Updates

Feb 1, 2024 

Preparing to Implement the 12-Month Continuous Enrollment for Children Requirement: Questions and Answers

In late 2022, Congress enacted section 5112 of the Consolidated Appropriations Act, 2023 (CAA), requiring states to provide children under age 19 determined eligible for Medicaid or the Children’s Health Insurance Program (CHIP) with 12 months of continuous enrollment (CE) effective January 1, 2024. To support states in implementing CE, the Centers for Medicare & Medicaid Services issued sub-regulatory guidance expanding on the CAA’s new requirement. This Q&A is intended to serve as an added resource for states as they newly take up CE for children or modify existing CE policies to meet the CAA requirement. As noted, some issues remain open pending further CMS guidance.

Dec 8, 2023 

New CMS Rule on Medicaid Unwinding Clarifies CMS Enforcement Authorities and State Reporting Requirements

On December 6, the Centers for Medicare & Medicaid Services published and made effective an interim final rule (IFR) with comment period regarding states’ ongoing unwinding efforts to redetermine eligibility for all Medicaid enrollees nationwide. This expert perspective summarizes the IFR, which interprets and implements the state reporting requirements and CMS enforcement authorities that Congress enacted last winter in the Consolidated Appropriations Act of 2023.

Nov 17, 2023 

CMS Releases Information Bulletin on Coverage of Services and Supports to Address Health-Related Social Needs in Medicaid

This expert perspective summarizes CMS’ new Informational Bulletin and accompanying framework which together detail Medicaid coverage options for services that address the health-related social needs (HRSN) of Medicaid enrollees. The new guidance reiterates the importance of addressing HRSNs to improve access to care and health outcomes, and summarizes (and in some cases updates) multiple previous sources of CMS guidance on how HRSN services may be covered in Medicaid, including guidance on in lieu of services authority and on HRSN coverage in section 1115 waivers.

Nov 16, 2023 

SHVS State Assessment Survey: Section 1902(e)(14) Waiver Flexibilities

This expert perspective provides insights on the temporary section 1902(e)(14) waiver flexibilities that may be valuable for the Centers for Medicare & Medicaid Services to consider extending or authorizing permanently to streamline and improve post-unwinding renewal processes. An informal and anonymous survey conducted by State Health and Value Strategies (SHVS) asked states to rate the value of these flexibilities during unwinding and their level of interest in making flexibilities permanent. Findings are not representative of all states and should be interpreted with caution.