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- 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 30, 2016
Comments on the Draft 2017 Letter
Read moreNHeLP provides comments on the Centers for Medicare and Medicaid Services (CMS) draft letter to issuers in the Federally Facilitated Marketplaces (FFMs). NHeLP provides comment on a number of matters including guidance and suggestions on standardized plan options, on network adequacy of Qualified Health Plans, Essential Community Providers, Discriminatory Benefit…
- 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
Issue Brief 6: Medicaid Managed Care Final Regulations: Older Adults
Leo Cuello and Andy DiAntonio 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…
- May 26, 2016
Issue Brief 3: Medicaid Managed Care Regulations: Network Adequacy & Access
Abbi Coursolle and Andy DiAntonio Issue BriefRead moreThis issue brief will review selected provisions in the final rule, Medicaid and Children's Health Insurance Program (CHIP) Programs, Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability implementing the requirements governing network adequacy and access to services in Medicaid managed care. We…
