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
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
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
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
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
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
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
By Daphne Saneholtz and Sylvia Brown Caution: this is a technical post – not for the faint of heart! In our last post, we discussed Governor Kasich’s plan to seek approval from the Controlling Board to appropriate funds to enable roughly 275,000 Ohioans to gain health insurance coverage under Medicaid. But how will this really… Continue Reading
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
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
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
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
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
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
On Monday, February 4th, Governor John Kasich proposed that Ohio will expand Medicaid benefits to individuals earning up to 138% of the federal poverty level (FPL) (about $15,800 for an individual and $32,500 for a family of four). The Affordable Care Act (ACA) originally made such an expansion mandatory, but the Supreme Court’s ruling on… Continue Reading
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
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
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
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
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 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
VHCA’s slides from Monday’s teleseminar discussing the U. S. Supreme Court’s opinion on the Affordable Care Act are now available. Please note that this content is specific to the Medicaid portion of the opinion and teleseminar discussion.
Individuals represented by the red boxes will be impacted by the Supreme Court’s ruling on the Medicaid expansion. This information is provided courtesy of the Ohio Governor’s Office of Health Transformation.
In our last post, we discussed the practical impact on the American public of the Affordable Care Act’s Medicaid expansion. There are also significant repercussions for states, as described below. What does the Medicaid expansion really mean for States? For Ohio, specifically? • States will be responsible for up to 10% of the cost of the… Continue Reading