Newsletters

11.02.22

Positioning for Value-Based Cancer Care: Lessons and Opportunities

The past 20 years have brought tremendous progress in cancer outcomes with improved screening and new treatments, such as immunotherapy, but with these innovations and our country’s aging population, escalating care costs and quality variation continue to confound the system.


11.01.22

340B Anti-Discrimination Provisions: A Review of Proposed and Enacted Legislation by State

The 340B Drug Pricing Program, which was enacted in 1992 by Section 340B of the federal Public Health Services Act, requires pharmaceutical manufacturers that participate in the Medicaid program to provide covered outpatient drugs at significantly reduced prices to certain health care providers and ...


10.27.22

Supporting Children & Families Enrolled in Medicaid as the COVID-19 PHE Conclusion & Unwinding Nears

During the COVID-19 public health emergency, states implemented numerous Medicaid and Children’s Health Insurance Program policies and operational processes that helped to maintain coverage and support access to needed physical and behavioral health services for children and adolescents.


09.28.22

CMS Reexamines Its Interpretation of the COVID-19 Continuous Enrollment Requirement

On September 23, the Centers for Medicare & Medicaid Services (CMS) reopened the comment period for a November 2020 interim final rule titled “Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency.”


09.26.22

Addressing Housing Insecurity via Medicaid Managed Care

With the prices of homes and rentals continuing to climb alongside already high rates of housing insecurity, access to basic, safe, and clean housing is at risk for many people with low incomes across the country.


09.15.22

States Push for Innovative Ways to Improve Health Outcomes for Justice-Involved Individuals

There is growing momentum among states to develop innovative models to help people involved with the justice system (i.e., justice-involved individuals) receive health care services covered by Medicaid while they are incarcerated. 


08.15.22

Scaling Remote Monitoring Programs: Strategic Imperatives for Health System Leaders

Remote monitoring technology and programs have proliferated over the past five years, accelerated by the continued miniaturization of medical-grade sensors; improvements in device accuracy, validity and pricing; and new reimbursement models such as coverage for remote patient monitoring and remote ...


08.03.22

Recent Developments in Section 1115 Waiver Budget Neutrality Policy

Section 1115 of the Social Security Act permits the secretary of the Department of Health and Human Services to waive certain Medicaid program rules and provide federal funding for states to test innovative coverage and delivery system reforms that would further the objectives of the Medicaid ...


07.28.22

Evolving Issues in Designing Local, Whole-Person Care Management Programs in Medicaid

Many state Medicaid programs have prioritized developing and expanding “local, whole-person care management” programs, believing that providing integrated care management closer to where enrollees live and obtain care will be more successful in helping them navigate the health care ...


07.21.22

EMTALA v. State Abortion Laws: Navigating the Legal Uncertainties of Emergency Abortion Care

In the wake of the Supreme Court’s decision overturning Roe v. Wade, the Centers for Medicare & Medicaid Services issued guidance to health care providers on July 11, 2022, underscoring that the federal Emergency Medical Treatment and Labor Act applies to patients who present at a ...