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Category Archives: Medicaid

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With a Year to Spare, Ohio Rebalances Spending on Long-Term Services/Supports

Posted in Medicaid

The Ohio Department of Medicaid recently announced that its work to rebalance spending on long-term services and supports in favor of home- and community-based services has hit an important milestone one year ahead of schedule.  In June 2013, Ohio was awarded $169 million in additional federal Medicaid matching funds as a result of the state’s… Continue Reading

So you graduated from high school, now what? It’s time to think about how you’ll get your health insurance.

Posted in Affordable Care Act, Medicaid

As recent high school graduates spend summer dreaming about the beginning of their college careers, it’s unlikely that many are thinking about how they are going to get their health insurance. But they should not throw caution to the wind; according to federal law, college students, like most other adults, are required to have health… Continue Reading

CMS to Study States’ Compliance With Medicaid Managed Care Actuarial Soundness Requirements; Early Reports “Troubling”

Posted in Managed Care, Medicaid

As recently reported in Modern Healthcare, the Centers for Medicare & Medicaid Services (CMS) have announced two initiatives that are likely to impact reimbursement to and operations of Medicaid managed care plans (MCPs). The first initiative is a study of the adequacy of how states set reimbursement rates for Medicaid MCPs.  Federal regulations require that… Continue Reading

The Centers for Medicare and Medicaid Services Issues Home and Community-Based Settings Toolkit

Posted in Managed Care, Medicaid

On March 20, 2014, the Centers for Medicare and Medicaid Services (CMS) posted a “Transition Plan Toolkit” to assist states in developing their Home and Community-Based Settings (HCBS) 1915(c) waiver and section 1915(i) state plan amendment or renewal application(s) so that they comply with new requirements in the HCBS Final Rule, released earlier this year…. Continue Reading

Is One Brand of Medicaid Expansion Waiver Better than Another?

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Different strokes for different folks as the old adage goes.  This saying, however, is particularly true when you look at the states that have chosen to expand their Medicaid programs under the Affordable Care Act (ACA) through waivers. States do not have to seek a waiver from the federal government in order to expand their… Continue Reading

New York State’s Budget Relies on Federal Medicaid Money –Expecting an Answer from CMS Soon

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In 2012, New York Governor Andrew Cuomo submitted to the federal Centers for Medicare & Medicaid Services (CMS) an amendment to New York’s existing Partnership Plan 1115 waiver that sought to “redesign” the state’s Medicaid program.  The amendment proposed to reinvest $10 billion of the $17 billion in savings the state anticipated it would achieve… Continue Reading

Federal Budget Agreement Delays Medicaid DSH Cuts

Posted in Affordable Care Act, Medicaid

Section 1204 of the federal budget agreement, HJ.Res.59, delays the Medicaid Disproportionate Share Hospital (DSH) payment reductions included in the Affordable Care Act (ACA) for two years.  As originally contemplated in the ACA, the DSH reductions were to have become effective in October 2013.  Instead, the budget agreement delays the reductions until October 1, 2015, but doubles… Continue Reading

Ohio Supreme Court Upholds Medicaid Expansion

Posted in Behavioral Health, Medicaid

The Ohio Supreme Court issued a decision today confirming the constitutionality of the state’s decision to expand the Medicaid program through an action of the Controlling Board.  The Court rejected a constitutional challenge made by six legislators. In November, our colleagues at Vorys, Sater, Seymour and Pease filed an amicus brief on behalf of Advocates for Ohio’s… Continue Reading

Mental Health Parity Requirements and Medicaid

Posted in Behavioral Health, Medicaid

The U. S. Department of Health and Human Services announced on Friday final regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).  The MHPAEA is intended to align insured health care benefits for mental and substance use disorders (M/SUD) with those for medical and surgical care…. Continue Reading

Ohio Clears Path to Medicaid Expansion

Posted in Medicaid

The Controlling Board today approved a measure that will allow the State of Ohio to spend federal-only funds to extend Medicaid coverage in Ohio beginning January 1, 2014.  As we reported in earlier posts, the Centers for Medicare & Medicaid Services recently approved the state’s request to amend its Medicaid State Plan to cover an… Continue Reading

The Governor’s Big Play: Pushing Ahead on Medicaid Expansion

Posted in Affordable Care Act, Behavioral Health, Health Care, Health Care Reform, Medicaid

By Sylvia Brown and Former State Senate President Tom Niehaus Anticipation is building as the battle over Medicaid expansion moves to the unlikely arena of the state Controlling Board. On Monday, October 21 at 1:30 p.m., Governor John Kasich will try to make good on his promise to take whatever action within his power to… Continue Reading

Vorys Health Care Advisors and Truven Health Analytics Co-Author SAMHSA’s “Medicaid Handbook: Interface with Behavioral Health Services”

Posted in Behavioral Health, Medicaid

Maureen Corcoran, president of Vorys Health Care Advisors (VHCA), and Daphne Saneholtz, senior advisor with VHCA, partnered with John Easterday, Ph.D. and Truven Health Analytics to author a Medicaid handbook for the federal Substance Abuse and Mental Health Services Administration (SAMHSA).  The handbook, titled “Medicaid Handbook:  Interface with Behavioral Health Services,” provides readers with an understanding of… Continue Reading

Health Insurance Options in 2014

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In a recent post, we discussed the insurance mandate itself.  That is, the requirement that most people have health insurance beginning in 2014 or face a financial penalty.  We also briefly mentioned the insurance options that will be available to you in order to fulfill this requirement.  They are— Have employer-sponsored insurance Be covered by… Continue Reading

CMS Addresses DSH Cuts; Impact on States That Do Not Expand Medicaid Remains Unclear

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that cuts federal payments to hospitals for uncompensated care.  What still remains unclear, however, is how these cuts will impact states that do not expand their Medicaid programs. The Affordable Care Act (ACA) requires significant cuts to Disproportionate Share Hospital… Continue Reading

HPIO Resources on Medicaid Expansion in Ohio

Posted in Affordable Care Act, Health Care Reform, Medicaid

The Health Policy Institute of Ohio (HPIO) has recently added to its collection of Medicaid resources a brief focused on projected new employment and new local general sales tax revenues due to Medicaid expansion.  Governor Kasich’s budget proposal includes language expanding Medicaid eligibility up to 138% of the federal poverty level, or $32,499 for a… Continue Reading

VHCA Webinar: How the Governor’s Executive Budget Impacts Providers

Posted in Medicaid

Vorys Health Care Advisors professionals, Maureen Corcoran and Daphne Saneholtz, along with Vorys attorney Suzanne Scrutton, will present How the Governor’s Executive Budget Impacts Providers 12 pm – 1 pm (Eastern time) on February 21. The presentation will discuss: Impact of the following on providers: Budget proposals affecting the behavioral health, developmental disability, child welfare,… Continue Reading

No Enhanced Federal Funds For Partial Medicaid Expansion

Posted in Affordable Care Act, Health Care Reform, Medicaid

Last week, 11 governors – including those in Ohio, Arizona, Louisiana, Florida, Virginia, Iowa, Maine, Mississippi, South Dakota, Utah, and Wyoming - submitted a letter to Health and Human Services Secretary Kathleen Sebelius asking whether states that expand Medicaid eligibility to a level less than that included in the Affordable Care Act (ACA) are eligible to… Continue Reading

Changes to Federal EHR Rule Will Likely Benefit Medicaid Providers

Posted in Health Care, Medicaid

Vorys’ HealtHITech Law blog recently shared news regarding two key changes to federal rules related to implementation of electronic health records (EHR) for Medicaid providers.  These two changes are likely to benefit providers seeking Medicaid incentive payments for EHR. Read about these changes and others included in the Medicare and Medicaid EHR Incentive Programs Stage… Continue Reading

States Begin to Choose Essential Health Benefits for Their Citizens

Posted in Health Care Reform, Medicaid

Although not a “hard” deadline, states were encouraged to submit to the federal government by Monday, October 1, 2012, their lists of essential health benefits required by the Affordable Care Act (ACA).  Essential health benefits are a set of health care service categories that must be covered by certain plans beginning in 2014.  According to… Continue Reading

Ohio Medicaid Announces Initiative to Enhance Clinical Guidelines for Prescribing Psychotropic Medications to Children

Posted in Behavioral Health, Medicaid

The Columbus Dispatch recently published a story on an initiative undertaken by Ohio Medicaid aimed at improving psychotropic-drug management by closely monitoring prescriptions and focusing on the safe, effective and appropriate use of psychotropic medications among children on Medicaid. This goal is important for all Ohio children on Medicaid, and there is a special focus… Continue Reading

ACA Teleseminar Recording Now Available

Posted in Health Care Reform, Medicaid

Now available: A recording of the July 2 teleseminar regarding the U. S. Supreme Court’s decision on the fate of the Affordable Care Act, provided by Vorys Health Care Advisors (VHCA) and Vorys, Sater, Seymour and Pease. You can also review VHCA’s PowerPoint presentation on which the Medicaid portion of the teleseminar was based.

VHCA Discusses Changing Health Care Landscape and Potential Future Opportunities for Assisted Living Providers

Posted in Health Care Reform, Medicaid

VHCA recently published an article in the Ohio Assisted Living Association’s quarterly newsletter.  The article is focused on the changing health care environment and potential future opportunities for assisted living providers.  Topics include: Medicare quality and payment reform provisions that could impact assisted living providers- Medicare Shared Savings Program Reducing avoidable hospitalizations in Medicare National… Continue Reading