Resources from the Federal Government

This brief explains various considerations for states deciding between Survey of Income and Program Participation (SIPP) and state administrative data, how to use the eligibility templates provided by CMS for the MAGI-based eligibility conversion process, and the steps that states wishing to perform the conversions using state Medicaid and CHIP data will need to follow.

This bulletin released by the Center for Medicaid and CHIP Services provides further information to state Medicaid and CHIP agencies on the verification plans required for both Medicaid and Children’s Health Insurance Program (CHIP) eligibility, the MAGI-based (Modified Adjusted Gross Income) Eligibility Verification Plan Template, and a review of the final verification regulations.

In this FAQ on states’ involvement in plan management activities, HHS establishes that states can evaluate whether health plans and issuers meet certification standards and conduct other specified plan management activities without submitting a Blueprint.

In this Medicaid FAQ document, the Centers for Medicare and Medicaid Services (CMS) addresses questions related to various Medicaid topics, including basic health plans, federal medical assistance percentages (FMAP), transitioning to modified adjusted gross income (MAGI), and children’s coverage. Of particular note, CMS announced the basic health plan will not be an option for states until 2015.

HHS released this omnibus rule modifying several provisions in Health Insurance Portability and Accountability Act (HIPAA) intended to enhance patient privacy and protect data. This includes modifications to the Notification Breach rule, HIPAA privacy and security rules as mandated by the Health Information for Economic and Clinical Health (HITECH) Act, HIPAA enforcement rule, and the privacy rule in accordance with the Genetic Information Nondiscrimination Act (GINA). 

CMS released this letter to state health officials and Medicaid directors providing guidance on the application of the Mental Health Parity and Addiction Equity Act requirements to Medicaid non-managed care benchmark and benchmark-equivalent plans, the Children’s Health Insurance Programs (CHIP), and Medicaid managed care programs.

HHS released joint Medicaid and exchange proposed rules addressing appeals and notices, eligibility and enrollment, Alternative Benefit Plans, and Medicaid cost-sharing.

The Internal Revenue Services (IRS) released proposed rules explaining the ACA’s shared responsibility provision and the process for determining eligibility for and granting certificates of exemption from the shared provision.

The Centers for Medicare and Medicaid Services (CMS) released proposed rules explaining the ACA’s shared responsibility provision and the process for determining eligibility for and granting certificates of exemption from the shared provision.

In this letter to State Medicaid Directors, the Centers for Medicare and Medicaid Services (CMS) provide recommendations for the core set of health care quality measures to be used for assessing the health home service delivery. This core set was released to help guide states as they consider the design and implementation of their health home programs.