Public Health

TFAH report examines public health spending

Posted on April 16, 2013

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation recently released their April 2013 Issue Report, focusing upon public health spending. The study ultimately found an inadequacy in public health financing at national, state and local levels, citing that 29 states decreased their public health budgets between fiscal years 2010-2011 and 2011-2012. The report provides several recommendations to ameliorate the implications of varying health outcomes resulting from the underfunded public health infrastructure. These include increasing core public health funds and creating new financing models for public health services.

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Update: Medicaid Preventive Services Coverage Incentive for Traditional Adult Beneficiaries Covered Under the Standard Medicaid Program

Posted on February 21, 2013

Preventive services are optional for traditional Medicaid beneficiaries^[1] ages 21 and older who are covered under the standard Medicaid program. Young adults ages 18-21 remain entitled to EPSDT benefits, which encompass periodic and as-needed health exams, all age-appropriate immunizations, and other preventive services.

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CMS suspends PCIP enrollment

Posted on February 16, 2013

Yesterday, the Centers for Medicare & Medicaid Services (CMS) suspended enrollment in pre-existing condition insurance plans (PCIPs), effective March 2 of this year. The letter, sent from Richard Popper, the director of Insurance Plan Groups, to PCIP contractors, also included language regarding benefit adjustment analysis.

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CMS releases preventive services State Medicaid Director letter

Posted on February 5, 2013

On February 1, 2013, the Centers for Medicare & Medicaid Services’ (CMS’) Center for Medicaid and CHIP Services released a State Medicaid Director letter regarding implementation of section 1406 of the Affordable Care Act (ACA). Section 4106(b) establishes a one percentage point increase in the federal medical assistance percentage (FMAP), effective January 1, 2013, applied to expenditures for adult vaccines and clinical preventive services for states that cover, without cost-sharing, the full list of ACA preventive services. Specifically, the preventive services covered under the policy are those assigned a grade of A or B by the U.S. Preventive Services Task Force and the approved vaccines are those recommend by the Advisory Committee on Immunization Practices. For a complete list of the preventive services covered under the policy, click here and for a complete list of covered vaccines, click here.

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CMS releases health homes guidance

Posted on January 18, 2013

The Centers for Medicare & Medicaid Services (CMS) issued a state Medicaid directors letter earlier this week that outlines quality measures to be used for health homes. The recommended health home core measures include:

1. Adult Body Mass Index (BMI) Assessment,
2. Ambulatory Care – Sensitive Condition Admission,
3. Care Transition – Transition Record Transmitted to Health care Professional,
4. Follow-up After Hospitalization for Mental Illness,
5. Plan- All Cause Readmission,
6. Screening for Clinical Depression and Follow-up Plan,
7. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment,
8. Controlling High Blood Pressure.

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CMS releases mental health guidance

Posted on January 17, 2013

The Centers for Medicare & Medicaid Services (CMS) today releaseda mental health guidance to the states clarifying requirements under the Mental Health Parity and Addiction Equity Act of 2008. Specifically, the letter address the applicability of the requirements under the parity law to Medicaid non-managed care benchmark and benchmark-equivalent plans as described in section 1937 of the Social Security Act, the Children’s Health Insurance Programs (CHIP) under title XXI of the Act, and Medicaid managed care programs as described in section 1932 of the Act.

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A Summary of the Health-Related Provisions of the American Taxpayer Relief Act of 2012 (H.R. 8)

Posted on January 8, 2013

Both the Senate and the House passed H.R.8 (89-8 and 257-167, respectively), the American Taxpayer Relief Act, on January 1, 2013. President Barack Obama signed the Act into law on January 3, 2013. The measure extends Bush-era income and other tax cuts for individuals and families making up to $400,000 and $450,000 respectively. For individuals and families above this income threshold, the bill increases taxes from 35% to 39.6%. H.R. 8 also postpones…

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SCOTUS denies contraceptive coverage emergency injunction

Posted on December 27, 2012

Hobby Lobby, a Christian-run arts and crafts chain, filed for an emergency injunction on December 21, 2012 with the Supreme Court to block President Obama’s birth control coverage rules. Hobby Lobby’s complaint surrounds the Affordable Care Act’s (ACA’s) requirement that most employers cover contraception without copay.

Yesterday, the Supreme Court today denied Hobby Lobby’s request, which was joined by the Christian book company, Mardel. The U.S. Supreme Court said it will not decide the case before lower courts have ruled. Justice Sonia Sotomayor argued that the petitioners did not meet the standards requisite for a preliminary injunction. The court also denied the request that the court take up the entire case, in which they argue that the ACA’s contraceptive coverage requirement forces them to violate their religious beliefs.

The case will return to the district court for a ruling on the merits of whether the Obama administration can require employers who have religious objections to contraceptive coverage to provide said insurance coverage in their employer plan.

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Update to Employer Wellness Programs: Notice of Proposed Rulemaking

Posted on December 20, 2012

As described in a previous Implementation Brief, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) generally prohibits group health plans and group health insurance issuers operating in the group health market from discriminating against similarly situated individuals with regard to premiums, benefits or eligibility based on a health factor. HIPAA recognized an exception…

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Courts block defunding of Planned Parenthood

Posted on October 23, 2012

Federal judges Friday and today ruled that Arizona and Indiana, respectively, cannot halt public funding to Planned Parenthood for general healthcare services that don’t include abortion.

In Arizona, the preliminary injunction by U.S. District Judge Neil Wake bars the state from applying a new state anti-abortion law to Planned Parenthood Arizona. The state already prohibits public funding for most abortions. The new law, passed earlier this year but not yet implemented, would go so far as to bar public funding for general health care services provided by entities that also provide abortions. Supporters of the new law said that public funding for agencies like Planned Parenthood indirectly subsidizes abortions. Judge Wake ruled that the subsidies could in no way fund abortions because Medicaid reimbursements to Planned Parenthood Arizona cover only about half of the costs and thus, the Judge ruled that, ”there is no excess funding that could be used to subsidize abortions.” The Judge found that it is in the best interest of Arizona to block the law’s implementation to prevent some 3,000 patients from being denied health care delivery from their chosen health care providers.

In Indiana, a federal appeals court similarly ruled that the state cannot cut off funding for Planned Parenthood just because they provide abortions, amongst many other health care services. The 7th U.S. Circuit Court of Appeals in Chicago upheld a lower court decision that found that Indiana cannot enforce a state law that barred abortion providers from collecting Medicaid reimbursements for any health care services provided.

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