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Showing posts from May 13, 2018

Proposed Changes to Medicaid Access Rule Could Lead to Deep Cuts in EPSDT Services

We have been busy working on  our comments  on the  proposed rule  that would make significant changes to the Medicaid Access Rule. As my colleague, Andy Schneider,  wrote  last month, one of the major changes in the proposed rule is to  allow states to make fee-for-service payment cuts of 4% a year (6% over two years, 12% over four, etc.) without reviewing their impacts on access and regardless of whether the payment rates being cut are already too low. Under the proposed rule, the 4% and 6% thresholds would apply to “overall service category spending.” The service categories are those generally defined under sections 1905(a)(1) through (29) of the Social Security Act.  EPSDT , the Medicaid pediatric benefit, is in the same overall service category as nursing facility services, family planning services and supplies, and tobacco cessation services for pregnant women. Using national FY 2016  expenditure reports  from MBES/CBES, we modeled a 4 percent payment reduction to the o

A Conversation on Meaningful Family Engagement, from Clinical Care to Health Policy

Engaging with families is vital to transforming the health care system and positively impacting the life course of vulnerable populations. Families have extensive experience in partnering with professionals to improve systems of care, are organized and connected across the country, and stand ready to assist at every level of next efforts for improvement. Learn how to meaningfully involve families at every level of health care systems and engage them as critical partners in designing policies that will improve care for all children. Join us for a lively discussion on the article,  Families of Children With Medical Complexity: A View From the Front Lines . The lead author and experts in the field will review the article’s key content and share ways to strengthen family engagement. We suggest attendees read the article prior to the event. Audience Q&A is highly encouraged. Attendees can listen via web or phone.  Learn more and register .

Legislative Study Topics

May 15, 2018 2018 Legislative Study Topics Set  Legislative leaders convened in Indianapolis today to set the agenda for the Indiana General Assembly’s interim study committees. Below is a list of topics impacting health care that will be given a closer look by committees during the summer and fall. Interim Study Committee on Public Health, Behavioral Health, and Human Services Issues related to medical marijuana   The impact that opioid treatment programs have on the neighborhoods and communities in the immediate area of the opioid treatment programs, including the following: Criminal activity, including violent crimes, property crimes, and drug-related crimes. Emergency medical services, including the number of calls for assistance, runs provided, and cases of overdoses. The effect on the local economy, including the area property values.The effect on the residents’ quality of life, including any additional traffic and excessive noises. Any other direct im

Trump Rule Targets Landmark Health Care Law by Weakening Essential Health Benefits’ Standards

from NHLP: by  Candace Gibson, Héctor Hernández-Delgado, and Wayne Turner   on  April 23, 2018   Sixty-seven percent of consumers  believe  that the top health care priority should be to lower out-of-pocket costs, instead of cutting benefits and consumer protections. Yet the Trump administration continues to undermine the progress made by the Affordable Care Act (ACA) in ensuring that people have access to basic health care services. The  latest regulation  issued by the Department of Health and Human Services, the Notice of Benefit and Payment Parameters for 2019 (Final Rule), continues that downward spiral. In its most recent effort to sabotage the Affordable Care Act, the Trump administration is seeking to weaken coverage of the federal law's essential health benefits (EHBs), which ensure that people enrolling in Marketplace plans can get comprehensive, affordable, quality insurance. The EHBs require individual market health plans to cover services in ten c