CMS Issues Medicaid Unwinding Enforcement Rule, Including Penalties
The Centers for Medicare and Medicaid Services says that states that don't comply with federal policies as they proceed with unwinding people from Medicaid rolls are at risk of reduced federal funding. The rule takes effect Wednesday, and includes helping states with the process.
Modern Healthcare:
CMS Medicaid Unwinding Enforcement Rule Issued
The Centers for Medicare and Medicaid Services outlined its plans to get Medicaid redeterminations disenrollments under control in an interim final rule published Monday. States that fail to comply with federal Medicaid policies as they review their benefit rolls for ineligible enrollees risk reduced federal funding under the regulation, which comes after 11.8 million Medicaid beneficiaries have been removed from the program since April, according to CMS data compiled by KFF. (Bennett, 12/4)
Fox 8 Live:
Louisiana Has Removed 197,000 People From Medicaid Over Five Months
Louisiana removed 197,000 people from its Medicaid rolls over a five-month period from June to October, as it complies with renewed federal standards for the government-backed insurance. About a quarter of the people dropped, or 47,000, are children. Two-thirds of the individuals cut have lost their health insurance for “procedural reasons,” including not filling out the appropriate paperwork. (O'Donoghue, 12/4)
More news about Medicaid and Medi-Cal —
Wisconsin State Journal:
Dane, Milwaukee Counties End Billing Dads In Medicaid Births
Dane County plans to stop making unmarried fathers pay back the state Medicaid program for birth costs of their children in cases before 2020, a step the county took that year with new cases. Milwaukee County said last month it will end new birth cost recovery actions, another move to curtail a practice opponents say contributes to poor birth outcomes by requiring pregnant women to disclose the fathers of their children or lose Medicaid coverage after the babies are born. (Wahlberg, 12/4)
Axios:
Meet The Man Who Helped Make NC Medicaid Expansion Happen: Kody Kinsley
You may not have heard of Kody Kinsley, the secretary of North Carolina's Department of Health and Human Services, but you oughta know him. Driving the news: Leaders throughout the state and country celebrated on Friday when the long-awaited expansion of Medicaid became a reality, extending coverage to 300,000 of the state's poorest residents immediately and eventually as many as 600,000. (Sherman, 12/4)
The Denver Post:
Colorado Investigates ‘Unprecedented’ Scheme By Drivers Paid To Transport Medicaid Patients Hundreds Of Miles A Day
The patients flocked to metro Denver methadone clinics in mid to late summer, five or six to a car. Most were users of illicit opioids, including fentanyl. Many were homeless. And all were from Pueblo or other parts of southern Colorado, driven up Interstate 25 by independent transportation contractors who suddenly had flooded the state’s Medicaid system.As clinics scrambled to process the patients, they thought it was odd so many were coming from outside of metro Denver — especially while clinics were open and waiting in southern Colorado, some recalled later to The Denver Post. Providers at the methadone facilities, which are tightly regulated and highly stigmatized, made note of the vehicles dropping off these new patients: new SUVs with temporary tags, driven by men who often spoke accented English and who all had enrolled in a lucrative program that paid them to drive patients to the doctor. (Klamann, 12/2)
KFF Health News:
California’s Ambitious Medicaid Experiment Gets Tripped Up In Implementation
Nearly two years into Gov. Gavin Newsom’s $12 billion experiment to transform California’s Medicaid program into a social services provider for the state’s most vulnerable residents, the institutions tasked with providing the new services aren’t effectively doing so, according to a survey released Tuesday. As part of the ambitious five-year initiative, called CalAIM, the state is supposed to offer the sickest and costliest patients a personal care manager and new services ranging from home-delivered healthy meals to help paying rental security deposits. (Hart, 12/5)
CMS' nursing home staffing proposal faces stiff resistance —
Modern Healthcare:
Biden's Nursing Home Staffing Rule Finds Scant Political Support
President Joe Biden’s high-profile plan to improve nursing home quality by setting staffing minimums has attracted intense resistance and lukewarm support, regulatory comments and public statements reveal. The nursing home industry strenuously opposes the policy, which the Centers for Medicare and Medicaid Services proposed Sept. 1. And as a growing number of congressional Republicans have spoken against it, Biden and CMS have gotten little support, and even resistance, from a cadre of Democrats and patient advocates. (Bennett, 12/4)
