Click <here> for a look at the latest OIG (Office of Inspector General, U.S. Department of Health and Human Services) audit findings on “State Use of Express Lane Eligibility for Medicaid and CHIP Enrollment.”
For children to have the best chance of becoming productive and healthy adults, child-serving systems need to coordinate their care and services. Two sectors in particular, education and health, play critical roles in promoting better outcomes for child wellbeing and long-term success. Excluding the home, schools and child health systems have the most direct influence on a child’s development. Yet, these two sectors often operate in silos, failing to leverage the resources accessible to each other, and so limiting their impact.
For the complete story, go to: https://www.brookings.edu/wp-content/uploads/2016/07/Price-Layout2.pdf
The Centers for Medicare and Medicaid Services (CMS) proposed a rule change to the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) programs that have to do with changes as a result of the Affordable Care Act to the way states decide eligibility for Medicaid and Children's Health Insurance Program (CHIP). More information about the proposed change as well as the proposed rule can be found here.
The Chicago Department of Public Health collaborated with the Partnership for Healthy Chicago develop of Health Plan for the city of Chicago. This was the work of many stakeholders from both public and private stakeholders. The strategies are outlined in the Healthy Chicago 2.0 Plan. The detailed plan outlines all areas for a healthy community including health and education which can be found starting on page 24.
The National Association of State Boards of Education (NASBE) hosted a webinar on December 15, 2015 regarding Promoting Access to School Health Services for Improved Student Health and Achievement.
The presenters included Paula Hall from the National Association for School Nurses (NASN) and John Hill from the National Alliance Medicaid in Education (NAME).
To watch the webinar <Click Here>.
The Centers for Medicaid and CHIP Services (CMCS) finalized “CMS-2390-P” on Monday April 25, 2016, which is a set of rules that will be published in the Federal Register soon.
The rule applies to health insurers operating Medicaid managed care plans for the states and it is the first major update to Medicaid and CHIP managed care regulations in more than a decade. It aligns key rules with those of other health insurance coverage programs; modernizes how states purchase Medicaid managed care services; and strengthens the consumer experience and key consumer protections.
As Families USA says in their news email, “The new rule is a big deal in part because it affects so many people: There are more than 72 million people enrolled in Medicaid. Three quarters of them are in managed care plans across 39 states. States can—and many already have—gone above and beyond these new standards in many areas. For other states, it will require substantial work to come into compliance. For many provisions (of the rule), CMS has given states (and managed care plans) a long implementation timeline.”
The final rule, when published, will be posted in the Federal Register: https://www.federalregister.gov/ It is currently available in PDF only, here: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-09581.pdf
For more information on CMS-2390-P, a summary of its key provisions, guidance documents, technical assistance documents, and information about state managed care programs, visit the federal Medicaid Agency’s Managed Care website: https://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/managed-care/managed-care-site.html
Statements from the Centers for Medicare and Medicaid Services (CMS) and national organizations on CMS-2390-P
From the CMS Blog of April 25, 2016:
From the National Association of Medicaid Directors (NAMD):
Press Release April 26, 2016
NAMD Statement on Medicaid Managed Care Final Rule
From Families USA:
Families USA’s take on New Medicaid Managed Care Rules
CMS final rule strengthens access to mental health and substance use disorder benefits for millions of beneficiaries who receive services through Medicaid managed care organizations, Medicaid alternative benefit plans or CHIP. Final rule released March 29 2016 by the CMS.
States and plans must be in compliance no later than 18 months after publication of the final rule, which will be published in the Federal Register March 30.
For more information the executive memo is at https://www.whitehouse.gov/the-press-office/2016/03/29/presidential-memorandum-mental-health-and-substance-use-disorder-parity.
Long-time NAME member Larry Charny (NC) who worked for many years as the Director of the Medicaid Special Projects Unit for the New York City Department of Education, has collaborated with the New York State Association of School Business Officials (www.nysasbo.org ) to publish an article in a recent issue of their journal, The Reporter.
His article, “Leadership Strategies for Success with School-Based Medicaid Claiming-and Why it Matters”, reminds the readers that not just administrators of special education and Medicaid coordinators, but school business officials need to understand and actively participate in their district’s Medicaid school based services claiming program. NAME thanks the NYSASBO for their permission to share the article with our members.
To read Larry’s article <Click Here>
A recent case study on the implementation of the Affordable Care Act and the impact the increased number of students now eligible for Medicaid has on the Medicaid School Health Services Program.
In addition one of the sources for the study was the 2013 NAME Biennial Survey. The full survey can be viewed on the Members Only page, once logged in and then following link. http://www.medicaidforeducation.org/members/name-national-surveys
Drawing on data from the U.S. National Survey of Children’s Health, a recent study in the Journal of the American Medical Association (JAMA), compared experiences of children with private and public health insurance and found that those with Medicaid and Children’s Health Insurance Program (“CHIP”) coverage were more likely to receive preventative medical and dental services as well as less likely to incur out-of-pocket costs. This study found that caregivers’ experience with Medicaid coverage was at least as positive, and sometimes more positive, than their experience with private insurance.