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- May 8, 2015
EHB Prescription Drug Standard – Exceptions Process
Read moreIntroduced by the Affordable Care Act (ACA), Essential Health Benefits (EHB) are a set of ten health care service categories that plans must cover. One of the ten categories of benefits is prescription drugs. On February 20th, 2015, the Department of Health and Human Services (HHS) issued the Notice…
- May 8, 2015
EHB Prescription Drug Standard – Formulary Transparency
Read moreIntroduced by the Affordable Care Act (ACA), Essential Health Benefits (EHB) are a set of ten health care service categories that plans must cover. One of the ten categories of benefits is prescription drugs. On February 20th, 2015, the Department of Health and Human Services (HHS) issued the Notice…
- May 5, 2015
Medicaid Assessments for Long-Term Supports & Services (LTSS)
Read moreLong-term care needs assessments serve a vital role in Medicaid. For individuals with disabilities and older adults, needs assessments are used to determine eligibility for both institutional and home and community-based services (HCBS). The assessment process establishes the type and extent of an individual's care needs, which inform the…
- April 28, 2015
Armstrong v. Exceptional Child Care Center
Read moreIn Armstrong v. Exceptional Child Care Center, 135 S. Ct. 1378 (2015), the Supreme Court held that health care providers cannot bring a case against state Medicaid officials in federal court to enjoin Medicaid payment rates that are arguably inconsistent with the Medicaid Act's payment provision. This issue brief…
- April 20, 2015
Intrauterine Devices and Implants: A Guide to Reimbursement
Read moreThe Intrauterine Devices and Implants: A Guide to Reimbursement (Second Edition) provides guidance on navigating the stocking, billing, and reimbursement of long-acting reversible contraceptive (LARC) methods. This guide was produced in collaboration with the National Family Planning & Reproductive Health Association, American College of Obstetricians and Gynecologists (ACOG), National Health…
