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- October 14, 2016
Issue Brief 7: Medicaid Managed Care Final Regulations: BSS
Read moreSenior Attorney Elizabeth Edwards provides analysis and guidance on the updated rule regarding managed care plans in Medicaid, and how it relates to new requirements around beneficiary support systems (BSS). Edwards explains that the updated rule, adopted this year by the U.S. Department of of Health and Human Services…
- October 4, 2016
Issue Brief: A Primer on Reference Pricing & VBID
Read moreCost sharing is too often a tool that prevents low-income individuals from being able to access quality and timely health care services. Health care experts, however, are exploring other mechanisms, such as Value-Based Insurance Design (VBID) and its Reference Pricing ways to address shortcomings of cost sharing. VBID, at…
- September 1, 2016
Q&A: Adequacy of Medicaid Fee-For-Service Payments Final Rule
Read moreThe federal Centers for Medicare & Medicaid Services (CMS) have issued final regulations establishing a process for states to comply with the Medicaid Act's requirements that payments be sufficient to ensure adequate provider participation in the program. This Q&A discusses those requirements and provides tips for advocates who want…
- August 31, 2016
Lessons from CA: Special Enrollment Period Verifications
Read moreThis issue of Lessons from California highlights the audit process that California's marketplace just implemented to ensure individuals who claim to have a basis for a special enrollment period in fact have a qualifying event to enroll outside of annual open enrollment.
- August 31, 2016
Issue Brief 6: Medicaid Managed Care Final Regulations: Older Adults
Leo Cuello Issue BriefRead moreIn this issue brief, Leonardo Cuello reviews the recently finalized Medicaid managed care regulations, and how they impact access to health care for older adults. He highlights important new provisions in the regulations on a range of topics such as enrollment protections, network adequacy requirements, long-term services and supports…
- August 26, 2016
Amicus Brief: State of Alaska v. Planned Parenthood of the Great Northwest
Read moreNHeLP and the Northern Justice Project filed an amicus brief in support of Planned Parenthood and urging affirmance of the lower court's decision. The case involves a challenge to a state law limiting abortion coverage for Medicaid-eligible women in Alaska.