Health Reform Hub

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4/2/2013

New Edition of the State Medicaid Integration Tracker Published

NASUAD has published the March Edition of the the State Medicaid Integration Tracker,a report which summarizes state actions in managed care for people who receive Medicaid-funded Long-Term Services and Supports (LTSS), as well state initiatives relating to services for people who are dually eligible for Medicaid and Medicare. This report is updated each month. The State Medicaid Integration Tracker focuses primarily on state actions in managed care for people who receive Medicaid-funded LTSS and on state initiatives relating to services and costs of services for people who are dually eligible for Medicaid and Medicare. Because so many states have informed the federal Center for Medicare and Medicaid Innovation that they intend to participate in the State Demonstrations to Integrate Care for Dual Eligible Individuals, the Tracker pays close attention to the status of state participation in this demonstration. The Tracker also includes updates on states participating in the Balancing Incentive Program (BIP), states developing or implementing Medicaid State Plan amendments under 1915(i), and states pursuing the Communities First Choice Option under 1915(k).

 
 

4/2/2013

State Health Insurance Exchanges: Assessing Rural Implications of Statutes

The RUPRI Center for Rural Health Policy Analysis issues a report examining the impact of health exchanges on rural health services and coverage, as well as related requirements for exchanges under the Affordable Care Act.

 
 

3/28/2013

Planning for Medicaid Expansion: An Online Toolkit

Under health reform, millions of Americans will be eligible to enroll in Medicaid in 2014. To prepare for this new population, it is critical that Medicaid stakeholders develop a better understanding of these individuals and their care needs. The newly eligible population will include a significant number of individuals with urgent and complex health care needs, who are likely to shift between subsidy programs over time, including health plans in newly created Health Insurance Exchanges. Coordination of benefits, eligibility, and enrollment, and contracting and oversight among medicaid and commercial payers will be essential to ensuring continuity of high-quality care for these individuals.

 
 

3/26/2013

Archived Webinar Updates Advocates on Dual Eligibile Demonstrations

The webinar explored the status of the submitted proposals, implementation timelines, highlights and suggestions to advocates for pushing consumer protections at the state level. You can watch and hear the webinar online.

 
 

3/26/2013

National Senior Citizens Law Center Provides Recommendations for National Commission on Long Term Care

Last week, President Obama appointed the final members of the Commission on Long Term Care. This new Commission has six months to accomplish one objective: develop a plan for the establishment, implementation and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports (LTSS) for individuals who need LTSS. A Policy Issue Brief with NCSL�s recommendations to the Commission can be found on their website.

 
 

3/21/2013

A Lost Opportunity For Persons With Disabilities? The Final Essential Health Benefits Rule

A blog about sections in the Affordable Care Act.

 
 

3/21/2013

Aligning Incentives in Medicaid

How Colorado, Minnesota, and Vermont Are Reforming Care Delivery and Payment to Improve Health and Lower Costs

Colorado, Minnesota, and Vermont are pioneering innovative health care payment and delivery system reforms.

 
 

3/21/2013

Almost No Existing Health Plans Meet New ACA Essential Health Benefit Standards

Maternity & Pediatric Care Especially Lacking from Existing Plans

Given that health insurance plans will have to meet new minimum coverage standards starting in 2014, HealthPocket examined the current marketplace of individual health plans to measure the market disruption that will occur as these plans are replaced by plans compliant with the new standards.

 
 

3/21/2013

Funding Heath-Related Vocational Rehabilitation Services: The Potential Impact of the Affordable Care Act

The Affordable Care Act (ACA) was passed into law in March 2010 and is supposed to have far reaching effects on health care in the United States. The ACA includes significant new potential funding sources, both private health insurance and Medicaid, to pay for health-related vocational rehabilitation (VR) services and supports. This companion brief illustrates a few practical steps the Rehabilitation Services Administration can take nationally and that VR directors should consider in their state.

 
 

3/21/2013

New NCD Report Makes Recommendations To Implement Medicaid Managed Care Without Harming Americans with Disabilities

WASHINGTON, DC - With no end to the budget conflict in sight, the National Council on Disability (NCD) - an independent federal agency that advises the President, Congress, and other federal agencies on disability policy - today released a report titled "Medicaid Managed Care for People with Disabilities: Policy and Implementation Considerations for State and Federal Policymakers" to assist with the implementation of managed care reforms without harming Americans with disabilities.

 
 

3/21/2013

New Resource on Health Insurance Marketplaces from CMS

CMS has launched a this new website to provide updates on the implementation of Affordable Care Act Exchanges (now called Marketplaces). In conjunction with HealthCare.gov, this website will provide updates on implementation, official resources for states and consumers, and social media links to help you learn what's happening in your state and across the country as the Marketplaces get ready to launch.

 
 

3/11/2013

HHS Notice of Benefit and Payment Parameters for 2014

This final rule provides detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for Federally facilitated Exchanges; advance payments of the premium tax credit; the Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. Cost-sharing reductions and advance payments of the premium tax credit, combined with new insurance market reforms, are expected to significantly increase the number of individuals with health insurance coverage, particularly in the individual market. In addition, we expect the premium stabilization programs-risk adjustment, reinsurance, and risk corridors-to protect against the effects of adverse selection. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance.

 
 

3/11/2013

Proposed Rule: Establishment of Exchanges and Qualified Health Plans for Small Businesses

This proposed rule would implement provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business Health Options Program (SHOP). Specifically, this proposed rule would amend existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and would implement a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.

 
 

3/8/2013

Updated State Medicaid Expansion Tracker and State Medicaid Integration Tracker

The State Medicaid Expansion Tracker is a monthly publication from the National Association of States United for Aging and Disabilities (NASUAD), which focuses on actions and activities around the implementation of the Affordable Care Act's (ACA) optional Medicaid expansion. The State Medicaid Integration Tracker is a report which summarizes state actions in managed care for people who receive Medicaid-funded Long-Term Services and Supports (LTSS), as well state initiatives relating to services for people who are dually eligible for Medicaid and Medicare. The State Medicaid Integration Tracker focuses primarily on state actions in managed care for people who receive Medicaid-funded LTSS and on state initiatives relating to services and costs of services for people who are dually eligible for Medicaid and Medicare.

 
 

2/28/2013

A National Evaluation of the Money Follows the Person Demonstration Program

Money Follows the Person (MFP) Demonstration grants and Managed Long-Term Services and Support (MLTSS) programs use different strategies to shift the balance of LTSS from institutional care to home- and community-based settings. MFP helps people living in institutions to relocate to the community, while MLTSS programs use risk-based capitation payment to give health plans a financial incentive to keep people out of institutions. The relationship between the two, particularly when they serve the same population groups, determines whether or not they work in concert. As increasing numbers of state Medicaid agencies implement both programs, it is important to understand how the programs can work together to achieve their common goal.

 
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