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Tuesday, Apr 23 2024

Full Issue

CMS Enacts New Rules Meant To Boost Medicaid Payment Transparency

States and Medicaid insurers will be required to annually report how payments are spent, and at least 80% of Medicaid payments must go toward wages for home care services. CMS also ordered states to create “one-stop-shop” websites so people can compare quality ratings.

Regulators enacted a pair of wide-reaching rules on Monday intended to increase transparency and improve the patient experience for the more than 80 million enrollees in Medicaid managed care plans. The Centers for Medicare and Medicaid Services will require states and Medicaid insurers to annually report how carriers spend state-directed payments to providers, how their rates compare to Medicare, and survey managed care enrollees about their experience with insurance companies. (Tepper, 4/22)

The Centers for Medicare & Medicaid Services (CMS) is hoping to improve Medicaid enrollees’ access to care through a final rule that better compensates caregiving roles. Under the final rule, at least 80% of Medicaid payments for home care services will go toward wages, according to a White House news release that included a controversial nursing home staffing rule. It also permits states to factor in the “unique experiences that small home care providers and providers in rural areas face.” (Tong, 4/22)

鶹Ů Health News: Unsheltered People Are Losing Medicaid In Redetermination Mix-Ups

On a cold February morning at the Flathead Warming Center, Tashya Evans waited for help with her Medicaid application as others at the shelter got ready for the day in this northwestern Montana city. Evans said she lost Medicaid coverage in September because she hadn’t received paperwork after moving from Great Falls, Montana. She has had to forgo the blood pressure medication she can no longer pay for since losing coverage. She has also had to put off needed dental work. (Bolton, 4/23)

More Medicaid news —

A bill renewing the federal reimbursement allowance taxes that fund Medicaid in Missouri is hung up in a factional fight among Republicans. (Keller, 4/22)

In Humphreys County, Mississippi ... a third of the residents live in poverty. In Belzoni, the county seat, there are just a handful of health care clinics. The town’s only major hospital closed more than a decade ago, around the same time its catfish industry collapsed. Jobs in the area are scarce, said Wardell Walton, who was mayor of Belzoni from 2005 to 2013. But even if there were jobs, he said, a lot of Belzoni residents wouldn’t be able to get to them — they don’t own cars, and there is no public transportation. (Chatlani, 4/22)

From Nebraska to North Carolina, states with Republican-led legislatures have slowly moved toward expanding access to Medicaid for thousands of their residents. But some are still holding out. Medicaid provides health care to some 80 million Americans living on low-incomes. But millions more fall into the so-called "coverage gap" where they make too much money for Medicaid but not enough to get their own insurance. (Conlon and Hawkins, 4/22)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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