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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.

New Rule Would Limit Immigrants’ Medicaid Access

October 11, 2018 | Medicaid | Take Action | Comments

Stephanie Pellitt

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 Pellitt

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 Pellitt

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 Pellitt

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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Trump Orders Review of Medicaid, Other Safety-Net Programs

April 12, 2018 | Medicaid | Comments

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Tuesday, President Trump signed an executive order directing federal agencies to initiate a review of social safety-net programs, including Medicaid. The stated goal of the review is to have fewer individuals enrolled in Medicaid and other safety-net programs and increase their workforce participation. The order will likely provide momentum to Medicaid work requirement proposals from states and could expand to large-scale entitlement reform. The National Council strongly opposes work requirements and any other proposal that would seek to limit ability of individuals with mental illness and addiction to receive care through Medicaid.

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Advocacy Coalition Promotes Therapeutic Family Care on Capitol Hill

March 22, 2018 | Children and Youth | Medicaid | Comments

Samantha Sears

Policy and Practice Improvement Intern

Last week, a coalition of family and foster care organizations hosted a congressional staff briefing advocating for the inclusion of Therapeutic Family Care (TFC) as a reimbursable service through Medicaid nationwide. TFC provides standardized care in a community-based setting for children who would instead be treated in group homes or institutionalized care settings. TFC is currently only reimbursable as a distinct Medicaid service via a demonstration program in Utah, though many states offer access to TFC via the rehabilitation option in Medicaid.

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Trump Releases Budget Proposal, Seeks Medicaid Cuts and Opioid Funding

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Monday, President Trump unveiled his Fiscal Year (FY) 2019 budget request — detailing his Administration’s legislative and regulatory priorities for next year. The document revives last year’s failed attempts to block grant Medicaid, boosts spending to combat opioid addiction, and outlines other major health care priorities. As with most presidential budgets, this proposal stands little chance of being enacted into law as written. Instead, the President’s budget proposal will act more as a messaging tool to Congress, which just passed a major budget deal boosting defense and non-defense discretionary spending limits last week.

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Medicaid Work Requirements to be Enacted in Indiana

February 8, 2018 | Addictions | Medicaid | Waivers/SPAs | Comments

Katiri Zuluaga

Manager, State Initiatives

Indiana is now the second state to receive approval from the Centers for Medicare and Medicaid Services (CMS) for a waiver request that imposes work requirements on Medicaid beneficiaries to maintain coverage. Indiana’s Section 1115 waiver also enacts a Substance Use Disorder (SUD) Program which will include coverage for residential treatment in Institutions for Mental Disease (IMD) and will increase premiums for beneficiaries who use tobacco and are not engaged in tobacco cessation activities. The National Council for Behavioral Health strongly opposes work requirements and any attempts to restrict access to needed behavioral health services.

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Senate Approves Azar as HHS Secretary

January 25, 2018 | ACA | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The Senate voted to confirm former pharmaceutical executive Alex Azar as the new Secretary of Health and Human Services (HHS) on Wednesday. Six Democrats and Independent Sen. Angus King (I-ME) joined all but one Republican Senator in supporting Azar. As the nation’s top health official, Azar will oversee critical health programs like Medicaid and Medicare and take over the implementation of the Affordable Care Act (ACA). Azar’s confirmation gives HHS its first permanent leader since September, when former Secretary Tom Price resigned due to a scandal regarding his use of public funds for travel.

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CMS Approves First-Ever Medicaid Work Requirements in Kentucky

January 18, 2018 | Medicaid | Waivers/SPAs | Comments

Katiri Zuluaga

Manager, State Initiatives

In a historic first, the Centers for Medicare and Medicaid Services (CMS) approved Kentucky’s Section 1115 waiver request that imposes work requirements on Medicaid beneficiaries to maintain coverage. The National Council for Behavioral Health strongly opposes work requirements and believes that work requirements not only prevent individuals with mental health or substance use disorders from receiving the treatment they need, but are in opposition to the core mission of Medicaid. Nine other states have pending work requirement waivers; however, any approvals will likely be challenged in court delaying their implementation.

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CMS Issues Guidance Allowing Medicaid Work Requirements

January 11, 2018 | Medicaid | Waivers/SPAs | Comments

Stephanie Pellitt

Policy and Advocacy Associate

On Thursday, the Trump Administration released guidelines for states to create the first-ever work requirements for Medicaid recipients. The guidance targets “able-bodied adults” with some exemptions. While details are still emerging, the National Council has grave concerns that the policy’s exemptions will not be broad enough to protect all individuals with mental health and substance use disorders. Ten states have asked the federal government for approval to institute Medicaid work requirements. With this new guidance, the Administration is expected to begin approving these requests.

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HHS Nominee Appears Before Senate Finance Committee

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The Senate Finance Committee held a confirmation hearing on Monday on the nomination of Alex Azar as Secretary of Health and Human Services (HHS). This is the second hearing on his nomination Mr. Azar has participated in. In late 2017, he appeared before the Senate Health, Education, Labor and Pensions Committee. The Finance Committee will vote on his nomination in the coming weeks.

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What to Watch for in Health Care in 2018

January 4, 2018 | ACA | Federal Budget | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

Members of Congress returned to Capitol Hill this week following a holiday break. Neither chamber starts the new year with a clean slate, however, as Congress faces deadlines on government funding and a host of individual programs after voting to delay those decisions at the end of last month. Congress has less than three weeks to avert another government shutdown as well as sort through several competing health care priorities. Here is a preview of what to watch for in early 2018.

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