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Vorys Health Care Advisors

Tag Archives: Medicaid

How Ohio’s Behavioral Health Redesign impacts providers

Posted in Behavioral Health

Over the next year, Ohio community behavioral health providers (mental health and substance use addition providers) will be participating in a truly transformational time as a result of a statewide initiative called Ohio’s Behavioral Health Redesign. Redesign will fundamentally alter the clinical and business processes of community behavioral health providers through the adoption of coding… Continue Reading

Date Nears for States to Implement CMS Access Rule

Posted in Access, CMS, Health Care, Medicaid, Regulations

On January 4, 2016, the Center for Medicare and Medicaid Services (CMS) implemented sweeping new requirements for ensuring access to specific categories of Medicaid services. The final rule, released on November 2, 2015, and titled Medicaid Program; Methods for Assuring Access to Covered Medicaid Services, creates a very important vehicle for beneficiaries, service providers, their… Continue Reading

VHCA Webinar on New Medicaid Managed Care Rules

Posted in Behavioral Health, CMS, Health Care, Managed Care, Medicaid, Regulations

CMS recently proposed regulations regarding Medicaid managed care.  The proposed rule, which was released on June 1, offers the fist major update to Medicaid and CHIP managed care regulations since 2002 – in many ways, this update and modernization of the regulations is overdue.  In general, the proposal takes a big step toward aligning Medicaid and CHIP managed… 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

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

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

Health Care Reform: Count Down to Decision Day

Posted in Health Care, Health Care Reform, Medicaid

Conventional wisdom holds that the U. S. Supreme Court is likely to render a decision on the fate of the Affordable Care Act (ACA) near the end of its term concluding on June 30th.  Four separate issues are under review: 1. The so-called “individual mandate” that all Americans have health insurance 2. The Medicaid expansion to low-income… Continue Reading

What the Affordable Care Act’s DSH Reductions Really Mean to High-DSH Hospitals

Posted in Health Care Reform, Medicaid

In fiscal year 2009, Ohio hospitals received nearly $408 million in Federal disproportionate share hospital (DSH) payments.  One provision of the Patient Protection and Affordable Care Act (ACA)—coupled with Ohio’s methodology for determining how DSH payments are allocated—will reduce important funding for Ohio’s safety net hospitals. In the early 1980s, Federal legislation established a requirement… Continue Reading

Vorys Health Care Advisors’ Medicaid Teleseminar a Success

Posted in Health Care, Health Care Reform, Medicaid

Thanks to the many health care professionals and children’s advocates from around Ohio and beyond  who participated in our Medicaid teleseminar last week!  Participants from at least five states, including all regions of Ohio, took part in the learning opportunity.  Our focus on Ohio’s Office of Health Transformation initiatives and other states’ coordinated care delivery… Continue Reading

Simple Guide to Understanding the GOP Candidates’ Positions on Health Care

Posted in Health Care, Health Care Reform, Medicaid, Uncategorized

The Deloitte Center for Health Solutions recently published a piece highlighting the GOP presidential candidates’ positions on health care.  This helpful chart (located a third of the way down the page) illustrates their plans for the Affordable Care Act, Medicare and Medicaid, public health and wellness, and other insurance industry issues. Check it out to… Continue Reading

Medicaid Tools Added to VHCA Site

Posted in Behavioral Health, Health Care, Health Care Reform, Medicaid, Physical and Behavioral Health Integration

We have added several tools under the “Resources” tab that can be used to help navigate the complex Medicaid system.  We originally shared these tools at an ANCOR conference VHCA facilitated in January 2012.  Under the Resources tab, you can now find: A description of Medicaid case management/care coordination services and the federal authorities that underly… Continue Reading

New care management requirements now in effect for Ohio’s Medicaid managed care plans

Posted in Medicaid

Beginning on January 1, 2012, Ohio’s Medicaid managed care plans must fully change to the existing set of care management requirements, which require face-to-face contact with a high risk group of individuals.  The new requirements are designed to ensure that plans’ members get the health care services they need, when they need them and in… Continue Reading

U.S. Supreme Court set to review Affordable Care Act’s Medicaid eligibility expansion

Posted in Health Care Reform, Medicaid

Can Congress mandate an expansion of Medicaid to individuals not currently covered by most states’ Medicaid programs?  That’s one of the questions the U.S. Supreme Court has agreed to consider as part of its review of the constitutionality of the Affordable Care Act of  2010. The justices also have said they will answer a second question… Continue Reading

Transforming Health Care Delivery – If not now, when?

Posted in Health Care Reform, Medicaid, Physical and Behavioral Health Integration

Change may be the only constant in health care. Some suggest that the Affordable Care Act (ACA), with its emphasis on the integration of services, elimination of system inefficiencies and commitment to payment reform, is synonymous with the changing tides in health care – even though the political debate around its merits is far from… Continue Reading