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Healthcare Reform

Insights on the ACA: Missing Out on Medicaid Money

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Note: ACA Watch is an ongoing, bi-weekly series with aggregated stories and insights on the latest developments regarding the Affordable Care Act. Look out for it every other Thursday.

States that have decided not to expand their Medicaid programs under the Affordable Care Act will lose out on billions of dollars over the next decade, while their residents will pay for the expansion in other states without experiencing any of the benefits, according to a new study released by the Commonwealth Fund. The study – which is the first to calculate the net cost to taxpayers in states refusing to participate in the Medicaid expansion — found that there is both a health care loss to residents of states not expanding Medicaid and an economic loss for state budgets.

Implementation 

Report on Lessons from Early Expansion

The Medicare & Medicaid Research Institute (MMRR) published a study that focuses on the experiences and lessons learned by early Medicaid expansion states. MMRR interviewed Medicaid officials from California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington, all states that chose to increase Medicaid income eligibility levels in advance of the January 1st optional Medicaid expansion coverage start date. Through these interviews, MMRI looked at enrollment outreach strategies, beneficiary impacts, as well as cost and utilization of services in order to uncover the implementation challenges, and potential lessons for states expanding in 2014. The full report is available here.

State Watch

Louisiana Sets Rule to Deter steering Patients into Managed Care Plans

Regulators in Louisiana are attempting to crack down on a perceived pattern of physicians inappropriately steering patients into particular Medicaid managed-care plans. Doctors caught exerting such influence could be booted from the program or asked to return payments for services they provided, and they face up to $5,000 in fines, according to an emergency rule effective Dec. 1 2013. Visit this page for further details.

Industry Watch

MU Compliance Announcement Sparks Concern, Confusion

Last week, providers thought they were getting relief from next year’s Meaningful Use Stage 2 implementation deadlines. But what many are calling a poorly worded announcement from CMS hid that the agency fully expects all Stage 2 start dates to remain unchanged. Instead, it appears the CMS announcement proposes to push back start dates for Meaningful Use Stage 3, by adding a third year of Stage 2 for those providers who attested for Stage 1 in 2011 or 2012. Visit this page for details.