On April 4, 2022, the Centers for Medicare and Medicaid Services (CMS) published two new resources addressing Medicaid’s Public Health Emergency (PHE) “unwinding” activities.[i] Today’s post focuses on CMS’ summary of promising state practices for unwinding planning efforts.
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2022 Michigan State of Reform Health Policy Conference Happening April 21
Senior healthcare leaders from across Michigan will convene at the Lansing Center for the 2022 Michigan State of Reform Health Policy Conference on April 21 to discuss health policy and topical issues across the spectrum of care. The day-long event, which kicks off at 9 a.m., will feature more than 60 speakers and 19 different sessions.
President’s Budget Recommends Significant Investments in Unity Agenda Issues
This week, our In Focus section reviews President Biden’s budget proposal for federal fiscal year 2023, released on March 28, 2022. The President’s proposal kicks off the Congressional budget process and negotiations on the annual spending bills for the federal fiscal year that starts October 1, 2022. The budget proposal highlights the Administration’s program initiatives and recommended legislative and regulatory changes. The President’s budget is merely a request of Congress, who drafts the actual budget resolution that will go into effect if passed.
Learning from COVID-19-related flexibilities: moving toward more person-centered Medicare and Medicaid programs
This week our In Focus section reviews the issue brief and policymaker playbook that explore the outlook for temporary COVID-19-related changes to the Medicare and Medicaid programs, prepared in partnership with Manatt Health for The SCAN Foundation. HMA experts Jennifer Podulka, Yamini Narayan, and Keyan Javadi offer a framework to support policymakers’ decisions on the future of temporary policies and highlight specific flexibilities that are good candidates for consideration. These temporary flexibilities expanded program eligibility and enrollment, enhanced remote service delivery options, authorized care delivery in alternative care sites, and much more.
How stakeholders can prepare now for unwinding of Medicaid public health emergency continuous eligibility
HMA Principal Jane Longo, Federal Policy Principal Andrea Maresca, and a team of experts from across HMA and HMA companies weigh in on the recent guidance to states on preparing for the end of the Public Health Emergency.
This year, one of the most significant issues the U.S. Department of Health and Human Services (HHS) is considering is whether and when to end the COVID-19 public health emergency (PHE) declaration. The PHE declaration has important implications for Medicaid enrollees as well as state Medicaid agencies and stakeholders.
The Moran Company, an HMA Company principal a featured speaker in Foley Hoag webinar on NTAP program
The Moran Company, an HMA Company Principal Clare Mamerow, will be a featured speaker in the upcoming Foley Hoag LLP webinar titled, “The New Technology Add-on Payment (NTAP) Program: What Life Sciences Companies Should Know About Medicare’s Time-Limited Program.”
The re-envisioned role of primary care in FQHCs: accelerating APMs to drive access, patient experience and outcomes
In October 2021, the Center for Medicare & Medicaid Innovation (the Innovation Center) published a white paper outlining its strategic vision and direction of the healthcare delivery system for Medicare and Medicaid beneficiaries through 2030. This included a focus on high-quality primary care, which they identify as the foundation of our health system, to achieve equitable, whole-person, integrated care and outcomes.
HMA Experts Lay Out Scenarios for Transitioning from COVID-19 Public Health Emergency
This week our In Focus section reviews scenarios in which the federal Public Health Emergency (PHE) may expire. In the weeks ahead, the U.S. Secretary of Health and Human Services (HHS), Xavier Becerra, will be faced with the decision of whether to extend the PHE or to allow it to expire. Dozens of critical waivers and coverage flexibilities are currently linked to the federal PHE and have enabled patients, providers, and payors to receive, deliver, and pay for health care for nearly two years. To date, the PHE has been extended eight times, each for the maximum allowed 90 days. However, declining COVID-19 infection rates and actions by state governors to relax COVID-19-related public health measures have renewed pressure on the Biden Administration to signal how they will choose to act on April 16, 2022 when the current federal PHE expires.
CMS Will Accept Applications for New Medicare ACO REACH Model
This week our In Focus section reviews the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center’s newly announced model – Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH). CMS will accept applications from organizations interested in participating and is particularly interested in partnering with provider-led organizations and similar groups with direct patient care experience and a strong track record serving underserved populations that focus on primary care to better manage Medicare beneficiaries’ health. Applications are due by April 22, 2022.
Iowa releases Health Link Medicaid managed care RFP
This week, our In Focus section reviews the Iowa Health Link request for proposals (RFP) for Medicaid managed care organizations (MCOs) to serve the state’s traditional Medicaid program, the Children’s Health Insurance Program (CHIP) known as Healthy and Well Kids in Iowa (Hawki), and the Iowa Health and Wellness Plan (IHAWP). The RFP was released by the Iowa Department of Human Services on February 17, 2022. Contracts are set to begin July 1, 2023, and are worth approximately $6.5 billion annually.
California releases Medi-Cal RFP for Two-Plan, GMC, Regional Models
This week, our In Focus section reviews the California Medicaid (Medi-Cal) managed care request for proposals (RFP) released by the California Department of Health Care Services (DHCS) on February 9, 2022. DHCS is procuring contracts for commercial plans for three of the Medi-Cal managed care plan models in 21 counties, serving approximately 3 million beneficiaries. Contracts will be awarded to one managed care organization (MCO) in each of the Two-Plan model counties, two MCOs in each of the geographic managed care (GMC) model counties, and two MCOs in each of the Regional model counties. This procurement is the largest released by California, rebidding contracts for commercial plans statewide.
CMS payment notice signals shift in COVID-19 policies for Medicare Advantage, Part D
This week our In Focus section reviews the Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies issued by the Centers for Medicare & Medicaid Services (CMS) on February 1, 2022. The Advance Notice includes proposed updates to MA payment rates and guidance to plan sponsors as they prepare their bids for CY 2023. It also shows CMS’ updates to Part D benefit parameters. Comments are due by 6:00 PM EST on March 4, 2022. The final Rate Announcement will be published by April 4, 2022.