On January 26, 2023, the Centers for Medicare & Medicaid Services approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. This expert perspective describes the amendment, a centerpiece of which is approval for California Medicaid to provide a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. By providing re-entry services to Medicaid-enrolled individuals who are incarcerated, California aims to build a bridge to community-based care for justice-involved enrollees, offering them services to stabilize their physical and behavioral health conditions and establishing, prior to release, a re-entry plan for their community-based care.
Department of Insurance Tools for Plan Year 2015 Form Filings and Review Webinar
With the first open enrollment period having come to an end, states are immediately gearing back up to ensure that consumers again have strong plan options available on the Marketplace for 2015. Insurers will soon be filing forms and rates with state insurance departments, and regulators will be working through those filings to certify products to be offered on the Marketplace during the next open enrollment period. States also will be looking especially closely at issues like network adequacy, which have received much attention in the news in early 2014.
To that end, the State Network, through its team at the Georgetown University Health Policy Institute, has updated its form review checklists and created a number of new tools to help insurance regulators streamline the form review process. In this webinar, Sally McCarty and David Cusano of Georgetown University Health Policy Institute introduced department of insurance staff to these tools, discussed how to use them, and described some of the policy and operational considerations that regulators will want to consider during the form review process. Specifically, the webinar walked through the following resources:
- Network adequacy planning tool
- Individual market form review checklist
- Small group market form review checklist
- Catastrophic plan form review checklist
- Stand-alone dental form review checklist
- Qualified health plan issuer certification checklist
- Mental health parity and addition equity act issuer checklist and certification
- Issuer essential health benefits crosswalk and certification
The webinar slides can be found at the “download” button and a webinar recording can be found here.