Phil Galewitz covers Medicaid, Medicare, long-term care, hospitals and various state health issues. He has covered the health beat for nearly two decades. He is a board member of the Association of Health Care Journalists.
Seema Verma, administrator of the Centers for Medicare & Medicaid Services, said it’s wrong to have ACOs that can only make profits but not risk any losses. “We want to put the accountability back into Accountable Care Organizations,” she said during a briefing with reporters.
CMS Administrator Seema Verma said the navigators that operate in the 34 states that use the federal marketplace — including many health and religious organizations — were ineffective and had outlived their usefulness.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
The 60-page ruling, which is likely to be appealed, was hailed by advocates for the poor. But it could limit the number of states expanding Medicaid under the Affordable Care Act.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, refused to discuss the findings in any detail or comment on any individual states that performed poorly or exceptionally.
CHIP, which covers 9 million children from low-income families that earn too much to qualify for Medicaid, is mostly federally funded. But states operate the program within federal guidelines.
The Centers for Medicare & Medicaid Services rejected a proposal from Kansas to place a three-year lifetime cap on some adult Medicaid enrollees. Arizona, Utah, Maine, and Wisconsin have also requested lifetime limits on Medicaid.
Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare.
The use of Medicaid demonstration programs accelerated during the 1990s. But in recent years the experiments have often reflected the political leanings of state officials or the party controlling the White House.
Congress has passed legislation legalizing the importation of prescription drugs several times in the past 20 years, but both Democratic and Republican administrations have opted not to implement it.
In a speech earlier this month, FDA Commissioner Scott Gottlieb said the agency would be stepping up its work to prevent the importation of drugs into the United States,
Critics say the Trump administration is intentionally undermining ACA, through regulatory actions. It shortened the enrollment period, withdrew money for advertising and cut the budget for navigator groups, which help people shop for plans.
Executives from Imagine360, Verily, BrightInsight, Lantern, and Rhapsody shared their approaches to reducing healthcare costs and facilitating digital transformation.
States that expanded Medicaid had an average uninsured rate of 6.5 percent compared with an 11.7 percent average among states that did not expand, the Census Bureau reported.
The payments have faced a legal challenge from House Republicans for several years, and Trump has threatened to drop the funding as part of his effort to let the “health care law implode.”
Half of Republicans (52 percent) and President Donald Trump’s supporters (51 percent) say Trump should be trying to make the health law work, according to poll conducted by the Kaiser Family Foundation.
Indiana, Arkansas, Kentucky, Arizona and Wisconsin are seeking the administration’s permission to require adult enrollees to work, submit to drug testing and demand that some of their poorest recipients pay monthly premiums or get barred from the program.
Half the money is used to help hospitals finance care for the uninsured, and the rest goes to hospitals and other providers to test regional programs to improve care and access.