On January 14, 2013, the Department of Health and Human Services (HHS) released a proposed rule implementing key Affordable Care Act provisions relating to Medicaid and the Exchanges. This proposed rule codifies statutory eligibility provisions, lays out a structure and options for coordinating Medicaid, the Children’s Health Insurance Program (CHIP), and Exchange eligibility notices and appeals. It also proposes to modify existing benchmark benefits regulations for low-income adults, and codify several of the provisions included in the Children’s Health Insurance Program Reauthorization Act (CHIPRA).
This proposed rule includes information on how consumers will receive coordinated communications on eligibility determinations and can appeal eligibility determinations. It gives states flexibility in designing benefits and determining cost sharing in the Medicaid program. The proposed rule also provides flexibility to state-based Exchanges by allowing them to opt to rely on HHS for verifying whether an individual has employer-sponsored coverage and conducting some types of appeals.
On August 21, 2012 the U.S. Department of Education forwarded the final version of the proposed changes to the parental consent to access Medicaid regulation, 34 CFR § 300.154(d)(iv)(A) to the Office of Management and Budget (OMB).
USDOE requested OMB to complete an expedited 45 day review period. If OMB is able to honor this request, the Final Rule should be released just prior to the NAME 2012 Annual Conference which is being held in Providence, RI October 9-12, 2012.
NAME is inviting to the Annual Conference a representative from the Office of Special Education and Rehabilitative Services (OSERS) to provide an update to this and other issues.
On May 14, 2012, the U.S. Department of Education released the Retrospective Review Plan Report. This was a summary of various regulations in regards to effectiveness, benefits and cost. The report included the proposed changes to the parental consent to access Medicaid regulation, 34 CFR § 300.154(d)(iv)(A). The report indicated that the proposed regulation would result in a savings of $14,144,000 to $41,423,000 annually. The report also indicated that they anticipate issuing the final regulation by July or August of 2012. To read this ten page report click here.
The Centers for Medicare & Medicaid Services (CMS) is hosting six Payment Error Rate Measurement (PERM) Provider Education Webinars/Conference Calls to assist PERM Cycle 1** Medicaid-enrolled providers prepare for these unique federal audits. The six sessions are identical in content, but you may want to listen in on more to hear the different questions and answers. The calls are designed to provide an opportunity for Medicaid and Children’s Health Insurance Program (CHIP) providers to enhance your understanding of your specific responsibilities so you are prepared before and during PERM audits.
The PERM program is designed to measure improper payments in the Medicaid and CHIP programs, as required by the Improper Payments Information Act (IPIA) of 2002 (amended in 2010 by the Improper Payments Elimination and Recovery Act or IPERA).
The dates of the calls in 2012 are May 23, June 21, July 24, August 23, September 25, and October 24. Each occurs 2-3 pm EST.
**PERM cycle 1 states are: Arkansas, Connecticut, Delaware, Idaho, Illinois, Kansas, Michigan, Minnesota, Missouri, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Virginia, Wisconsin, Wyoming)