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Archive: Medicaid

Capitol Connector
Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

National Council Files Comments Against Public Charge Rule

December 13, 2018 | Medicaid | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

Last week, the National Council for Behavioral Health submitted comments to the Department of Homeland Security (DHS) regarding the Trump Administration’s proposed rule that would allow legal immigrants to be denied lawful permanent residency if they enroll in Medicaid or other public benefits. The proposed rule would expand the definition of “public charge,” a test that determines if immigrants are likely to become dependent on government for subsistence, to include federal health, housing and nutrition programs. The National Council expressed strong opposition to the rule as it would deter legal immigrant families from seeking health care coverage, harming the health of millions of adults and children.

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CCBHC Expiration Presents “A Looming Crisis” for Addiction Care

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

Since launching in mid-2017, Certified Community Behavioral Health Clinics (CCBHCs) have dramatically improved access to community-based addiction care in the eight states where they operate, particularly opioid addiction services. CCBHCs have hired hundreds of new addiction-focused clinicians, expanded medication-assisted treatment (MAT) and other addiction services, and reduced patient wait times. However, with the CCBHC program set to end in mid-2019, access to lifesaving treatment could be lost. A new National Council report shows that the end of the CCBHC demonstration would result in massive program closures, staff layoffs and reduced addiction treatment access for patients. The National Council is calling on Congress to act quickly to extend the life of this critical program.

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Law Enforcement & CCBHCs: Increasing Access to Treatment, Decreasing Recidivism

Shelley Starkey

The National Council for Behavioral Health, in partnership with Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO), hosted a Congressional staff briefing on Tuesday to highlight how Certified Community Behavioral Health Clinics (CCBHCs) are partnering with their local law enforcement to connect community members to timely addiction and mental health treatment and help officers to focus more of their time on their main duty: keeping their communities safe. The briefing brought together law enforcement officers and clinic leaders who urged Congress to act quickly to pass the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 1905/H.R. 3931) to extend the CCBHC demonstration.

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Trump Administration Approves Kentucky Work Requirements for Second Time

November 29, 2018 | Medicaid | Waivers/SPAs | Comments

Shelley Starkey

The Centers for Medicare and Medicaid Services (CMS) re-approved Kentucky’s request to add work requirements to the state’s Medicaid program last week, following a federal judge’s ruling earlier this year that overturned the first iteration of these requirements. These changes would require the population covered by Kentucky’s Medicaid expansion to report 80 hours of work or “work-related activities” each month, or face losing their coverage for a six-month lockout period. The approved 1115 waiver, which takes effect April 1, 2019, is almost identical to the state’s previously overturned application, and has been projected to result in at least 95,000 Kentuckians losing Medicaid coverage over the next five years.

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CMS Proposes Overhaul of Medicaid Managed Care Rules

November 16, 2018 | Medicaid | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule to update the regulations governing Medicaid and Children’s Health Insurance Program (CHIP) managed care plans. The proposed rule would rollback many of the managed care standards established by the Obama Administration in 2016 that help ensure Medicaid beneficiaries have timely access to comprehensive health care. Now CMS intends to “increase state flexibility” by relaxing requirements that support network adequacy and provider pay. CMS is accepting comments on the proposed rule through January 14, 2019.

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CMS Announces New Opportunities to Expand Mental Health Services

November 15, 2018 | Medicaid | Mental Health | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

This week the Centers for Medicare and Medicaid Services (CMS) announced a new opportunity for states to expand Medicaid coverage for mental health services, including treatment delivered in inpatient facilities with more than 16 beds known as institutions for mental disease (IMDs). In a letter, CMS explains how states can use Section 1115 waivers to “support innovative service delivery systems” for adults with serious mental illness (SMI) and children with serious emotional disturbance (SED). CMS emphasized the need for states to bolster early identification services, better integrate mental health and primary care, increase access to crisis services and expand the use of Certified Community Behavioral Health Clinics (CCBHCs).

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Health Care Emerges as Top Issue in Midterms

November 8, 2018 | ACA | Medicaid | Mental Health | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

With historic levels of voter turnout, Tuesday’s midterm election results saw Democrats regain control of the House of Representatives, while Republicans strengthened their majority in the Senate. Health care emerged as a clear priority for voters and Medicaid expansion proved to be a big winner on election night. With power now divided in Congress, the next two years could feature intense political gridlock or force bipartisan compromise. Right now, one thing is clear – the 2018 midterms will send one of the largest classes of freshmen Members to Washington in recent history – and with them come new advocacy opportunities for the National Council and its members.

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Wisconsin Waiver Adds Medicaid Work Requirements, Drug Screens

November 1, 2018 | Medicaid | Waivers/SPAs | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

On Wednesday, the Centers for Medicare and Medicaid Services (CMS) approved Wisconsin’s request to enact a series of restrictions that would limit Medicaid eligibility and restrict enrollees’ use of Medicaid benefits. The newly-approved Section 1115 waiver will require certain adult beneficiaries to work 80 hours per month to maintain health coverage, institute premiums and subject applicants to drug use screening questions. This decision is the latest in a series of work requirement approvals, however, Wisconsin is the first non-Medicaid expansion state to receive permission from CMS to impose work requirements.

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Kaiser Family Foundation Survey Outlines Medicaid’s Future

November 1, 2018 | Medicaid | Comments

Shelley Starkey

Results from a new survey suggest that state Medicaid programs have seen stagnant enrollment over the past year while combined federal and state spending continued to grow similarly to the previous year. Additionally, states have reported a shifting focus toward prioritizing improvements in outcomes and value through delivery system changes and managed care requirements. The Kaiser Family Foundation (KFF) and Health Management Associates (HMA) included these results from their 18th annual survey of state Medicaid directors in two reports, released last week.

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New Rule Would Limit Immigrants’ Medicaid Access

October 11, 2018 | Medicaid | Take Action | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

This week, the Trump Administration formally published a rule that would allow legal immigrants to be denied lawful permanent residency if they enroll in Medicaid or other public benefits. The proposed rule would expand the definition of “public charge,” a test that determines if immigrants are likely to become dependent on government for subsistence, to include federal health, housing and nutrition programs. The National Council strongly opposes the rule as it would deter immigrant families from seeking health care coverage, harming the health of millions of adults and children. The proposed rule is subject to a 60-day comment period, meaning comments on the rule will be accepted until December 10.

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National Council Submits Comments on Kentucky Medicaid Work Requirement

August 23, 2018 | Medicaid | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Last week, the National Council submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding Kentucky’s Medicaid proposal to impose work requirements on Medicaid beneficiaries. In July, a district court judge blocked the state’s waiver request and required the agency to reevaluate the waiver application and analyze its impact on beneficiaries. This legal decision only applies to Kentucky and has no bearings on work requirements being imposed in other states.

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CMS Announces Updates to Medicaid Wavier Reviews and Processes

August 23, 2018 | Medicaid | Waivers/SPAs | Comments

Shelley Starkey

New guidance from the Centers for Medicare and Medicaid Services (CMS) reports updated policies and procedures around state plan amendments (SPAs), 1115 waivers and 1915 waivers in states’ Medicaid programs. Two informational bulletins released within the past week outline the agency’s efforts to streamline approval processes and provide clarity around these options that are meant to give states flexibility in how they administer their Medicaid programs. These updates are part of CMS’s ongoing efforts to address concerns from states and federal policymakers around long administrative approval times and lack of transparency and oversight.

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National Council Publishes New Advocacy Guide on Managed Care Contracting

August 9, 2018 | Medicaid | Comments

Katiri Zuluaga

Manager, State Initiatives

As states move more Medicaid services to managed care, the National Council for Behavioral Health has released Medicaid Managed Care Contracting, an advocacy guide to ensure mental health and addiction care is protected under managed care arrangements. Behavioral health providers are often subject to practices that restrict reimbursement and reduce patients’ options. The guide offers community behavioral health providers and associations talking points and sample contract language they can use with their state Medicaid agency to ensure Medicaid managed care will enhance behavioral health access.

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Administration Continues Pushing for Medicaid Work Requirements

August 2, 2018 | ACA | Medicaid | Comments

Katiri Zuluaga

Manager, State Initiatives

The Trump Administration intends to continue approving states’ requests to institute work requirements on Medicaid enrollees, despite a recent court ruling that set such efforts back. In an address last week, Health and Human Services (HHS) Secretary Alex Azar said the administration is ‘undeterred’ after a federal judge blocked Kentucky’s Medicaid work requirements last month. This move invalidated the Centers for Medicare and Medicaid Services’ (CMS) approval of an 1115 Medicaid waiver to redefine eligibility for the public program in Kentucky.

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Court Blocks Kentucky’s Medicaid Work Requirements

July 12, 2018 | Medicaid | Waivers/SPAs | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

On June 29th, a district court judge blocked Kentucky’s waiver request to require Medicaid enrollees to work or participate in a job-related activity for at least 80 hours per month or lose their health coverage. The court ruled that the Centers for Medicare and Medicaid Services (CMS) had not properly considered whether the initiative would violate Medicaid’s central objective of providing medical assistance to the state’s citizens. The decision could have broad implications for other states hoping to limit Medicaid enrollment through work requirements.

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Senate Committees Moving on Opioid Legislation

Shelley Starkey

Following an action-packed week for opioid-related legislation in the House, multiple Senate committees took up the mantle this week, hosting hearings, releasing new bills and considering legislation ahead of the Memorial Day recess. As bills advance out of committees, the full Senate is expected to consider the large package of opioid legislation later this summer. Meanwhile, similar efforts in the House are expected to make it to the floor in the coming weeks. The collective work of both chambers of Congress seek to address the opioid crisis from a number of fronts including prevention, treatment and recovery.

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CCBHCs Are Transforming Opioid Addiction Treatment Access

Katiri Zuluaga

Manager, State Initiatives

Despite the surging opioid crisis, only one in ten Americans with an addiction disorder receives treatment in any given year. Certified Community Behavioral Health Clinics (CCBHCs) were enacted in 2014 to fill the gaps in unmet need for addiction and mental health care and expand access to comprehensive, community-based treatment. Early results from the two-year program demonstrate how CCBHCs are dramatically improving access to opioid and other addiction care.

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National Council Submits Comments on CMS Medicaid Access Rule

May 24, 2018 | Medicaid | Comments

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

On Monday, the National Council submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding its proposed changes to the Medicaid access rule. The proposed changes would weaken the enforcement of federal requirements that ensure Medicaid enrollees have timely access to a variety of health care services. The National Council expressed strong opposition to these proposed changes as they would harm patients’ access to care for mental health and addiction services.

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House Committee Sends Opioid Package to House Floor

Stephanie Pasternak

Policy Associate, National Council for Behavioral Health

On Thursday, the House Energy and Commerce Committee reviewed remaining opioid legislation to be included in a large package aimed at addressing the opioid crisis, an effort which began last week in the full Committee. The Committee approved 32 bills, a week after approving another 25 opioid measures, bringing the total up to 57. Bills that advanced this week include provisions to loosen both the Institution for Mental Disease (IMD) rule on residential substance use disorder (SUD) treatment and privacy rules governing SUD treatment records, promote best practices for recovery housing and to ensure mental health and SUD parity in the Children’s Health Insurance Program (CHIP).

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CBO Releases Economic Outlook, Future Health Care Spending Report

April 19, 2018 | Federal Budget | Medicaid | Medicare | Comments

Samantha Sears

Behavioral Health Policy and Practice Intern

The Congressional Budget Office (CBO) projects the country’s annual budget deficit will reach $1 trillion by 2020 in a new report released this week. The annual report was delayed this year to incorporate analysis on the impact of the Tax Cuts and Jobs Act passed in late 2017. The report highlights not only growing deficits but also growing health care spending for programs like Medicare, Medicaid and social safety net programs.

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