Final Prior Authorization Rules Look to Streamline the Process, but Issues Remain May 2, 2024 Issue Brief This brief examines the final CMS regulations governing prior authorization in Medicare Advantage, Marketplace, Medicaid, and other plans, how they might address some current consumer concerns, and some issues that remain.
Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment May 1, 2024 State Indicator Medicaid Enrollment, Monthly Medicaid Enrollment, total Medicaid enrollment
What You Need to Know About Medicaid Managed Care, Amid the New Federal Rules May 1, 2024 News Release Managed care is the most common delivery system for Medicaid. Most states (42, including DC) use comprehensive managed care plans to provide care to at least some of their Medicaid enrollees, according to KFF’s updated explainer. Roughly 3 out of 4 Medicaid enrollees receive care through managed care organizations and…
10 Things to Know About Medicaid Managed Care May 1, 2024 Issue Brief Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees, as well as new federal rules that strengthen managed care access standards.
Coverage of Sexual and Reproductive Health Services in Medicare April 30, 2024 Issue Brief This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State April 23, 2024 Issue Brief This Medicaid waiver tracker page aggregates tracking information on pending and approved Section 1115 Medicaid waivers. It includes resources such as an overview figure, detailed waiver topic tables, and explanatory briefs.
Examining New Medicaid Resources to Expand School-Based Behavioral Health Services April 23, 2024 Issue Brief In light of worsening mental health among youth, strategies have been implemented to improve access to behavioral health services in recent years, including expanding school-based care for students. Leveraging Medicaid to improve and address gaps in school-based behavioral health services has been a key strategy in recent years as youth mental health concerns have grown. Provisions from the Safer Communities Act of 2022 utilize Medicaid to expand both school-based health care and other mechanisms of youth behavioral health care. This issue brief explores the implementation of these provisions from the Safer Communities Act thus far, with a focus on the guidance issued from CMS.
The Vast Majority of Nursing Facilities Will Need to Hire More Staff to Comply with the Final Federal Rule When Fully Implemented, Unless They Qualify for an Exemption April 22, 2024 News Release Based on a new KFF analysis, fewer than 1 in 5 (19%) nursing facilities currently meet the minimum staffing standards set out in the final requirements of the federal rule released today by the Centers for Medicare and Medicaid Services (CMS). CMS adopted staffing standards that are similar to the…
With Current Staffing Levels, About 1 in 5 Nursing Facilities Would Meet Fully-Implemented Minimum Staffing Standards in the Final Rule April 22, 2024 Blog This analysis uses the most recently-available data to examine the percentage of nursing facilities that currently meet the minimum staffing requirements in the final rule.