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- October 20, 2015
Health Advocate: Autism Spectrum Disorders
Read moreThis month's Health Advocate reviews the advocacy history that led up to guidance from the Centers for Medicare & Medicaid Services (CMS) to ensure that state EPSDT programs keep up with the evolving standard of care for children. In July 2014, CMS issued a Clarification of Medicaid Coverage of…
- September 23, 2015
Health Advocate: Nondiscrimination and the ACA
Read moreIn this month's Health Advocate, NHeLP provides an overview of the proposed regulation implementing Section 1557 of the ACA. Section 1557 updates nondiscrimination provisions to include prohibiting sex, gender identity, and sex stereotyping discrimination, as well as clarifying standards regarding discrimination based on language, disability, and other protected groups.…
- September 10, 2015
Ensuring that Assessment Tools are Available to Enrollees
Read moreThe amount of Medicaid services for enrollees, particularly home and community based services, is increasingly being determined through prior authorization processes that use assessment tools and clinical coverage criteria. These assessment documents may not be made available to the enrollee. However, Medicaid law and due process call for disclosure…
- August 31, 2015
Step Guide to Reviewing Your State’s 2017 Essential Health Benefits Benchmark
Read moreIntroduced by the Affordable Care Act, Essential Health Benefits (EHB) are a set of ten health care service categories that certain health plans must cover. The EHBs are defined through a benchmark approach where states either select or get assigned a benchmark plan which serves as a reference plan…
