Medicaid Expansions

This brief summarizes efforts to develop quality of care measures for Medicare-Medicaid enrollees. It provides guidance to states in developing measurement approaches for proposed integrated programs, including assessment of quality in specific domains of integrated care such as long-term services and supports and behavioral health services.

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 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.

This survey provides a snapshot of Medicaid and CHIP enrollment and eligibility policies and procedures and highlights the changes that states will need to make in their programs to prepare for the ACA in 2014.

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.

In this article, Alice Weiss examines Oklahoma’s efforts to streamline and modernize Medicaid enrollment. Oklahoma is the only state so far to implement an online application system for Medicaid, and its automated eligibility determination system for Medicaid is among the most modern and efficient nationwide, with the state is expected to achieve a nearly three-to-one return on its investment in 2015.

This letter to state Medicaid Directors details the Affordable Care Act provisions for converting current net income eligibility thresholds to equivalent modified adjusted gross income (MAGI) thresholds in the Medicaid program and Children's Health Insurance Program (CHIP), the conversion methodology and process, and the timeframes for executing the conversions.

The Wyoming Department of Health released this report analyzing the costs of full Medicaid expansion, as prescribed by the ACA. It estimates that expanding Medicaid in Wyoming would insure an additional 28,200 individuals and it would save the state $47 million over six years.

This report analyzes the enrollment and costs implications of Medicaid expansion in Kansas. With Kansas’s current Medicaid eligibility threshold being among the lowest in the nation, the Kansas Health Institute estimates Medicaid expansion would result in more than 240,000 individuals enrolling in Medicaid, and the cost to Kansas from 2014-2020 would be close to $519 million.