Today, Medicaid faces unique threats, and these threats are happening largely below the radar screen. So far, we have succeeded in averting multiple attempts to erode Medicaid as we know it through federal legislation, but efforts to undermine coverage continue through legally questionable regulatory actions and destructive Medicaid waivers. These Medicaid waivers have the potential to have a profound impact on children, families, and their oral health coverage.
What are uncompensated care pools (also known as a “low-income pool” in Florida)? And why are they getting attention now? This short analysis explains what these pools are and how they relate to the CMS process of approving Medicaid Section 1115 waivers.
Explains how a “special enrollment opportunity” works for employer health plans and who is eligible for special enrollment.
Explains how states and health assistance programs handle billing disputes for Medicaid beneficiaries, answers questions about Medicaid billing issues.
Examines interstate billing problems, presents the results of a survey of state approaches to out-of-state billing, lists some promising practices for processing out-of-state Medicaid claims.
Congress Should Vote to Make Permanent Two Federal Programs Benefitting Low-Income Families and Individuals
Unless Congress acts quickly, funding for two federal health programs that are critical to low-income families will expire on March 31. Both the Qualified Individual (QI) program and the Transitional Medical Assistance (TMA) program are integral to providing health care to families transitioning from welfare to work and to helping low-income seniors pay their Medicare monthly premiums. Making both programs permanent is the best way to ensure that these small but important programs continue to meet the needs of the individuals who rely on them.
Medicaid Alternative Benefit Plans: What States Should Consider When Designing Coverage for the Expansion Population and the Role for Advocates
Examines issues states should consider when designing benefit plans for people who are newly eligible for Medicaid; outlines opportunities where advocates can engage in the process.
Explains three reasons why states should use data from SNAP (formerly known as food stamps) data to enroll adults in Medicaid without requiring a full application.
Explains the two ways states can change their Medicaid programs, including an at-a-glance comparison chart; discusses what advocates should do based on which option their state uses.
Explains what Medicaid Section 1115 waivers are and how advocates can take advantage of new rules that give them a bigger voice in the waiver process.