Admin and Procedural Barriers Archive

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August 23, 2021
Medicaid Retroactive Coverage: Stop these Waivers!
Jane Perkins and Catherine McKee Issue Brief
The Medicaid Act requires states to extend Medicaid coverage retroactively--for up to 3 months prior to the date of application. Retroactive coverage is vital because the need often arises because of the sudden onset of a health care crisis—a stroke, an automobile accident, a dangerous communicable disease, a gunshot…
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July 14, 2021
Medicaid During and “After” the Pandemic: Changes that Should Become Permanent Policies
Héctor Hernández-Delgado, Abigail Coursolle, Fabiola De Liban, and Elizabeth Edwards Issue Brief
This paper identifies temporary policies to address COVID-19 implemented throughout the pandemic, as well as other steps taken by states, that should be made permanent Medicaid policies for the sake of fighting COVID-19 in the short-term, improving access to health care in the long-term, and addressing nre and on-going…
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June 11, 2021
Demanding Ascertainable Standards: Medicaid as a Case Study
Jane Perkins Issue Brief, Article
State Medicaid agencies and their contractors are increasingly relying on preset guidelines or assessment tools or both to make coverage decisions. Problems arise when the use of these tools results in program enrollees and advocates being refused access to the standards and procedures that govern the operation of the…
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June 10, 2021
NHeLP AHRQ Comments
Elizabeth Edwards, David Machledt, Skyler Rosellini, and Liz McCaman Taylor Comments, Issue Brief
In these comments, NHeLP responds to a request for information from AHRQ regarding the use of clinical algorithms that have the potential to introduce racial/ethnic bias into healthcare delivery. Using our long history of litigation and advocacy on issues that involve the use of automated decision-making systems, including algorithms,…
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December 23, 2020
California Policy Needs During and After COVID: Eligibility, Enrollment, and Retention
Alicia Emanuel and Skyler Rosellini Issue Brief
The COVID-19 public health emergency (PHE) has fundamentally altered how California’s Medi-Cal program is administered. At the start of the pandemic, the state worked swiftly to seek waivers and other flexibilities of federal Medicaid requirements and to implement these COVID-19 flexibilities, including significant changes intended to streamline Medi-Cal eligibility…
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June 13, 2017
Evaluating Functional Assessments for Older Adults
David Machledt Issue Brief
State Medicaid agencies and their contractors rely on functional assessment tools to make coverage and eligibility decisions for long-term services and supports (LTSS). Many states use tools developed and licensed by private entities, while others have developed and implemented their own tools. The variety of tools is staggering. One…
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Admin and Procedural Barriers Archive

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Medicaid Retroactive Coverage: Stop these Waivers!

Medicaid During and “After” the Pandemic: Changes that Should Become Permanent Policies

Demanding Ascertainable Standards: Medicaid as a Case Study

NHeLP AHRQ Comments

California Policy Needs During and After COVID: Eligibility, Enrollment, and Retention

Evaluating Functional Assessments for Older Adults