Category Archives: Health Network Alert

As recently announced by the Centers for Medicare and Medicaid Services (CMS), New Hampshire is the first state to receive federal approval under the Balancing Incentive Payments Program (BIPP) to shift state Medicaid spending towards community-based care.

New Hampshire is the first state to receive federal approval under the Balancing Incentive Payments Program (BIPP) to shift state Medicaid spending towards community-based care.

CMS has rejected requests by both California and Florida to require additional cost sharing from Medicaid beneficiaries. The rejections are good news for Medicaid beneficiaries, who too frequently are being targeted by states to bear an unfair proportion of states’ efforts to address budget shortfalls.

On February 22, the Supreme Court rejected an attempt to eliminate a critical legal tool for protecting the rights of low-income individuals. Douglas v Independent Living Center is a significant victory for court access for low-income individuals who rely on Medicaid coverage to obtain prescription medications, hospital care, and other medical services.

Six national aging groups filed a friend of the court brief with the Supreme Court last Friday saying that there are extensive provisions in the Patient Protection and Affordable Care Act (ACA) that are of “vital importance to the health and well-being of people 65 and older” and that Congress did not intend for any of them to be contingent on whether or not the minimum coverage provision (also called the individual mandate) was constitutional.

CMS recently released an informational bulleting to state Medicaid agencies addressing the prohibition on balance billing of QMBs for Medicare-covered services when charges are not fully paid by Medicare and Medicaid.

Effective January 1, 2012, full-benefit dual eligibles receiving Medicaid home and community based services (HCBS) have no Medicare Part D copayments.