year extension of its Healthy Indiana Plan (HIP) 2.0 Section 1115 demonstration. Through HIP 2.0, which the Centers for Medicare and Medicaid Services (CMS) approved in January 2015, Indiana...more
On May 12, 2017, Massachusetts released for public comment a proposed amendment to its MassHealth Section 1115 demonstration. MassHealth is a comprehensive demonstration that applies to the State’s entire Medicaid population....more
On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more
5/2/2017
/ 1115 Waivers ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Fee-for-Service ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicaid Work Requirements ,
Premiums
CMS Issues Self-Referral Disclosure Protocol for Stark Law Violations -
On March 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a new voluntary self-referral disclosure protocol (SRDP) for disclosing...more
4/25/2017
/ Affordable Care Act ,
Anti-Steering Rules ,
Antitrust Provisions ,
Centers for Medicare & Medicaid Services (CMS) ,
Deceptive Intent ,
Department of Justice (DOJ) ,
Drug Pricing ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmacist ,
Self-Referral ,
Stark Law ,
Telehealth ,
Trump Administration
On April 19, 2017, Wisconsin released for public comment a proposed amendment to its BadgerCare Reform Section 1115 demonstration. BadgerCare Reform currently provides coverage to approximately 150,000 childless adults ages...more
4/24/2017
/ 1115 Waivers ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Testing ,
Drug Treatment ,
Eligibility ,
Enrollment ,
Federal Poverty Line ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicaid Work Requirements ,
Mental Illness ,
Proposed Amendments ,
Trump Administration ,
Waivers
On April 25, 2016, the Centers for Medicare and Medicaid Services (CMS) released its final rule that significantly overhauls regulations governing Medicaid managed care. The final rule establishes new requirements for...more