November 1, 2017
Trump Administration approves Iowa Medicaid waiver request
The Trump Administration has approved a waiver from Iowa, effective November 1, that allows the state to end retroactive Medicaid coverage for three months prior to when someone applied. Some say the waiver will prevent people from only applying for Medicaid when they are sick. However, the move will deny retroactive benefits to 40,000 Iowans and could lead to higher medical bills. In addition, hospitals worry the decision could put them at financial risk. This is one of the first major Medicaid waivers approved under CMS Administrator Seema Verma.
ACA signup figures expected to be subpar
Open enrollment begins today and experts are predicting much lower enrollment numbers than past years. The health care exchanges have faced a great deal of uncertainty recently and there is still confusion among consumers about the status of the ACA. While premiums have gone up across the board, the price increases won’t affect most exchange consumers. Eighty percent of ACA enrollees will be able to find a plan for less than $75 a month, according to HHS, and in many cases the more comprehensive “gold” plans will now cost less than a mid-tier “silver” plan. HHS has said it will provide updates on the number of people signing up throughout the open enrollment period.
Funding for ACA enrollment campaigns varies among states
With a 90 percent cut in federal funding for enrollment outreach, the 39 states that rely on healthcare.gov to enroll Americans in health coverage are seeing major reductions in important enrollment outreach. On the other hand, the 11 states and DC that run their own websites and exchanges are responsible for their own outreach and have ramped up state-wide efforts. For example, California and New York, which both run their own health insurance exchanges, will spend $111 million and $27 million respectively on advertising and outreach. Both California and New York are also maintaining the original 12-week enrollment period, while the federal exchange sign-up was modified to 45 days.
CHIP renewal proposal could hit snag in the House
The House will vote on Friday to reauthorize federal funding for CHIP. But some policymakers still oppose the funding for the legislation. The revised version of the bill eliminates a provision that would have charged higher premiums to Medicare beneficiaries earning high incomes, but cuts money from the ACA’s public health fund. The bill is expected to pass the House on a party-line vote. In the Senate, CHIP funding is likely to be included in a supplemental or year-end package.
Results of CMS bundled-payment initiative unclear
For the third year in a row, researchers were unable to determine if a voluntary Medicare bundled-payment initiative cut costs and improved care. Because providers often participate in multiple value-based payment initiatives, it was unclear if savings and improved quality seen by providers were a result of the Bundled Payments for Care Improvement (BPCI) initiative. BPCI is one of the longest-running programs to transition Medicare from a fee-for-service system to a value-based care model. Hospital and policy experts would like the report be used as a roadmap to develop better voluntary models.
CMS offers guidance to groups on info blocking of patient information
CMS issued guidance for physician groups participating in new payment methods for Medicare in 2018. The rule requires clinicians to show that they are not restricting the use of electronic health records and that physicians respond promptly to requests to retrieve electronic health information. The agency is working to make sure the flow of patient information through electronic medical records is not limited by providers or vendors.
| Spread the News!
Please tell others in your organization about ACHP’s Media
Monitoring Report. To sign up, email ACHPcommunications@achp.org