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- August 17, 2023
Comments on CMS Health Insurance Common Claims Form (CMS-1500)
Read moreCMS invited public comment on the standard form that health care providers use to submit claims to CMS for reimbursement. This form has a great impact on how Medicare, Medicaid, and CHIP, as well as private insurers, collect and share information about patient populations and services provided. In our…
- August 11, 2023
Medicaid Eligibility Call Centers: Questions for LEP & Disability Access
Read moreCall centers are often the primary way that Medicaid enrollees interact with the Medicaid agency. During the unwinding of the Medicaid continuous coverage period, people are often relying on the Medicaid call centers for answers to questions, to submit requested information, file appeals, and otherwise receive assistance. But call…
- August 1, 2023
Case Explainer: Health & Hospital System of Marion Co., Indiana v. Talevski
Read moreIn Health and Hospital System of Marion County, Indiana v. Talevski, the Supreme Court addressed whether provisions of federal safety net programs can be enforced by individuals pursuant to 42 U.S.C. § 1983 and, if so, whether individuals can enforce provisions of the Medicaid Nursing Home Reform Act. The…
- June 14, 2023
The Constitutionality of Demographic Data Collection
Read moreCollecting demographic data is legal and constitutional. Questions have arisen about the constitutionality of the collection and use of demographic data. This concern has been attributed to the Supreme Court’s 1995 decision in Adarand Constructors, Inc. v. Pena. Yet Adarand and the cases following it preclude neither the collection…
- June 2, 2023
NHeLP Comments on 2024 Medicare Inpatient Prospective Payment System Proposed Rule
Read moreNHeLP submitted comments on the annual Medicare IPPS/LTCH Proposed Rule in support of two new health equity measures. NHeLP supports the proposals to add a health equity adjustment and to require certain hospitals to attest to a Facility Commitment to Health Equity measure. However, NHeLP asks CMS to invest…
- May 15, 2023
Principles for Fairer, More Responsive Automated Decision-Making Systems
Read moreMany government agencies use automated decision-making systems (ADS) for public benefits coverage and enrollment decisions, including Medicaid. By ADS we mean, broadly, systems that use standardized logic or algorithms to assess eligibility for and access to public benefits. This includes not only sophisticated “big data” systems, such as programs…