Upcoming Conference
Tampa, May 18, 2023

The CMS-Georgia waiver battle

| Jan 28, 2022 | Federal

Georgia Gov. Brian Kemp has been engaged in a multi-year back-and-forth with federal officials over the state’s Medicaid and insurance market waiver programs, as reflected in the following timeline of the most notable steps taken by both sides. A final resolution of the standoff is not yet in sight, or...[ Read More ]

Medicaid’s budget neutrality rules for section 1115 waivers

| Jan 18, 2022 | Federal

For decades, a focus in Medicaid has been on state proposals that fall outside what is allowable under the program’s normal rules. The Secretary of Health and Human Services (HHS) has wide discretion under section 1115 of the Social Security Act to “waive” legal or regulatory impediments to state initiatives...[ Read More ]

The status of federal price transparency requirements

| Dec 28, 2021 | Federal

The health sector has long resisted revealing the prices it charges payers and consumers, but bipartisan pressure from Washington is forcing it to change. New rules are beginning to take effect, or will in the coming years, which will push into the public domain a flood of pricing data. The...[ Read More ]

The 2020 national health expenditures report

| Dec 16, 2021 | Federal

The COVID-19 pandemic has been a transformative global event with far-reaching effects that are still unfolding. The recent annual report on national health spending from the Office of the Actuary’s National Health Expenditures Accounts Team in the Centers for Medicare and Medicaid Services (CMS) documents some of the dramatic shifts...[ Read More ]

Evaluations of four state-run dually eligible demonstrations

| Dec 1, 2021 | Federal

Federal and state policymakers have been working to improve the cost-effectiveness of care provided to the “dually eligible” -- those entitled to services under both Medicare and Medicaid -- for more than two decades, but the results to date have been disappointing. The two giant public insurance programs are run...[ Read More ]

A closer look at the House plan to close the coverage gap

| Nov 12, 2021 | Federal

The current House version of the Build Back Better (BBB) legislation, as posted by the Rules Committee, includes provisions that would close the health insurance coverage gap in states that have declined to expand Medicaid pursuant to the Affordable Care Act (ACA). The individuals who now are ineligible both for...[ Read More ]