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- May 30, 2014
ACA-related State Plan Amendments in Medicaid
Read moreThe Affordable Care Act (ACA) brought significant changes to the Medicaid program, including expanded coverage opportunities for adults under 65 with incomes under 138 percent of the Federal Poverty Level (FPL) and new methodologies for determining and renewing eligibility. States must update their existing Medicaid state plans to implement…
- May 30, 2014
Lessons from CA: Delaying 2014 Renewals for Medi-Cal Enrollees
Read moreIn June, current enrollees of California's Medicaid program, Medi-Cal, will be asked to complete a new renewal process and be evaluated under the new MAGI eligibility rules. But with nearly one million Medi-Cal applications still pending and a faulty IT system unable to accurately determine Medi-Cal eligibility, hundreds of…
- April 29, 2014
Lessons from CA: Exchange Eligibility Appeals under the Affordable Care
Read moreSection 1411(f) of the Affordable Care Act requires the HHS Secretary to establish an appeals process related to eligibility determinations made by Exchanges, including among other things, eligibility for enrollment in a QHP and eligibility for premium tax credits and cost-sharing reductions. The federal Department of Health & Human…
- April 21, 2014
Important Consumer Considerations in Design of Pediatric Dental Benefits
Read morePediatric dental benefits are essential health benefits (EHBs) under federal and state law. Both inside and outside of the Exchange, non-grandfathered health plans in the individual and small group markets have to provide all ten EHBs, including pediatric dental health benefits.
- April 21, 2014
Women’s Health Services and the Low Income Health Program (LIHP)
Read moreBenefits Available to LIHP Eligible Women.
- April 21, 2014
The Transition of People Living with HIV/AIDS from Ryan White-Funded Care to California’s Early Medicaid Expansion Program: Lessons Learned and Looking Ahead
Read moreIn 2010, the Federal Centers for Medicare & Medicaid Services (CMS) approved a California Medicaid waiver (pursuant to § 1115 of the Social Security Act) that authorized counties to receive federal Medicaid funds for health services they provide to certain low-income individuals. In July, 2011 California took the first…