CMS Approves Utah Work Requirements Just Two Days After Court Ruled Them Illegal For Kentucky, Arkansas
Utah voters approved expanding the state's Medicaid program through a ballot initiative last year, but state lawmakers scrambled to add restrictions to the program. One of those was work requirements. The waiver also has a novel feature to control costs: Utah can freeze enrollment of newly eligible beneficiaries if the projected costs of their coverage exceed the funds appropriated by the state Legislature.
The New York Times:
Trump Administration Approves Medicaid Work Requirements In Utah
Just two days after a federal court struck down work requirements for Medicaid beneficiaries in Arkansas and Kentucky, the Trump administration approved similar requirements in Utah on Friday. The administration acknowledged that some Utah residents might lose coverage, but said that others would become healthier and gain financial independence because they were working. In approving a Medicaid waiver for Utah, the Trump administration is reaffirming its conservative priorities, defying critics and inviting another round of litigation. (Pear, 3/29)
Modern Healthcare:
Utah Gets CMS Waiver For A Partial Medicaid Expansion
Utah won an unusual CMS waiver Friday to implement a partial expansion of Medicaid to adults with incomes up to 100% of the federal poverty level, starting April 1. The waiver also allows the state to cap enrollment in the expansion program if the state lacks sufficient funds to match the federal payments. No other state has been allowed to do that. The state will receive its standard federal match rate of about 70% for the partial expansion population, rather than the current 94% rate for a full Affordable Care Act Medicaid expansion to adults up to 138% of poverty. (Meyer, 3/29)
Kaiser Health News:
CMS Ignores Federal Judge Ruling To Approve Medicaid Work Rules In Utah
CMS Administrator Seema Verma said in her approval letter that requiring Medicaid enrollees to work was allowed because it helps make them healthier. “Therefore we believe an objective of the Medicaid program, in addition to paying for services, is to advance the health and wellness needs of its beneficiaries, and that it is appropriate for the state to structure its demonstration project in a manner that prioritizes meeting those needs,” she wrote. (Galewitz, 3/29)
The Wall Street Journal:
Utah Allowed To Limit Voter-Approved Medicaid Expansion
Voters in the November midterm elections had approved a full expansion under the Affordable Care Act that was projected to result in more than 120,000 people gaining coverage. But state lawmakers in the Republican-led legislature asked the federal government to let Utah pursue a more scaled-back expansion that would cover an estimated 50,000 fewer people. The program approved Friday by the Centers for Medicare and Medicaid Services will serve as a bridge for one year, when the federal government could increase its share of costs for the expansion, per request from the state. Utah also got approval to impose work requirements but state officials said that won’t begin until 2020. (Armour, 3/29)
Politico:
Trump Administration Approves Partial Utah Medicaid Expansion To Replace Voter-Approved Plan
The Utah plan will initially cost the state tens of millions of dollars more and was spearheaded by Republican leaders critical of Obamacare's Medicaid expansion. Liberal groups caused an uproar earlier this year as the legislature quickly moved to override the ballot initiative, saying the GOP lawmakers were blatantly defying the will of the people. (Pradhan, 3/29)
CQ:
Utah Moves Toward Partial Medicaid Expansion
Utah Gov. Gary R. Herbert, a Republican, cheered the approval. “This is an important first step in covering vulnerable Utahns in a financially sustainable way,” said Herbert. “But it’s just a first step. In the coming months, we will submit a detailed proposal seeking a new funding arrangement with CMS that will decrease the state’s share of the costs, provide the federal government with assurances on its costs, and provide the state with additional flexibility to manage the program.” (Raman, 3/29)
Other Medicaid and health law news comes out of Arkansas, Georgia, Iowa, Missouri, New York, Minnesota, Alabama and Wisconsin —
The Associated Press:
Arkansas' Medicaid Plan In Jeopardy After Work Rule Decision
An effort to keep Arkansas' Medicaid expansion failed Friday in the state House, leaving the future of coverage uncertain for thousands of low-income residents two days after a judge blocked the state's work requirement on the program. The majority-Republican House voted 52-28 in favor of the budget bill for Medicaid and the expansion program, nearly two dozen votes shy of the 75 needed in the 100-member chamber to send the legislation to GOP Gov. Asa Hutchinson. (DeMillo, 3/29)
Georgia Health News:
Breakthrough: Legislature Approves CON Changes, Medicaid Funding Plan, Hospital Transparency
The CON provisions in House Bill 186 will allow Cancer Treatment Centers of America a pathway to expand the capacity of its Newnan facility and treat more Georgia patients. And in a separate bill, the House and then the Senate agreed to renew the hospital provider fee that fills a nearly $1 billion hole in the state Medicaid budget. House Bill 321 also contains strong financial disclosure requirements for nonprofit hospitals. (Miller, 3/29)
Des Moines Register:
UnitedHealthcare Pulling Out Of Privatized Iowa Medicaid System
More than 425,000 poor or disabled Iowans will soon have to switch health insurance carriers. UnitedHealthcare, which manages health care for more than two-thirds of Iowans on Medicaid, is leaving the market, Gov. Kim Reynolds’ office announced late Friday afternoon. The departure, to come in the next few months, came after Iowa officials broke off contract negotiations due to what Reynolds termed "unreasonable and unsustainable" demands from UnitedHealthcare. (Leys, 3/29)
Kaiser Health News:
Suicide Risk Grew After Missouri Medicaid Kids Shifted To Managed Care, Hospitals Say
After more than 2,000 Missouri children diagnosed with mental illness were shifted from traditional Medicaid into three for-profit managed-care companies, the state’s hospitals noticed an alarming trend: a doubling in the percentage who had thoughts of suicide or attempted suicide. Additionally, the average length of stay for these children in psychiatric hospitals dropped from 10 days to seven following the Medicaid change in May 2017, according to a study released this month by the Missouri Hospital Association. (Galewitz, 4/1)
Modern Healthcare:
Health Program Proposal May Cause New York, Minnesota To Lose Millions
The CMS is proposing a cut of $300 million over two years to the two states participating in the Affordable Care Act's Basic Health Program. The agency released a proposed rule on Friday that outlined a new payment methodology for calculating the payments to New York and Minnesota under the program that provides insurance coverage for low-income residents who fall in the range of 133 to 200% of the federal poverty level and aren't eligible for Medicaid or CHIP. (King, 3/29)
Modern Healthcare:
Alabama Lawmakers Push Wage Index Reform
Alabama congressional members sent a letter to CMS Administrator Seema Verma on Friday to support the HHS' Office of Inspector General's recommendation to overhaul the wage index, something lawmakers say has jeopardized the state's rural hospitals. The letter, which was signed by U.S. Senators Richard Shelby (D-Ala.) and Doug Jones (D-Ala.) along with U.S. Representatives Robert Aderholt (R-Ala), Mike Rogers, (R-Ala.), Mo Brooks (R-Ala.), Martha Roby (R-Ala.), Terri Sewell (D-Ala.), Bradley Byrne (R-Ala.) and Gary Palmer (R-Ala.), said that the wage index "is a fundamentally flawed and administratively burdensome system" that is negatively impacting the Alabama healthcare system. (Kacik, 3/29)
Milwaukee Journal Sentinel:
Closed Milwaukee Clinic To Pay $4.1M Over Fraudulent Urine Screens
From 2011 to 2015, Acacia Mental Health Clinic LLC, 5228 W. Fond du Lac Ave., captured 99% of all Medicaid payments to mental health and substance abuse counseling providers in Wisconsin, according to federal prosecutors who sued to claw back some of that money. Rose Presser, a nurse practitioner who revealed the scams in a whistleblower lawsuit in 2013, will be entitled to receive up to 30% of the settlement, though rewards are generally 15% to 20% of the recovery. (Vielmetti, 3/29)