Budget Blog

June 18, 2020 - Health Care Issues Update

By Stacey Mazer posted 06-18-2020 03:16 PM

  

Changes to Medicaid Telehealth Policies Due to COVID-19

This publication released by the Medicaid and CHIP Payment and Access Commission (MACPAC) catalogs telehealth policy changes in all states, the District of Columbia, and the territories. The catalog provides state-specific information on telehealth policy changes pertaining to services and specialties, providers, modalities, originating site and licensure rules, and payment. The information was collected from several publicly available sources and is current as of May 1.

 

CMS Releases Proposed Rule for Value-Based Drug Purchasing in Medicaid

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule to support state flexibility to enter into innovative value-based purchasing arrangements  with manufacturers for drugs and would update how states, private plans, and manufacturers pay for drugs based on the clinical effectiveness of a given therapy or a reduction in hospitalizations. The proposed rule also creates minimum standards in state Medicaid drug utilization review programs designed to reduce opioid-related fraud, misuse, and abuse.

 

Altarum Institute Report on National Health Care Spending

National health spending in April 2020 was 24.3 percent lower than in April 2019, according to a brief by Altarum. The two largest categories, hospital spending and physician and clinical services spending, fell by 40.7 percent and 40.9 percent, respectively, while dental services declined by 60.8 percent, year over year. Nursing home care and prescription drugs were the only major categories to increase at 6.3 percent and 5.1 percent, respectively, year over year. Altarum is a nonprofit health care research and consulting organization.

 

MACPAC Releases Report to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2020 Report to Congress on Medicaid and CHIP. The report covers how to improve integration of care for dually eligible beneficiaries who have both Medicaid and Medicare coverage; increasing enrollment in the Medicare Savings Programs that use Medicaid funds to cover certain Medicare costs for low-income beneficiaries; Medicaid’s role in maternal health; and ensuring that Medicaid remains the payer of last resort when beneficiaries have other sources of coverage.

 

CMS Releases Medicaid Managed Care Data

The Centers for Medicare & Medicaid Services (CMS) released 2018 Medicaid managed care enrollment and program characteristics and data tables. This national data is broken down by program and population, as well as by individual state. The enrollment data provides a snapshot of Medicaid managed care enrollment for a particular year as of July 1st.

 

Considerations for Countercyclical Financing Adjustments in Medicaid

This brief by the Medicaid and CHIP Payment and Access Commission (MACPAC) provides background information on how Medicaid functions as a countercyclical program, both by design and through congressional intervention, and shows how the program has responded during prior economic downturns.