Presidential Executive Orders have long required cost estimates and impact analyses for every major proposed or final rule. However, the Centers for Medicare and Medicaid Services (CMS), perhaps under direction from the White House Office of Management and Budget (OMB), has apparently stopped providing cost estimates for rules implementing the...
Medicaid Disproportionate Share Hospital Payments: Understanding DSH and Funding Cuts Under Affordable Care ActKip Piper -
A common story during the health reform debate was that of an uninsured person who went to the hospital for treatment and left behind a mountain of unpaid medical bills. Uninsured and under-insured patients account for billions of dollars in uncompensated health care each year, which reached a total $57.4...
State Medicaid Changes: Cuts and Increases During Recession to Medicaid Benefits and Provider PaymentsKip Piper -
Medicaid accounts for the largest share of state budgets and is growing still. Since fiscal year 2010, state Medicaid spending nationwide grew from 22.2 percent to about 24 percent of the average state budget, according to the National Association of State Budget Officers (NASBO). Since the recession began in...
Medicaid Eligibility Streamlining: Modified Adjusted Gross Income Test for Medicaid Eligibility in 2014Kip Piper -
Medicaid eligibility and enrollment is being substantially streamlined. State Medicaid agencies and their contractors are busy adapting eligibility systems and processes to a dramatically new set of federal standards, all required under the Affordable Care Act. Starting in January 2014, the new framework for Medicaid eligibility and enrollment will...
Integrated Care for Medicare-Medicaid Dual Eligibles: CMS Grants for Implementation of State DemonstrationsKip Piper -
To support demonstrations to integrate Medicare and Medicaid for dual eligibles, the Centers for Medicare and Medicaid Services (CMS) offering state Medicaid agencies grants of up to $15 million each. The funds are for implementation of CMS approved designs to integrate care for Medicare-Medicaid enrollees. Most of the state...
Kip Piper -
State Medicaid programs must increase primary care physician payment rates in 2013 and 2014 to at least 100 percent of Medicare rates. The Medicaid-Medicare payment parity mandate is part of the Affordable Care Act (ACA). For the difference between prior rates and the necessary rate increase, states will receive a 100...
Medicare and Medicaid spending will exceed $1 trillion in FY 2013. Together, the two programs now serve about 113 million Americans - over a third of the population. Policymakers in Washington and the states face a daunting challenge to containing costs in Medicare and Medicaid – both health programs are...
Health Insurance Exchanges, Market Reforms, and Medicaid Expansion: CMS Answers 39 State Questions on ACA ImplementationKip Piper -
Health Insurance Exchanges, new health insurance market rules, and Medicaid expansion under the Affordable Care Act (ACA) presents states with a massive array of policy, fiscal, and technical challenges. In sheer complexity, magnitude of change, and impact on consumers, employers, health care providers, government programs, and taxpayers, ACA is...
Kip Piper -
Much of the nation's long-term care is paid for with Medicaid funding. Medicaid pays 43 percent of all long-term care, while Medicare pays 24 percent and a mix of private health plans and consumers funds the rest, according to the Kaiser Family Foundation. Only half of people who need...
Kip Piper -
Somewhere between 11 million and 21 million will become newly insured under Medicaid thanks to the Affordable Care Act (ACA), depending on whether you subscribe to the latest estimates from the Congressional Budget Office (CBO) or the Urban Institute. The Supreme Court’s decision in NFIB v. Sebelius gave states...
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