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Medicaid
Background
News

Medicaid (Title XIX) is the federal-state medical assistance program designed to pay for healthcare services used by eligible people. It is operated and partially funded by the states under general federal rules and with federal financial assistance.

 

The Medicaid program is a vital source of support for people with mental disorders, funding more than 50% of state and local spending on mental health services. 

 

NAPHS advocates on a variety of issues related to Medicaid, including dual eligibles, the Medicaid Emergency Psychiatric Care Demonstration, Medicaid RACs, expansion of Medicaid coverage under healthcare reform, and quality.

4/16/2014

CMS proposed rule: "Medicare and Medicaid Programs: Fire Safety Requirements for Certain Health Care Facilities"

3/31/2014

NAPHS comment letter to CMS proposed rule on "Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers"

3/26/2014

NAPHS release: "Millions of Disabled and Poor Americans Encounter Discrimination When They Face Mental or Addictive Disorders, Says NAPHS; NAPHS Applauds House Oversight Hearing on Challenges Facing Families in Mental Health Crisis."

3/26/2014

NAPHS letter submitted to House Energy and Commerce Oversight Committee hearing on “Where Have All the Patients Gone? Examining the Psychiatric Bed Shortage.”

3/10/2014

2014 Advocacy Priorities: 1) End discrimination (modify the Medicaid IMD exclusion); 2) Fix gaps (support H.R.3717); 3) Support Medicare/Medicaid funding for health information technology.

2/4/2014

Senate Finance Committee "Summary and Overview of Mental Health Recommendations" received in response to their 8.1.13 Open Letter seeking input on how to improve the US mental health system.

1/16/2014

CMS final rule: "Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Home and Community-Based Setting Requirements for Community First Choice and Home and Community-Based Services (HCBS) Waivers"

12/27/2013

CMS proposed rule: “Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers”. (Comment deadline extended to 3.31.14)

12/19/2013

MedPAC/MACPAC data book: Beneficiaries Dually Eligible for Medicare and Medicaid (with demographic, expenditure, and healthcare utilization information)

12/12/2013

NAPHS statement: "NAPHS Applauds Rep. Tim Murphy for Introduction of Comprehensive Mental Health Reform Legislation; Dialogue on Tough Challenges Will Help Advance Policy Changes"

9/30/2013

Mental Health Liaison Group (MHLG) comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system

9/20/2013

NAPHS comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system

7/15/2013

CMS/HHS final rule: "Medicaid and Children’s Health Insurance Programs: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment"

7/3/2013

NAPHS comment letter on proposed rule on "Medicare/Medicaid Programs: Survey, Certification and Enforcement Procedures”

6/7/2013

CMCS-MMCO-CM Informational Bulletin:  "Payment of Medicare Cost Sharing for Qualified Medicare Beneficiaries (QMBs)." Tells states that they “have a legal obligation to reimburse providers for any Medicare cost sharing due for QMBs according to the state’s CMS-approved Medicare cost-sharing payment methodology.” 

6/4/2013

Joint NAPHS / NAMI letter:  Urging HHS not to apply the IMD exclusion to the Medicaid expansion population

5/17/2013

OIG final rule: "State Medicaid Fraud Control Units; Data Mining"

5/8/2013

OIG guidance: "Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs."  Also see 5/9/13 Federal Register.

4/18/2013

National Association of Medicaid Directors letter to Senate HELP Committee:  Includes a call for elimination of the IMD exclusion

4/4/2013

CMS issues informational bulletin on EPSDT

4/2/2013

CMS final rule with request for comments: "Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable Care Act of 2010." Also see 6.3.13 correction.

2/21/2013

NAPHS comment letter on proposed rule on Medicaid, CHIP expansion under ACA. NAPHS urges clarification that IMD restrictions should not apply. 

12/3/2012

Center for Medicaid & CHIP Services Informational Bulletin: "Coverage and Service Design Opportunities for Individuals with Mental Illness and Substance Use Disorders"

11/28/2012

CMS' Center for Medicaid and CHIP Services Informational Bulletin (guidance on the mechanisms states may use to reimburse the cost of medical care for children residing in psychiatric hospitals or PRTFs)

11/13/2012

NAPHS Action Alert: Tell Congress to support behavioral health as fiscal cliff solutions are discussed lock icon

8/2/2012

Mental Health Liaison Group (MHLG) ad on demonstration programs for dual-eligibles (as seen in Politico): "Living with mental and addictive disorders is hard enough...don't make it worse for us" [View]

7/24/2012

CMS notice: "Disproportionate Share Hospital Allotments and Institutions for Mental Diseases Disproportionate Share Hospital Limits for FYs 2010, 2011, and Preliminary FY12 DSH Allotments and Limits " [View]

7/18/2012

Mental Health Liaison Group (MHLG) release: "Mental health groups raise concerns about the current structure of dual-eligible demonstrations." Also see a MHLG letter to the Senate Special Committee on Aging

6/6/2012

Mental Health Liaison Group letter to CMS on concerns related to dual-eligible demonstrations as they impact individuals with mental illness [View]

6/1/2012

MedPAC Chapter 3 on dual eligibles (from A Data Book: Health care spending and the Medicare Program)

5/24/2012

Kaiser Commission on Medicaid & the Uninsured: "Geographic Variation in Dual-Eligible Enrollment" (by state) [View]

5/16/2012

CMS final rule: "Medicare and Medicaid Programs: Reform of Hospital and Critical Access Hospital Conditions of Participation" [View]

5/16/2012

CMS final rule: "Medicare and Medicaid Programs: Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction" [View]

4/27/2012

CMS final rule: "Medicare & Medicaid: Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements" (including use of NPI) [View]

3/23/2012

CMS final rule (and interim final rule for some sections): "Medicaid Program: eligibility changes under the Affordable Care Act of 2010" [View]

3/19/2012

NAPHS comment letter and position paper on dual-eligible demonstrations sent to CMS Medicare-Medicaid Coordination Office (in response to request for feedback on Massachusetts dual-eligible demonstration). [NOTE: Check periodically online to view additional state demonstrations as they become available for comment.]

3/13/2012

CMS release: "Affordable Care Act Demonstration to Expand Access to Emergency Psychiatric Care; New Demonstration Program to Help States Improve the Quality of Care for Patients with Psychiatric Emergency." Also see additional information.

2/27/2012

CMS final rule: "Medicaid Program: Review and Approval Process for Section 1115 Demonstrations" [View]

1/4/2012

HHS final notice: "Medicaid Program: Initial Core Set of Health Care Quality Measures for Medicaid Eligible Adults" [View]

12/1/2011

Frequently Asked Questions on the Medicaid RAC Program [View]

10/11/2011

Robert Wood Johnson Foundation: Report on "Refocusing Responsibility for Dual Eligibles: Why Medicare Should Take the Lead"

9/16/2011

CMS final rule: "Medicaid Program: Recovery Audit Contractors" [View]

7/11/2011

NAPHS comment letter: "Medicare and Medicaid Programs: Opportunities for Alignment Under Medicaid and Medicare" [View]

7/5/2011

NAPHS comment letter to CMS on proposed rule: "Medicare and Medicaid Programs: Influenza Vaccination Standard for Certain Participating Providers and Suppliers" [View]

6/21/2011

NAPHS comment letter to CMS on proposed rule: "Medicaid Program: Methods for Assuring Access to Covered Medicaid Services" [View]

6/1/2011

June 2011 MACPAC Report to the Congress: "The Evolution of Managed Care in Medicaid" [View]

5/5/2011

Final rule: Medicare & Medicaid: Changes Affecting Hospital and Critical Access Hospital Conditions of Participation: Telemedicine Credentialing and Privileging [View]

3/1/2011

NAPHS comment letter to AHRQ on "Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults" [View]

1/7/2011

NAPHS comment letter to CMS on Medicaid Recovery Audit Contractor (Medicaid RAC) proposed rule (published 11/10/10) [View]

12/30/2010

Federal Register notice with comment period: "Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults" [View]

11/19/2010

Federal Register: Final rule: "Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation to Ensure Visitation Rights for All Patients" [View]

8/16/2010

Federal Register: Medicare program final rule, including...."Medicaid Program: Accreditation for Providers of Inpatient Psychiatric Services" (large file--please allow time for file to open) [View]

6/15/2010

NAPHS comment letter: Accreditation Requirements for Providers of Inpatient Psychiatric Services for Individuals Under Age 21 [View]

3/23/2010

NAPHS statement: Reform law includes provisions important to Americans facing mental and addictive disorders. Includes IMD/EMTALA demonstration on emergency psychiatric care. [View]

6/30/2009

"Medicaid Program: Rescission of School-Based Administration/Transportation Final Rule, Outpatient Hospital Services Final Rule, and Partial Rescission of Case Management Interim Final Rule" [CMS–2287–F2; CMS–2213–F2; CMS 2237–F]. Also "Medicaid Program; Health Care-Related Taxes" Final Rule [CMS-2275-F2].

11/27/2006

"Hospital Conditions of Participation: Requirements for History and Physical Examinations; Authentication of Verbal Orders; Securing Medications; and Postanesthesia Evalutions (CMS-3122-F)."

3/1/2006

NAPHS teams with the National Association for Children's Behavioral Health to tell Congress that Medicaid dollars spent on children & youth with emotional and substance use disorders pay long-term dividends. The two associations also have released Principles for Treatment of Children and Youth with Emotional and Substance Use Disorders, which include recommended action steps for Congress and the states.

1/12/2005

OIG Report: Seven States Medicaid Claims for 21- to 64-year old residents of private and county-operated IMDs [View]

1/1/1990

RECURRING:  CMS Web site on RACs (Recovery Audit Programs).

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