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5/28/2013

CMS Guidance on Long-Term Services and Supports Delivered through Medicaid Managed Care

The Centers for Medicare & Medicaid Services (CMS) has posted two important documents on Medicaid.gov that outline essential elements that we believe are critical to strong managed long term services and supports (MLTSS) programs. The first of the two documents includes a summary overview of each element. The second document outlines, in detail, each element and the expectations associated with each.

 
 

5/28/2013

Families USA Releases Issue Brief on the Managed Fee-for-Service Option To Integrate Care for Dual Eligibles

States implementing demonstrations to integrate care for those dually eligible for Medicare and Medicaid have two options: capitated managed care or managed fee-for-service. The managed fee-for-service model is not as widely understood as the captiated managed care model. Managed fee-for-service avoids some of the potential problems of capitation, but implementation presents its own set of opportunities and challenges. This brief, from Families USA, explains some of the differences and gives examples from the states implementing managed fee-for-service.

 
 

5/23/2013

Health Care Innovation Awards Round Two Webinar

The CMS Innovation Center released a Funding Opportunity Announcement for Round Two of the Health Care Innovation Awards. Under this announcement, CMS will spend up to $1 billion for awards and evaluation of projects from across the country that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and Children's Health Insurance Program (CHIP) enrollees.

 
 

5/23/2013

Interim Final Rule on Pre-Existing Condition Insurance Plan Program

HHS has issued an interim final rule on the Pre-Existing Insurance Plan (PCIP), also known as the "high risk pool". An original part of the ACA, the PCIP was intended to provide immediate insurance for those with pre-existing conditions before health insurance reforms and Exchanges became available in 2014. The interim final rule with comment period sets the payment rates for covered services furnished to individuals enrolled in the Pre-Existing Condition Insurance Plan (PCIP) program administered directly by HHS beginning with covered services furnished on June 15, 2013.

 
 

5/22/2013

President's Committee for People with Intellectual Disabilities Report on Managed Long-Term Services and Supports

The President's Committee on People with Intellectual Disabilities 2012 report on Managed Long Term Services and Supports provides 15 recommendations in the areas of disability stakeholder engagement, choice and self-determination, consumer protection and rights, and quality measurement, data collection, and research.

 
 

5/22/2013

President's Committee for People with Intellectual Disabilities Report on Managed Long-Term Services and Supports

The President's Committee on People with Intellectual Disabilities 2012 report on Managed Long Term Services and Supports provides 15 recommendations in the areas of disability stakeholder engagement, choice and self-determination, consumer protection and rights, and quality measurement, data collection, and research.

 
 

5/21/2013

CMS Managed Care Technical Assistance Center

CMS will provide individualized technical assistance to the states on managed care program operations, including planning and procurement, benefit design and serving the needs of complex populations, access and quality, and the use of data for program oversight and management. The Medicaid Managed Care Technical Assistance Center is part of CMS's larger efforts to provide comprehensive information and guidance on Medicaid managed care program operations.

 
 

5/21/2013

NASHP Summarizes State Approaches to Qualified Health Plan Certification

Beginning on October 1, 2013, state health insurance exchanges must certify qualified health plans (QHP) that are available for people to purchase through the exchange. To date, states have taken unique strategies for certifying these plans - some exchanges plan to selectively contract and negotiate prices with plans; others plan to add standards for plans beyond the federal requirements; and others are accepting all plans that meet the federal requirements. To summarize the standards states have set for allowing plans to be sold in their exchanges, the National Academy for State Health Policy's (NASHP) State Refor(u)m staff examined the QHP certification processes of 24 states and created a chart with key information on network adequacy requirements, rating standards, expected certification dates, and more.

 
 

5/21/2013

NASUAD Updates State Medicaid Expansion Tracker

The State Medicaid Expansion Tracker is a publication from the National Association of States United for Aging and Disabilities (NASUAD). The regularly-updated document focuses on actions and activities around the implementation of the Affordable Care Act's (ACA) optional Medicaid expansion. This resource is also available on AUCD's Health Hub State Information page.

 
 

5/21/2013

National Resource Center on Chronic Disease Self-Management Education Programs Financed by 2013 Prevention and Public Health Funds

Website  from http://acl.gov

Grant Title: National Resource Center on Chronic Disease Self-Management Education Programs financed by 2013 Prevention and Public Health Funds (PPHF-2013) Agency Issuing Grant: Administration for Community Living Eligible Applicants: Nonprofits Close Date: June 17, 2013 Funding Opportunity Number: HHS-2013-ACL-AOA-CR-0042 CDFA Number: 93.734 Grant Amount: $2,730,000 for 1 award Description: This opportunity will enable the Center to assist states, the aging, disability and public health networks and their partners to increase access to and sustain evidence-based prevention programs, particularly Chronic Disease Self-Management Education (CDSME) programs, that improve the health and quality of life of older adults and adults with disabilities. The Center will serve as a national clearinghouse of tools and information on CDSMEs.

 
 

5/21/2013

Report: Who Qualifies for Insurance Premium Tax Credits?

Starting in 2014, many Americans will be eligible for significant, Affordable Care Act-mandated tax credits to help pay for their health insurance premiums. But today, consumers are largely unaware of whether they are eligible for a tax credit and how the new incentive will work. New consumer-tested materials clearly explain what Americans need to know about the new premium tax credit program, and can help raise awareness.

 
 

5/16/2013

HHS Announces Second Round of Health Care Innovation Awards

Health and Human Services Secretary Kathleen Sebelius has announced a nearly $1 billion initiative that will fund awards and evaluation to build on the Obama administration's work to transform the health care system by delivering better care and lowering costs. This second round of Health Care Innovation Awards will fund applicants that have a high likelihood of driving health care system transformation and delivering better outcomes.

 
 

5/15/2013

Ensuring Accessibility for Individuals with Disabilities in the ACA's Marketplaces

The ACA (particularly 1557, the nondiscrimination provision) and federal civil rights laws (including 504 of the Rehabilitation Act and the Americans with Disabilities Act) require that individuals with disabilities have access to the federal and state marketplaces as well as the health plans offering insurance through the marketplaces. This document provides a checklist of recommendations advocates can use to encourage their states to address the needs of consumers with disabilities.

 
 

5/14/2013

VIDEO: PWC Study Finds Increase in Employer-Sponsored Health Coverage in Massachusetts

PricewaterhouseCoopers's Health Research Institute analyzed the rate of employer-sponsored health insurance in Massachusetts after that state's 2006 health reform and found that the proportion of employers offering health care actually increased as the state implemented its first-in-the-nation individual and employer mandate.

 
 

5/9/2013

ACA 101: What You Need to Know

Website  from http://kff.org

Especially helpful to audiences with limited knowledge of the Patient Protection and Affordable Care Act (ACA), this briefing is a useful review for anyone struggling to understand the complex changes scheduled to take effect in 2014.

 
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