Monday, April 1, 2013

Obama Administration Finalizes Medicaid Expansion Regulations.

The Hill (3/29, Goad) "Regwatch" blog reported HHS finalized new regulations Friday that said "the federal government will reimburse states for 100 percent of the costs for some newly eligible Medicaid patients" for three years, and "after that, the federal contribution would be gradually phased down to 90 percent in 2020, and would remain there permanently." The rule was released after HHS Secretary Sebelius said this week that the new law "could cause healthcare costs to increase for some Americans. It was the first time a top administration official publicly made such a statement."

        The Washington Times (3/29, Howell) "Inside Politics" blog reported, "The Department of Health and Human Services announced it has proposed a final rule that describes a 'simple and accurate method' for states to claim the matching rate for enrollees deemed 'newly eligible' under the Affordable Care Act, which expands the program in 2014 to those making up to 133 percent of the federal poverty level."

        Modern Healthcare (3/30, Block, Subscription Publication) added that "although HHS on Friday released a final rule regarding the expanded 100% federal funding of the cost of new Medicaid beneficiaries, the department is still accepting comments on the methodology states can use to determine whether a new beneficiary qualifies for the enhanced funding."

        HHS To Allow Private Medicaid Expansion Option With Waiver. The Gannett News Service (3/29, Barton) reported that the Obama Administration "said Friday it would allow states to experiment with alternative approaches to the Medicaid expansion called for by the 2010 healthcare reform law." CMS provided "guidelines under which alternative or 'demonstration programs' could be established as a way of 'providing flexibility in pursuit of our shared goals,'" CMS Deputy Administrator Cindy Mann said. Several states are looking for something "other than a expansion of traditional Medicaid, something seen as politically tricky for those in conservative states."

        The Hill (3/29, Baker) "Healthwatch" blog reported that HHS said Friday that "states that want to privatize the healthcare law's Medicaid expansion will need a waiver from the federal government." HHS also "released a questions-and-answers document Friday explaining more about its approach to private expansions." The Hill points out that the privatization option "has gained traction since Arkansas Gov. Mike Beebe (D) first proposed it last month."

        The Washington Post (3/29, Kliff) "Wonkblog" reported that states that wanted "the so-called Arkansas option" to buy private insurance with Medicaid expansion money "have a few more answers." CMS "on Friday issued a Q&A to address some of the questions posed by states. It's not comprehensive - it includes three questions that span two pages - but it has a few new details that might help states make up their minds." Among the answers are that "a partial expansion isn't on the table," while "a waiver might be in order, though." Moreover, CMS said "benefits need to be comparable."

        Bloomberg News (3/29, Wayne) reported that CMS made "a departure" from the ACA and said Friday that "an unspecified number of states" will be able to use Medicaid money to allow low-income residents "to buy health insurance from private plans such as UnitedHealth Group Inc. or Humana Inc." CMS said it would allow the practice "as long as it doesn't cost the government more than the traditional Medicaid program." Arkansas and Ohio both have asked for permission to try private plans.

        Modern Healthcare (4/1, Blesch, Subscription Publication) notes that HHS will only grant a "limited number" of waivers.

        The National Journal (3/29, Sanger-Katz, Subscription Publication) reported that the Obama Administration on Friday "dampened...enthusiasm" in states that want to use private health plans to cover the poor, "laying out strict rules for the program that will interest only a few states." While "the details will reassure many Medicaid advocates," the "rules also could discourage some on-the-fence states from pursuing a Medicaid expansion at all, leaving more Americans without health insurance after the health law's biggest provisions kick in next year." The National Journal said Friday's announcement of rules "sets a high bar for the states to clear."

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