recent developments
State-by-State Analysis of the House Budget on Out-of-Pocket Health Care Costs
May 20, 2011
A new state-by-state analysis by the U.S. Congress Joint Economic Committee (JEC) finds that in each state in the country, out-of-pocket health care costs will more than double for residents turning 65 in 2022 under the Republican budget plan passed by House Republicans in April. The report also shows that current Medicare beneficiaries will be harmed by the GOP budget, immediately losing preventive services such as mammograms and facing higher prescription drug costs. Click here for the state-by-state breakdown of the increase in out-of-pocket health care costs. Click here for the full press release
New Report on Home and Community-Based Long-Term Services and Supports
May 20, 2011
More than 5 million older people need services and supports to remain living in their homes and communities. Most receive help exclusively from family caregivers, but others pay for services through public programs, out-of-pocket spending, or private insurance. The primary source of public funding is Medicaid, but other sources include the Older Americans Act and state funds. Residential alternatives that deliver supportive services in a home-like environment also play a role in helping older people avoid more institutional settings. Click here to read the report.
HHS Announces Final FY 11 LIHEAP Allocations to the States
May 19, 2011
HHS announced the release of the final FY11 Low Income Home Energy Assistance Program (LIHEAP) allocations to the states. The Department of Defense and Full Year Continuing Resolution Act of 2011 (PL 112-10) provided $4.510 billion for the LIHEAP block grant, which is reduced by $9 million to $4.501 billion to reflect the 0.2 percent across-the-board reduction applied to all non-defense discretionary spending accounts. Additionally, the law maintained the legislative language from the previous two years that revises the formula used to allocate block grant funds, with all but $840 million allocated according to the FY 1984 state shares. HHS made minor adjustments to the tribal allocations in four states; these adjustments do not affect the overall gross allocation to the states. Unlike previous years, the FY11 budget did not include language that allows states to serve households with incomes at or below 75 percent of state median income. Accordingly, 60 percent of state median income standard will apply to all new LIHEAP funds awarded to grantees by HHS after the CR’s date of enactment, April 15. Notably, PL 112-10 provided $200 million in LIHEAP Emergency Contingency funds for FY11, all of which was awarded on January 24, 2011. More information on the LIHEAP program is available here .
HHS Releases New Rules Requiring Review of Large Insurance Rate Hikes
May 19, 2011
The Department of Health and Human Services (HHS) issued a final regulation to ensure that large health insurance premium increases will be thoroughly reviewed, and consumers will have access to clear information about those increases. In 2011, rate increases of 10-percent or more must be reviewed by state or federal officials. The regulation finalizes the proposed rules issued in December 2010, and includes a requirement that states provide an opportunity for public input in the evaluation of rate increases subject to review. HHS is also requesting comment from the public on applying the rule to individual and small group coverage sold through associations, which are sometimes exempt from state oversight. For more information about recent trends in health insurance rates and the final rule, visit here.
New AARP Report on the Medicaid Safety Net for Older Adults
May 19, 2011
The AARP Public Policy Institute’s Wendy Fox Grage and Donald Redfoot published a new report, Medicaid: A Program of Last Resort for People Who Need Long-Term Services and Supports. This report explains how Medicaid provides a critical safety net for people who have spent their life savings paying for long-term services and supports (LTSS). Most older people will need some LTSS, and nearly a third of people turning age 65 will need to rely on Medicaid Assistance.
Health Information Exchange (HIE) State Medicaid Director letter
May 18, 2011
CMCS is pleased to announce the release today of the Health Information Exchange (HIE) State Medicaid Director letter . This letter provides further guidance on implementation of the section 4201 of the American Recovery and Reinvestment Act of 2009 that established the Medicare and Medicaid Electronic Health Record Incentive Programs. This letter specifies our approval criteria as it pertains to States’ involvement in HIE activities whose costs are divided equitably across other payers along the fair share principle, are appropriately cost-allocated, leverage efficiencies, and that are developmental and time-limited in nature. This letter also reiterates the principle that the 90 percent Federal financial participation would not be available for on-going HIE costs where these services are fully operational.
CMS Announces New ACO Initiatives
May 17, 2011
On May 17, the Centers for Medicare & Medicaid Services (CMS) announced three new initiatives to support the Affordable Care Act’s Accountable Care Organization (ACO) model for improving care coordination for Medicare beneficiaries. These efforts to incentivize providers to participate in ACOs will be coordinated by the Center for Medicare and Medicaid Innovation (Innovation Center) within CMS, and include the opportunity for organizations with advanced care coordination processes to participate in the Pioneer ACO Model. Additional information on the Pioneer Model, including application guidelines, is available in the notice published by CMS in the May 20 Federal Register. Additionally, to educate provider groups and encourage their participation in ACOs, the Innovation Center will be sponsoring a series of Accelerated Development Learning Sessions (ADLs) throughout 2011. The first meeting will be held on June 20-22 in Minneapolis, Minnesota, and registration details are available here . Lastly, the Innovation Center is seeking public input through June 17 on the idea of an Advance Payment ACO Model that would provide additional up-front funding to providers. To learn more about the proposal, or to submit a comment, please follow this link .
CMS Proposes Rule for Alignment under Medicaid and Medicare
May 16, 2011
CMS is requesting comments on opportunities to more effectively align benefits and incentives to prevent cost-shifting and improve access to care under the Medicare and Medicaid programs for dual eligibles. As part of the Medicare-Medicaid Coordination Office's efforts to fulfill its responsibilities and meet its goals, the Office is undertaking an initiative to identify and address conflicting requirements between Medicaid and Medicare that potentially create barriers to high quality, seamless, and cost-effective care for dual eligible beneficiaries, “the Alignment Initiative.” This request for comments represents the first step of the Alignment Initiative, which is is to identify opportunities to align potentially conflicting Medicaid and Medicare requirements. The request is available here , and comments must be submitted by July 11 to be considered.
New Guide Helps Consumers Navigate Long-Term Care System
May 13, 2011
The National Consumer Voice for Quality Long-Term Care recently launched its new guide Piecing Together Quality Long-Term Care: A Consumer’s Guide to Choices and Advocacy, which is intended to educate people with disabilities and older adults about their options for long-term services and supports and empower them to be self-advocates for quality long-term care. The guide also provides information and resources to assist people currently living in nursing homes to move back into the community.
The Consumer Voice has developed a website for the guide, which features Piecing Together Quality Long-Term Care in different formats, including an HTML version, a PDF version and audio portions of the guide. The website also includes three state-specific guides funded by the Consumer Voice and written by citizen advocacy groups in Kansas, North Carolina and Virginia. These state guides are designed to assist older adults and persons with disabilities in making informed decisions when choosing long-term care services. Access the guide online at www.theconsumervoice.org/piecing-together-quality-long-term-care .
HHS Releases $100 Million for Community Transformation Grants
May 13, 2011
HHS announced the availability of $100 million in funding for up to 75 Community Transformation Grants. Created by the Affordable Care Act (ACA) and funded through the ACA’s Prevention and Public Health Fund, these grants are designed to help communities implement projects proven to reduce chronic diseases. These five-year grants will focus on five priority areas, including tobacco-free living; active living and healthy eating; evidence-based quality clinical and other preventive services; social and emotional wellness; and healthy and safe physical environments. State and local government agencies, tribes, territories, and state and local non-profit organizations are eligible to apply for Community Transformation Grants, and applications are due in July, with awards expected to be announced near the end of the summer. For more information on the Community Transformation Grants, please see this fact sheet , and the official funding opportunity announcement can be found at www.Grants.gov , by searching for CDFA 93.544.
Annual Social Security and Medicare Trustees Reports Released
May 13, 2011
Each year, the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. Partly the result of a slower than projected economic recovery and lower than anticipated death rates among individuals at advanced ages, the combined assets of the Social Security funds, the Disability Insurance (DI) fund and the Old-Age and Survivors Insurance (OASI) fund, are projected to remain solvent through 2036, a year earlier than previously expected. Due primarily to lower inflation-adjusted non-interest income caused by a lower assumed economic recovery, and by higher Medicare Hospital Insurance (HI) real costs caused by higher assumed near-term average wage growth, the report found that the HI fund will be exhausted by 2014, five years earlier than last year’s estimate. The reports are available for download here .
House to Consider the State Flexibility Act of 2011
May 12, 2011
The House Energy and Commerce Health Subcommittee voted along party lines, 14 to 9, to send the State Flexibility Act of 2011 (H.R. 1683), to the full House and Energy and Commerce Committee for consideration. It is unclear how far House Republicans plan to take the legislation. If eventually brought to the floor for a vote, the measure would likely pass the GOP-controlled House, but would then face a more challenging path to passage in the Senate, where Democrats have vowed to block the companion bill (S. 868) introduced by Sen. Orrin Hatch (R-Utah) on May 3. For a fact sheet on H.R. 1683 developed by the House Energy and Commerce Committee click here .
CMS Report on the Impact of the Affordable Care Act on Medicare
May 12, 2011
HHS released a report detailing the impact of the Affordable Care Act (ACA) entitled, Strengthening Medicare: Better Health, Better Care, Lower Costs. This report reviews how the Centers for Medicare and Medicaid (CMS) expect to save nearly $120 billion on changes to Medicare over five years. The report is available here.
CBO Releases Estimate of the State Flexibility Act of 2011
May 11, 2011
The nonpartisan Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) estimated in a May 11 analysis that the State Flexibility Act of 2011 (H.R. 1683) would reduce the federal deficit by $2.1 billion between 2012 and 2021. Additionally, CBO and JCT estimate that enacting H.R. 1683’s repeal of the MOE requirements would reduce enrollment and spending for both Medicaid and CHIP and raise both enrollment in, and spending for, health insurance plans offered through the ACA health insurance exchanges. Further, CBO and JCT estimate that some of those adults and children who are no longer eligible for Medicaid and CHIP would enroll in employment-based insurance or become uninsured. To view the report, please click here .
HHS Announces Initiatives for Dual Eligible Care Coordination
May 11, 2011
HHS announced two new initiatives designed to improve care coordination for dual eligibles. The first, a request comment on opportunities to align benefits, prevent cost-shifting, and improve access to care for dual eligibles, was published in the May 15 Federal Register and is available here . Comments are due by July 11. In conjunction with this request for information, HHS also unveiled a new process to provide state Medicaid agencies with faster access to Medicare Parts A, B, and D claims/event data for their dual eligible beneficiaries. For more information on this new process, please click here to access a CMCS Informational Bulletin . For more information on both of these announcements, please visit: www.cms.gov/medicare-medicaid-coordination/ .
ASA Greenlee Highlights Community Living Initiatives
May 9, 2011
On May 9, Assistant Secretary for Aging at the Administration on Aging, Kathy Greenlee, was a Guest Blogger on Disability.gov’s blog, Disability.Blog, which monitors the latest disability-related news and hosts weekly guest blogs from experts on disability issues. In her post, Assistant Secretary Greenlee highlights several federal government initiatives currently underway that are designed to increase community living opportunities and promote independence, such as the Community Living Initiative; the Aging and Disability Resource Center (ADRC) program; the Veteran-Directed Home and Community Based Services Program; the Lifespan Respite Care Program; and the Community Living Assistance Supports and Services (CLASS) program. To view Assistant Secretary Greenlee’s entry, Working to Ensure Community Living For All, please click here.
National Women’s Health Week
May 8, 2011
National Women’s Health Week, a weeklong health observance coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health, brings together communities, businesses, government, health organizations, and other groups in an effort to promote women’s health. Scheduled this year for May 8 – 14, the goals of National Women’s Health Week are to empower women to make their health a top priority, and to encourage them to take steps to improve their physical and mental health and lower their risks of certain diseases. Click here for more information on National Women’s Health Week
HHS Updates Enrollment Data for PCIP
May 6, 2011
HHS updated the enrollment data for the Affordable Care Act created-Pre-Existing Condition Insurance Plan (PCIP) to reflect the number of people enrolled in the program by state as of March 31, 2011. The chart is available here .
HHS Proposes Rule on Medicaid Access and Payment Rates
May 6, 2011
In the May 6 Federal Register, CMS issued a proposed rule that would require states to conduct periodic reviews of data for all covered services in Medicaid to evaluate access to care. According to the proposed rule, payment rate changes are not incompliance with the Medicaid access requirements if they result in denial of sufficient access to covered care and services. The proposal uses a framework developed by the Medicaid and CHIP Payment and Access Commission (MACPAC). Comments are due by July 5, 2011, and the proposed regulation is available here .
HHS Outlines Medicaid Flexibility for States Affected by the Tornados
May 6, 2011
Secretary Sebelius offered guidance to several states affected by the damaging tornados earlier this month, sending a letter to Alabama, Kentucky, Mississippi, and Tennessee outlining ways these states can speed up Medicaid eligibility for those individuals who may need access to such health services. In the wake of the devastating storms, these states can provide temporary increases in Medicaid income eligibility limits, remove resource tests, adjust income and residency certifications to accommodate those who may have lost documents in the storm, and delay the process of re-determining Medicaid eligibility. The May 6 letter, in which the Secretary also pledged to expedite federal approvals these states may need for state plan amendments or waivers and clarified that such authorities could be retroactive as early as the beginning of the disaster period, is available here .
CMS Hosts Webinar to Discuss Partnership for Patients and Care Transitions
May 5, 2011
On May 5, CMS held a webinar to clarify questions about a new national patient safety initiative,
Partnership for Patients, through which the Administration is supporting broad-based efforts to reduce harm caused to patients in hospitals and improve care transitions. The Community-Based Care Transitions Program (CCTP), mandated by section 3026 of the Affordable Care Act, and included in the goals of Partnerships for Patients, provides funding to test models for improving care transitions for high risk Medicare beneficiaries. The goals of the CCTP are to improve transitions of beneficiaries from the inpatient hospital setting to other care settings, to improve quality of care, to reduce readmissions for high risk beneficiaries, and to document measureable savings to the Medicare program. Further application details can be found in the solicitation for CCTP funding.
CMS Proposes Rule on Medicare and Medicaid Influenza Vaccinations
May 4, 2011
CMS published a proposed rule in the May 4 Federal Register that would require certain Medicare and Medicaid providers and suppliers to offer all patients an influenza vaccination. Comments are due by July 5, 2011, and the proposal is available here.
Learning from the Best- and Worst- Performing States
May 3, 2011
The Commonwealth Fund released Lessons from High- and Low-Performing states for Raising Overall Health System Performance, a brief which examines data from the Fund’s recent State Scorecard on Health Systems Performance and interviews with health policy experts. This brief contains information from interviews with the highest and lowest performing states, according to the State Scorecard. The findings show that socioeconomic and demographic factors play a large role in health systems. Similarities among high-performing states include a history of reform and government leadership, greater collaboration of stakeholders, transparency of information about health care options, and a set of policies focused on improving the health care system. These findings could be helpful for other states hoping to improve their system. The issue brief can be found here.
State Flexibility Act of 2011 Introduced
May 3, 2011
On May 3, Rep. Phil Gingrey (R-GA) introduced the State Flexibility Act of 2011 (H.R. 1683), which repeals the maintenance of effort (MOE) requirements for Medicaid and the Children’s Health Insurance Program (CHIP) that were included in the American Recovery and Reinvestment Act of 2009 (P.L. 111-5) (ARRA) and extended by the Patient Protection and Affordable Care Act (P.L. 111-148) (ACA). The MOE provisions require, as a condition of receiving federal Medicaid and CHIP payments, that states maintain the eligibility standards, methodologies and procedures that were in place as of the date of ACA enactment with respect to children and adults in Medicaid and CHIP. The ACA MOE requirements expire for adults when a state has a functioning health insurance exchange, required by the ACA in 2014, and in 2019 for children.
CMS Finalizes New Rule for Telemedicine Services
May 2, 2011
On Monday, Centers for Medicare and Medicaid Services (CMS) announced a final rule for telemedicine services, which will ensure that patients in remote areas will receive cutting-edge care from local hospitals. This rule changes the process that hospitals and critical access hospitals use for credentialing physicians and practitioners to deliver care through telemedicine. The rule simplifies and streamlines how hospitals can partner with non-hospital telemedicine entities to deliver care. This rule will benefit patients in rural areas where hospitals lack the staff or resources to deliver specialized services to patients. The final rule can be found here.
Improving Advanced Illness Care: The Evolution of State POLST Programs
May 1, 2011
Physician Orders for Life-Sustaining Treatment (POLST) is a program currently running in 12 states. POLST allows physicians (as well as physician assistants and nurse practitioners in some states) to translate a patient’s needs and wishes for their care into a standardized, visible form. This form is transferrable if a patient moves to a different institution and could be easily understood by any physician or other health care worker. The AARP Public Policy Institute released Improving Advanced Illness Care: The Evolution of State POLST Programs, a report which documents the 12 state programs, and the evolution of their POLST program. The report discusses the similarities and differences in the different programs, identifies the key facilitators of POLST development, discusses the barriers and issues surrounding POLST programs, and offers advice for other states in developing and implementing POLST programs. To view the full report, click here.
ACF Releases Q and A on TANF Reporting Requirements
May 1, 2011
The Administration for Children and Families (ACF) published a compiled list of frequently-asked questions and answers from states on Temporary Assistance for Needy Families (TANF) reporting requirements included in the Claims Resolution Act of 2010 (PL 111-291). The list is available here.
May is Older Americans Month
May 1, 2011
In recognition of Older Americans Month, President Obama issued a Presidential Proclamation recognizing the important role of older adults in American society, and highlighting the theme for this year’s Older American’s Month, Older Americans: Connecting the Community. To read the announcement, please follow this link.
CMS Proposes Changes to Medicare Program
April 29, 2011
CMS published a proposed rule in the April 29 Federal Register to implement section 3004 of the ACA, which establishes a new quality reporting program that provides for a two percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to HHS. The proposed rule would also update the prospective payment rates for inpatient rehabilitation facilities (IRF) for FY 2012. CMS is also proposing to consolidate, clarify, and revise existing policies regarding IRF hospitals and IRF units of hospitals, as well as to amend existing regulatory provisions regarding “new” facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material. Comments on the proposed rule are due by June 21, 2011. The proposed rule is available here.
National Resource Center on LGBT Aging Unveils Caregiving Resources
April 29, 2011
The National Resource Center on LGBT Aging, funded in part by AoA, recently announced the launch of its new portal on Lesbian, Gay, Bisexual and Transgender (LGBT) caregiving. The resource center is available here.
CMS Proposes to Expand Access to Flu Vaccine
April 29, 2011
CMS proposed new requirements for Medicare-certified providers that are designed to expand access to seasonal influenza vaccination. The notice of proposed rulemaking would update the conditions of participation and conditions for coverage for a number of provider types, in an effort to increase access to the vaccine, increase the number of patient receiving annual vaccination against the seasonal flu, and to decrease flu-linked morbidity and mortality. CMS will accept public comments on the proposed rule until July 5, 2011, and will respond to comments in a final rule to be published in the coming months. The proposed rule is available online from the Federal Register here.
HHS Implements Hospital Value-Based Purchasing Program
April 29, 2011
HHS launched a new initiative that will reward hospitals for the quality of care they provide to people with Medicare and help reduce health care costs. Authorized by the ACA, the Value-Based Purchasing program marks the beginning of an historic change in how Medicare pays health care providers and facilities. For more information, including links to a fact sheet on the Hospital Value-Based Purchasing program and the final rule establishing the program, please click here.
New Report Examines Global and Episodic Bundling Payment Strategies for States
April 28, 2011
According to a report prepared by the Robert Wood Johnson Foundation-funded State Coverage Initiatives (SCI), bundled payments might help states control rising Medicaid costs while increasing quality and coordination of care. The report outlines key implementation considerations for state Medicaid agencies, and the report’s authors conclude that pilot programs may be particularly useful in helping states to determine which bundling approaches work best and when. To download the report, Global and Episodic Bundling: An Overview and Considerations for Medicaid, please click here.
CMCS Releases Informational Bulletin on Recent Developments in Medicaid
April 26, 2011
The Center for Medicaid, CHIP, and Survey & Certification (CMCS) released an Informational Bulletin highlighting several new announcements from Medicaid, including a State Medicaid Director’s letter regarding the appeals component of the five National Correct Coding Initiative methodologies; issuance for the third multi-year National Background Check Program for Patient Protection solicitation for federal matching grants to all states and territories that did not submit proposals during the first two solicitations; and the release of the CMCS Oral Health Strategy to improve access to oral health services in Medicaid and CHIP. The guidance is available for download here.
CMS Issues Guidance on National Correct Coding Initiative
April 22, 2011
CMS released a Dear State Medicaid Director letter to clarify earlier guidance CMS provided in September of 2010 regarding Section 6507 of the ACA, which amends Section 1903® of the Social Security Act, and requires CMS to notify states of the components of the Medicare National Correct Coding Initiative (NCCI) methodologies, as well as the appeals process. The letter is available here.
Area Health Education Centers Infrastructure Development Grant Opportunity
April 22, 2011
The Health Resources & Services Administration (HRSA) within HHS announced a funding opportunity for Area Health Education Center (AHEC) programs, which consist of interdisciplinary, community-based, primary care training program wherein academic and community-based leaders work to improve the distribution, diversity, supply, and quality of health care personnel. This funding opportunity announcement (FOA) solicits applications for a one-year project. Eligible entities include public or private nonprofit accredited schools. Applications are due by June 10, 2011, and the full announcement (CFDA Number 93.824) is available here.
Third National Criminal Background Check Solicitation
April 22, 2011
CMS released a notification of funding for the National Background Check Program, the third multi-year solicitation for federal matching grants to states and territories. The program provides funding to states to perform criminal background checks for direct patient access employees of long-term care facilities and providers. To date, 19 states have qualified under the first two solicitations. This program is open for those that did not submit proposals during the first two solicitations. States that applied during the previous cycles but did not receive the full award amount may also apply for the remaining amount allowed under the provisions of the ACA. A memo with instructions and further details can be found here.
New Outreach Effort for Graduating Students
April 20, 2011
The Secretaries of Education and HHS launched a new initiative to help educate graduating college and university students about their new health insurance options under the ACA. The guidance, which outlined several ways university officials and student leaders can reach out to this population, is accessible here.
CDC Publishes Notice of Intent to Award ACA Funding
April 19, 2011
In the April 19 Federal Register, the Centers for Disease Control and Prevention (CDC) published a notice of intent to award ACA funding to approved applications received by the CDC in response to the Enhanced Surveillance for New Vaccine Preventable Disease funding opportunity. These funds are made possible through Section 4002 of the ACA, and the notice is available here.
CMS Finalizes Rule on Federal Funding and for Eligibility and Enrollment in Medicaid
April 19, 2011
CMS released a final rule that revises Medicaid regulations for “mechanized claims processing and retrieval systems” and modifying regulations framing enhanced federal financial participation (FFP) in system design. Historically, Medicaid eligibility and related systems were primarily driven by linkage to “cash welfare assistance determinations.” Based on the Affordable Care Act, CMS anticipates the need for states to make changes to eligibility processes and business operations, to accommodate newly eligible individuals, and to “operate seamlessly with newly authorized Health Insurance Exchanges.” CMS expects that such Medicaid systems changes, “should be undertaken in full partnership with Exchanges….” The rule is effective upon its publication in the April 19 Federal Register, and is available for download here.
CMS Proposes Rule on Medicaid HCBS Waivers
April 15, 2011
In the April 15 Federal Register, the Centers for Medicare and Medicaid Services (CMS) promulgated a proposed rule potentially making changes to home and community based services (HCBS) regulations. By amending the Section 1915(c) home and community based services (HCBS) waiver regulations, the proposed rule would reduce administrative barriers for states seeking to help multiple populations, and would allow individuals to participate in the design of their own array of services and supports. Attached, please NASUAD’s summary of the proposed rule, including the changes the regulations would make to waiver targeting; HCBS settings; person-centered planning; the waiver amendment process; and state waiver compliance procedures. The proposed rule will be open for comments until June 14, and is available here.
New Issue Briefs on the Development and Implementation of the CLASS Plan
April 14, 2011
The National Resource Center for Participant Directed Services (NRCPDS) released five issue briefs intended to address issues pertinent to the development and implementation of the Community Living Assistance Services and Support (CLASS) Plan. These papers are part of a series of 17 briefs funded by the SCAN Foundation, CLASS Technical Assistance Brief Series, and these in-depth analyses from industry and academic experts shed light on critical issues facing the program. The series is available here.
CMCS Releases Informational Bulletin on Recent Developments in Medicaid
April 14, 2011
The Center for Medicaid, CHIP, and Survey & Certification released an Informational Bulletin describing the initiatives recently announced by CMS that are designed to give states more resources and flexibility to adopt innovative practices and provide better, more coordinated care at a lower cost in the Medicaid program. Specifically, the guidance outlines the new flexibility that states will have to (1) develop and upgrade state information technology systems to help people enroll in Medicaid or CHIP; (2) reduce administrative barriers to helping beneficiaries live in their communities rather than institutions; and (3) develop creative ways to provide more efficient health care delivery for dual eligibly beneficiaries. The Informational Bulletin is available here.
CMS Releases New Medicaid Rules
April 14, 2011
HHS announced four new initiatives to provide states with more flexibility in Medicaid. Fifteen states will receive up to $1 million each to coordinated care for people with Medicare and Medicaid; states will receive an enhanced match rate for developing and upgrading their Medicaid IT enrollment systems; states would face greater flexibility for their programs to help people with disabilities live in their communities; and New Jersey received approval for a Section 1115 demonstration project to expand health coverage. For more information on these new initiatives, please click here.
New Resource for Tracking Local Health News Stories
April 13, 2011
The Alliance for Health Reform recently launched a selection of local news stories on health-related topics, such as emerging trends, community health issues, and innovative strategies. The subjects and stories are updated frequently, and are available here.
CMS Accepting Applications for the Community Based Care Transitions Program
April 13, 2011
CMS announced that it is now accepting applications for participation in the Community Based Care Transitions Program (CCTP). Eligible entities for the CCTP are statutorily defined under Section 3026(d) of the Affordable Care Act as hospitals with high readmission rates that partner with community based organizations that provide care transition services. Applications will be accepted, and reviewed, on a rolling basis beginning April 12, 2011, and the applications are available here.
CMS Announces Community-based Care Transitions Program
April 12, 2011
The Centers for Medicare & Medicaid Services (CMS) has announced it is now accepting applications for participation in the Community-based Care Transitions Program (CCTP). You may view the CCTP Application by clicking here. The CCTP, created by section 3026 of the Affordable Care Act (P.L. 111-148), provides funding to test models for improving care transitions for high risk Medicare beneficiaries. The goals of the CCTP are to: Improve transitions of beneficiaries from the inpatient hospital setting to other care settings; improve quality of care; reduce readmissions for high risk beneficiaries; and document measureable savings to the Medicare program. For further information regarding the CCTP, including Application and Solicitation documents, go to the Community Care Transitions Program Website here.
HHS Launches Partnership for Patients
April 12, 2011
HHS Secretary Kathleen Sebelius announced a new national partnership to improve patient care and generate cost savings, the Partnership for Patients. To launch this initiative, HHS announced it would invest up to $1 billion in federal funding, made available under the ACA, in reforms that help achieve the shared goals of keeping hospital patients from getting injured or sicker, and helping patients heal without complication. For more information on this partnership, please click here. For more information on the program, please see the Special Edition of AoA’s Affordable Care Act Enews focusing on the Partnership for Patients, available here.
HHS Releases Grants to Enhance Older Adult Behavioral Health Services
April 8, 2011
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services, is accepting applications for fiscal year (FY) 2011 for Grants to Enhance Older Adult Behavioral Services, in order to expand existing Older Adult Targeted Capacity Expansion (TCE) programs to include a focus on the prevention of suicide and prescription drug misuse among the older adult population. Eligible applicants are domestic public and private nonprofit entities, including state and local governments. However, eligibility is limited to current and previous Older Adult Targeted Capacity Expansion grantees from cohorts FY 2002 through 2008. Applicants must also comply with the requirement to address the target population of persons 60 years of age and older who are at risk for, or are experiencing, behavioral health problems. Applications are due by June 7, 2011, and the announcement (CFDA Number 93.243) is available here.
HHS Releases Strategic Prevention Framework State Prevention Enhancement Grants
April 8, 2011
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Abuse Prevention (CSAP) is accepting applications for fiscal year (FY) 2011 Strategic Prevention Framework State Prevention Enhancement (SPF) grants, to bring the SPF to scale and support communities of high need nationwide (CFDA Number 93.243). The SPF process is an integral part of SAMHSA’s mission to reduce the impact of substance abuse and mental illness on America’s communities. Eligible applicants are states, territories, and tribes, and the application must be submitted by the agency that receives the Substance Abuse Prevention and Treatment (SAPT) Block Grant. The SPE grant is not open to community applicants, as it is designed for the sole purpose of strengthening and enhancing state and tribal level infrastructures and systems. Applications are due by June 3, 2011, and the announcement is available here.
CMCS Releases Guidance on HITECH Program
April 8, 2011
The Center for Medicaid, CHIP and Survey & Certification (CMCS) released a letter today to State Medicaid Directors to provide guidance on technical changes impacting the Medicaid Electronic Health Record Incentive Program as a result of the 2010 Medicare and Medicaid Extenders Act. The letter is available here.
CMS Releases Guidance on Electronic Health Records
April 8, 2011
HHS Released a State Medicaid Director letter on technical changes impacting the Medicaid Electronic Health Record (EHR) Incentive Program as a result of the 2010 Medicare and Medicaid Extenders Act. Specifically, the law changes the requirement for an Eligible Professional to demonstrate the “net average allowable costs,” the contributions from other sources, and the 15 percent provider contribution to participate in the program. The guidance is available here.
HHS Announces Plan to Reduce Health Disparities
April 8, 2011
HHS released two plans aimed at reducing health disparities: the HHS Action Plan to Reduce Health Disparities, which outlines the goals and actions HHS will take to reduce disparities; and the National Stakeholder Strategy for Achieving Health Equity, which sets goals and actions for the public and private sectors to help reduce these disparities. The ACA includes several provisions with the potential to address the needs of racial and ethnic minority populations, in part by driving down health care costs, investing in prevention and wellness, supporting improvements in primary care, and creating linkages between the traditional realms of health and social services. For more information about the plans, please click here.
HHS Releases $311 Million in LIHEAP funds
April 7, 2011
HHS announced the release of an additional $311 million to states to help qualified families with their home energy needs under the Low-Income Home Energy Assistance Program (LIHEAP). The $311 in block grant funds released today supplement the previous LIHEAP funding made available to states under the continuing resolutions since October 1, totaling $4.2 billion for FY11. For more information, including state allocations of the funds, please click here.
AoA Releases $2.25 Million for Lifespan Respite Care Programs
April 6, 2011
AoA announced the availability of approximately $2.25 million for the implementation of the Lifespan Respite Care Act of 2006. The money will allow states to establish, enhance, or expand their Lifespan Respite Care systems. AoA will award up to 12 states with federal funding of up to $200,000 for three year projects. These projects must propose to serve all eligible unpaid caregivers, and they must also enhance the state’s respite services and improve the access to these services. Applications are due on Friday, May 20, 2011. Letters of intent must be submitted by Monday, April 25, 2011. For more information on this opportunity, please click here.
New Toolkit for States Building Health Insurance Exchange Websites
April 5, 2011
A new toolkit series from the Robert Wood Johnson Foundation provides state officials with valuable information and resources to design an effective website on their state’s health insurance exchange. Under the ACA, all states must either develop or participate in a health insurance exchange, which must give consumers complete information about their health insurance options. This new toolkit is available here.
Webcast on Launching Insurance Exchanges
April 4, 2011
The AARP Public Policy Institute hosted a webcast on how states are launching the insurance exchanges created by the ACA. The webinar, Launching Insurance Exchanges: What are States Doing?, featured AARP Executive Vice President John Rother; the head of the Exchange Office at HHS, Joel Ario; and officials in charge of the exchanges in Colorado, Utah, Virginia and Maryland. The event was moderated by Chuck Milligan, Director of the Hilltop Institute, and the archived webcast and transcript are available here.
Final Payment Policies for Medicare
April 4, 2011
CMS issued changes to Medicare Advantage (Part C) and Medicare Prescription Drug (Part D) Plans for 2012. The updates, detailed in what is known as the Rate Announcement and Call letter, are the result of comments received regarding the Advance Notice and 2012 Call Letter (Advance Notice) published February 18. In 2012, Medicare Advantage Plans (MA) will increase, on average, 0.4 percent, a decrease from the 1.6 percent estimated in the Advance Notice. The Part D deductible will increase from $310 to $320, the initial coverage limit will rise from $2,840 to $2,930, and the out-of-pocket threshold will go from $4,550 to $4,700. To read the CMS Fact Sheet on these changes, please click here.
Medicaid’s Role in the Exchanges: A Roadmap for States
April 4, 2011
A new report from the National Academy for State Health Policy (NASHP)’s Maximizing Enrollment program offers states a road map for many of the issues states are expected to face in effectively integrating Medicaid as they build, operate, and finance their health benefit exchanges. The report focus on four key areas where state officials can expand Medicaid’s role in planning exchanges, including (1) Eligibility, enrollment and outreach; (2) Health plan standards and requirements; (3) Benefit package design; and (4) Infrastructure. Among other conclusions, the study finds that a thorough evaluation of Medicaid’s role in planning and operating any state’s exchange is a pivotal early step. To download the report, please follow this link.
Issue Brief Examines Multi-State Insurance Exchanges
April 1, 2011
A new issue brief funded by the Robert Wood Johnson Foundation and written by the Urban Institute’s Linda Blumberg examines why states might form multi-state exchanges, and the issues raised by doing so. The analysis suggests four rationales for establishing multi-state exchanges, and concludes that because cross-state risk sharing could lead to one state’s population effectively subsidizing another state’s population, multi-state exchanges are likely to focus on shared administrative structures and efficiencies as opposed to risk-sharing. To download the report, please click here.
ACA’ s Early Retiree Reinsurance Program to Stop Accepting Applications
April 1, 2011
CMS released a notice, to be published in the April 5 Federal Register, announcing that in early May, the agency will no longer accept applications for the Early Retiree Reinsurance Program (ERRP). Created by Section 1102 of the ACA, the ERRP provides reimbursement to eligible sponsors of employment-based plans for a portion of the costs of providing health coverage to early retirees. Based on the $5 billion in appropriated funding that the program received under the ACA, CMS has concluded that a sufficient number of applications have been approved to exhaust the remaining program funding. The notice is available here until April 5, when it will be accessible here.
CBO Releases Report on Deficit Reduction Options
April 1, 2011
The Congressional Budget Office (CBO) regularly issues a compendium of budget options to help inform federal lawmakers about the implications of possible policy choices. This volume, Reducing the Deficit: Spending and Revenue Options, presents more than 100 options for altering federal spending and revenues. Among the ways to reduce mandatory spending, CBO suggests converting the federal share of Medicaid payments for long-term services into a block grant; reducing the floor on federal matching rates for Medicaid services; raising the Medicare eligibility age to 67; and raising both the eligibility and retirement age for Social Security. The report is available for download here.
HHS Releases Public Prevention Health Fund Grant Opportunity
April 1, 2011
HHS announced the availability of grant awards to provide additional financial and programmatic assistance to strengthen the ability of states that are currently receiving funds to reduce tobacco use through legislative, regulatory, and educational arenas, as well as to enhance and expand the national network of tobacco cessation and reduce morbidity from tobacco use, as well as associated health care costs. The funds are available through the ACA’s Communities Putting Prevention to Work program, administered by the Centers of Disease Control and Prevention. Applications are due by May 2, 2011, and the modification to the previous grants notice is available for download here.