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- February 25, 2016
Health Advocate: Medicaid’s EPSDT in Schools versus the Free Care Rule
Read moreIn this month's Health Advocate, we analyze clarifications to the "Free Care Rule," which no longer prevents schools from being reimbursed for services provided to children through Medicaid's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program.
- January 25, 2016
Health Advocate: 2016: Our New Year’s Resolutions
Read moreWe're off to a roaring start in 2016 with over 8.5 million individuals enrolled in health insurance through the Marketplaces in the first six weeks of open enrollment 3 (OE3), an increase of over 2 million from the same time last year. And, an additional 13.5 million individuals have…
- January 20, 2016
Managed Care in California Series, Issue 6: Continuity of Care in Medi-Cal Managed Care
Abbi Coursolle and Shyaam Subramanian Issue BriefRead moreThere are a number of laws and policies that govern continuity of care for Medi-Cal beneficiaries; some protect access to particular services or access to an existing provider for a course of treatment or for a period of time, and others protect a specific population of beneficiaries. Additionally, some…
- January 20, 2016
NHeLP Equal Access Regulation Comments
Abbi Coursolle, Leo Cuello, and Jane Perkins CommentsRead moreMedicaid law requires states to make payments to providers that promote quality and equal access to care for Medicaid enrollees. HHS published regulations implementing those legal requirements. NHeLP's comments suggest ways HHS can improve the regulations to better improve quality and access.
- 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…