Budget Blog

June 11, 2020 - Health Care Issues Update

By Stacey Mazer posted 06-11-2020 12:00 AM

  

HHS Announces $25 Billion to Medicaid and CHIP Providers and Safety Net Hospitals

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $25 billion in distributions from the $175 billion Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers. The distribution is expected to be $15 billion to eligible Medicaid and CHIP providers who have not received a payment from the Provider Relief Fund General Distribution and $10 billion to safety net hospitals that serve vulnerable citizens. HHS is launching an enhanced Provider Relief Fund Payment Portal for Medicaid and CHIP providers to report their annual patient revenue. The payment to each provider will be at least 2 percent of reported gross revenue from patient care. For the safety net hospitals, the payments will go to hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care. Recipients will receive a minimum distribution of $5 million and maximum distribution of $50 million. Additional information on the distributions made under the Provider Relief Fund can be found here.

 

CMS Issues Guidance on Medical Loss Ratio Requirements for Managed Care  

The Centers for Medicare & Medicaid Services (CMS) issued a Medicaid informational bulletin providing guidance to states on the implementation and compliance requirements of the Medical Loss Ratio (MLR) that should be included in their Medicaid managed care contracts.  States are required to include requirements for managed care plans to calculate and report an MLR. These requirements were established under the 2016 Medicaid managed care regulations for contracts that started on or after July 1, 2017.  Additionally, the SUPPORT Act added statutory requirements to encourage the use of remittances if a managed care plan does not meet a minimum MLR of at least 85 percent.

 

State Approaches to Contact Tracing During the Pandemic

The National Academy for State Health Policy (NASHP) is tracking how each state is expanding its contact tracing capacity to curb the COVID-19 pandemic and reopen its economy. NASHP’s interactive map highlights each state’s contact tracing program model, workforce, lead agencies, funding sources, and support technology. NASHP plans to update this resource as programs evolve.

 

HHS Issues Guidance on New Testing Data Reporting Requirements

The Department of Health and Human Services (HHS) announced new guidance that specifies what additional data must be reported to HHS by laboratories along with COVID-19 test results. The new guidance requires collection of demographic data including race, ethnicity, age and sex to more accurately determine the burden of infection on vulnerable groups. The department also released frequently asked questions on the guidance.

 

State Views on Medicaid Program Administration Challenges

The Government Accountability Office (GAO) was asked to assess a range of federal Medicaid policies and interviewed Medicaid officials from all 50 states and the District of Columbia. The report describes states’ perspectives on challenges related to federal Medicaid policies, including laws, regulations, and procedures. Federal policies identified as posing challenges for effective program administration include Medicaid prescription drug coverage for newer outpatient prescription drugs costing more without proven benefits, exclusion of residents of certain mental health institutions from Medicaid coverage, and challenges related to integrating care for beneficiaries eligible for both Medicare and Medicaid, due in part to differences between the programs.

 

New CMS Payment Model Flexibilities For COVID-19 

The Centers for Medicare & Medicaid Services (CMS) is providing new flexibilities and adjustments to current and future Center for Medicare and Medicaid Innovation (CMMI) models to address the COVID-19 pandemic and released a table outlining the models and the new changes. CMS Administrator Seema Verma published a blog post with Health Affairs discussing the new CMS payment models during COVID-19. In the post, Administrator Verma highlights adjustments to value-based payment models that have been made both prior to and in response to the pandemic.