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- September 25, 2023
NHeLP Letter to CCIIO on Legal Authorities and Regulatory Changes for Essential Health Benefits
Read moreIn this letter to the HHS Center for Consumer Information and Insurance Oversight (CCIIO), NHeLP urges changes in regulations governing Essential Health Benefits (EHB). As NHeLP points out, nothing in the Affordable Care Act precludes HHS from adding adult oral health as part of the department's statutory responsibility to…
- September 18, 2023
EPSDT’s Legal Landscape & Implementation History
Jane Perkins and Amanda Avery Court Document, Health Advocate, Regulations and Laws, Fact Sheet, CasesRead moreThis Fact Sheet provides essential information to help advocates become EPSDT experts. After giving an overview to EPSDT, we focus on: (1) legislative milestones; (2) notable federal agency guidance; and (3) precedent-setting cases from the judiciary. Next, we provide a snapshot of states’ performance implementing EPSDT, using government reports…
- August 21, 2023
An Advocate’s Guide to Reproductive and Sexual Health in the Medicaid Program (with 2023 Supplement)
Read moreIn 2019, NHeLP published the 2nd Edition of An Advocate’s Guide to Reproductive and Sexual Health in the Medicaid Program (“Guide”). The Guide is designed to familiarize readers with the basics of the Medicaid program and highlight features that support reproductive and sexual health. Since the Guide was first…
- 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…
- July 14, 2023
Comments on Proposed Medicaid Managed Care Access Rule
Read moreCMS proposed a major administrative rule that would increase transparency in managed care; improve monitoring and assure adequacy of payments in managed care; increase accountability, transparency, and participant input into external quality review; and help states to make information about quality measures widely available. NHeLP filed comments in support…
- July 13, 2023
Comments on Proposed Medicaid Access Rule
Jennifer Lav, Wayne Turner, David Machledt, Abigail Coursolle, Dania Douglas, Charly Gilfoil, Jasmine Young, and Madeline Morcelle CommentsRead moreCMS proposed changes and additions to regulations enforcing the "equal access" provision of Medicaid. These changes would strengthen opportunities for enrollees' input and oversight of state Medciaid programs, would help promote access to Medicaid services, would improve quality of care, and promoting transparency and adequate payment for fee-for-service Medicaid.…