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State Directed Payments: Part II– Medicaid Supplemental Payments
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In the second installment of the series on State Directed Payments, Sarah Jagger shares the good, the bad, and the really (really) stupid about Medicaid Supplemental Payments.
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State Directed Payments: Part I—Medicaid Financing 101
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Atrómitos Vice President of Operations, Sarah Jagger, kicks off a new 3-part series on Medicaid State Directed Payments. This first article provides an important primer on key constructs of Medicaid financing. And a brief introduction of state-directed payments that play an important role in state Medicaid financing strategies and are the focus of upcoming policy recommendations to Congress by the Medicaid and CHIP Payment and Access Commission (MACPAC).
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NC Medicaid Tailored Plans: We Gotta Get this Right
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North Carolina is poised to implement Tailored Plans, a new managed care program, that will serve as an integrated health plan for individuals with significant behavioral health needs and intellectual/developmental disabilities (I/DDs) next July. Reflecting on lessons learned from other states, DHHS has the opportunity to take action NOW to ensure provider, plan, and system readiness.
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A Call to Understand and Expand Medicaid This Year
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In Atrómitos’ final article of 2020, we wrote about the need for 2021 to be the year we address the myriad wicked problems confronting our nation. In keeping with that theme and also given that the N.C. General Assembly has recently convened for its new session, we’re talking about Medicaid expansion.
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ICYMI: Big Changes Coming to NC Advanced Medical Home Program
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Last week, the North Carolina Division of Health Benefits (Medicaid) launched its Advanced Medical Home (AMH) Webinar series with North Carolina Area Health Education Centers (NC AHEC) to support providers in the transition to Medicaid Managed Care. Here’s what you need to know.
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Medicaid Work Requirements: Who Exactly Are They Working For?
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This week all eyes were on the Supreme Court as it heard arguments in Texas v. California, a case that once again challenges the constitutionality of the Affordable Care Act (ACA). However, there is another case making its way to the SCOTUS that is also critically important to tens of millions of people: Alex M. Azar, II, Secretary of Health and Human Services, et al., Petitioners v. Charles Gresham, et al.
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COVID-19: Section 1135 Waiver Flexibilities to Support State and Provider Needs
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Shortly after the presidential declaration on March 13, the Centers for Medicare and Medicaid Services (CMS) announced a set of blanket waivers specific to the COVID-19 pandemic (COVID-19 waivers). Here’s what you need to know.
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NCDHHS Seeks Comments On Changes to Value-Based Payment Program and Two New Accountable Care Organization Models by February 19
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On January 8, 2020, the Department released two Medicaid Managed Care Policy Papers that advance its design of the value-based payment program and incorporate two new Accountable Care Organization (ACO) models into the overall programmatic strategy for Medicaid Transformation.
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Our Perspective: North Carolina Medicaid Rollout Suspended
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On November 19, the North Carolina Department of Health and Human Services (NCDHHS) announced that the transition to Medicaid managed care would be indefinitely suspended. Here’s what you need to know and our perspective on the right path forward.
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Budget Impasse Causes Delay in NC’s Medicaid Transformation
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On September 3, NCDHHS Secretary Mandy Cohen, announced that implementation of the state’s Medicaid Transformation would be delayed.
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Stakeholders Provide Feedback to Changes in CMS Hospital Star Ratings
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On August 19, the Centers for Medicare and Medicaid Services (CMS) announced its plans to change the controversial methodology used for its hospital star ratings on Hospital Compare. However, changes won’t occur until 2021.
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CMS Releases State Guidance for Medicaid Implementation of SUPPORT Act
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States must amend their State Plan and receive CMS approval of the application for implementation of these DUR requirements.
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North Carolina Republicans Introduce Bill to Expand Medicaid
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On April 9, 2019, a group of House Republicans in North Carolina introduced House Bill (HB) 655 named the “NC Health Insurance for Working Families Act”. The bill mirrors “Carolina Cares” legislation that was introduced in the 2017-2018 legislative session.
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Opportunities for Behavioral Health Transformation: Making Change
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Over the past decade, public behavioral health systems across the country have undergone one transformation after another. As a result, providers and system stakeholders are often left feeling like just when one transformation finishes, it’s time to start over again.