Medicaid and CHIP

CMS writes State Medicaid Directors on political subdivision provisions

Posted on November 9, 2010

In a letter to State Medicaid Directors, CMS clarified provisions of the Affordable Care Act related to poltical subdivision provisions and FMAP.

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Categories: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Key Developments, Medicaid and CHIP

HHS announces support for enrollment IT

Posted on November 4, 2010

The Department of Health and Human Services has proposed funding to help states upgrade their Medicaid enrollment procedures to implement the changes that take effect in 2014 and issued guidance on the IT infrastructure to establish the health insurance exchanges that will come online that year.

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Categories: Department of Health and Human Services, Health Information, Health Insurance, Key Developments, Medicaid and CHIP

GAO report examines Recovery Act FMAP

Posted on November 1, 2010

A new report from the Government Accountability Office examines the impact of federal funds made possible by the Recovery Act to expand Medicaid enrollment. “[N]early all states and the District reported using the increased FMAP to cover increased enrollment,” the GAO writes, “which grew by 14.2 percent nationally between October 2007 and February 2010.”

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Categories: Congressional Documents, Government Accountability Office, Library, Medicaid and CHIP

CMS grants $9 million to combat fraud

Posted on October 1, 2010

The Centers for Medicare and Medicaid Services has granted $9 million to support more than 50 Senior Medicare Patrol (SMP) Programs fight fraud. According to the agency, “The grants will provide additional funds to increase awareness of Medicare and Medicaid beneficiaries of health care fraud prevention, identification and reporting through expansion of SMP program capacity.”

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Categories: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Fraud and Abuse, Key Developments, Medicaid and CHIP, Medicare

Richard Gilfillan to head Center for Medicare and Medicaid Innovation

Posted on September 30, 2010

According to media reports, Richard Gifillan has been chosen to head the Center for Medicare and Medicaid Innovation, an office created by the health reform law. Gilfillan is the former head of the Geisinger Health Plan.

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Categories: Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Department of Health and Human Services, Health Care Quality and Delivery System Reform, Key Developments, Medicaid and CHIP, Medicare

HHS issues proposed rule to stem Medicare, Medicaid, and CHIP fraud

Posted on September 21, 2010

The Department of Health and Human Services has issued a proposed rule to stem fraud in the Medicare, Medicaid, and Children’s Health Insurance Program under authority created by the health reform law.

According to the agency, the proposed rule will:

“Establish the requirements for suspending payments to providers and suppliers based on credible allegations of fraud in Medicare and Medicaid;
“Establish the authority for imposing a temporary moratorium on Medicare, Medicaid, and CHIP enrollment on providers and suppliers when necessary to help prevent or fight fraud, waste, and abuse without impeding beneficiaries’ access to care.
“Strengthen and build on current provider enrollment and screening procedures to more accurately assure that fraudulent providers are not gaming the system and that only qualified health care providers and suppliers are allowed to enroll in and bill Medicare, Medicaid and CHIP;
“Outline requirements for states to terminate providers from Medicaid and CHIP when they have been terminated by Medicare or by another state Medicaid program or CHIP;
“Solicit input on how to best structure and develop provider compliance programs, now required under the Affordable Care Act, that will ensure providers are aware of and comply with CMS program requirements.”

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Categories: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Fraud and Abuse, Key Developments, Medicaid and CHIP, Medicare

Sebelius and Duncan launch campaign to enroll uninsured kids

Posted on September 3, 2010

Health and Human Services Secretary Kathleen Sebelius and Department of Education Secretary Arne Duncan have rolled out a campaign to enroll five million additional children in Medicaid and the Children’s Health Insurance program within five years, called the “Connecting Kids to Coverage Challenge.” The health reform law, along with the Children’s Health Insurance Program Reauthorization Act, provide $120 million for grants to promote enrollment and retention.

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Categories: Department of Education, Department of Health and Human Services, Key Developments, Medicaid and CHIP

CMS announces additional $2.25 billion for Money Follows the Person Rebalancing Demonstration

Posted on July 27, 2010

The Centers for Medicare and Medicaid Services has announced $2.25 billion to extend the existing Money Follows the Person Rebalancing Demonstration Program, which is designed to facilitate people with disabilities staying in their communities instead of being placed in institutional settings.

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Categories: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Grants, Key Developments, Medicaid and CHIP

Bundled Payments – Medicaid Demonstration Project

Posted on July 7, 2010

The health reform law requires the Secretary of HHS to establish a Medicaid demonstration project “to evaluate integrated care around a hospitalization.” Specifically, this project aims “to evaluate the use of bundled payments for the provision of integrated care for a Medicaid beneficiary . . . with respect to an episode of care that includes a hospitalization . . . and for concurrent physicians services provided during a hospitalization.”

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Categories: Health Care Quality and Delivery System Reform, Implementation Briefs, Medicaid and CHIP

Medicaid director writes states on family planning services

Posted on July 2, 2010

Medicaid director Cindy Mann has written state Medicaid directors on family planning services options and rules for benchmark plans under the health reform law.

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Categories: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Key Developments, Medicaid and CHIP