The Affordable Care Act (ACA) allows hospitals to use preliminary information to enroll people who appear eligible for Medicaid into coverage on a temporary basis. The goal of this “presumptive eligibility” (PE) option for hospitals is to quickly and efficiently enroll eligible people into Medicaid while insuring immediate health care costs are covered.
Earlier this year, the Centers for Medicare & Medicaid Services (CMS) issued guidance alerting states to the availability of waivers to facilitate the enrollment of eligible individuals into Medicaid using data states already have “on hand” in their Supplemental Nutrition Assistance Program (SNAP) and Medicaid files.
Implementation of the Affordable Care Act’s Hospital Presumptive Eligibility Option: Considerations for States
The Affordable Care Act (ACA) gives qualified hospitals the opportunity to determine presumptive eligibility (PE) for all Medicaid-eligible populations which will enable hospitals to temporarily enroll individuals in Medicaid, ensuring compensation for hospital-based services, while providing patients access to medical care and a pathway to longer-term Medicaid coverage.
This brief, prepared by the National Academy for State Health Policy, lays out the major factors states have considered in estimating the cost of a potential Medicaid expansion. The major factors addressed in this brief are: Who will enroll in Medicaid with or without a Medicaid expansion?; How do the alternatives afforded by Medicaid’s Alternative Benefit Plans and Medicaid waivers affect expansion considerations?; How are health care institutions, state agencies, and a state’s broader economy affected by a state’s decision regarding Medicaid expansion?
A number of provisions in the Affordable Care Act (ACA), from changes to income eligibility (section 2002) to coverage for freestanding birth center services (section 2301), require states to alter Medicaid eligibility guidelines, service benefits, or payment criteria.
The State Network hosted a Small Group Convening in Balitmore, MD on April 25-26, 2013, bringing together state officials and technical experts to discuss pressing Medicaid implementation issues.
The National Academy of State Health Policy (NASHP) compiled this checklist to highlight the Affordable Care Act (ACA) Medicaid requirements that will take effect in the next two years, nearly all of which will apply to states regardless of whether the state chooses to expand Medicaid eligibility.
Purchasing Coverage for Medicaid Beneficiaries in the Exchange: A Review of Premium Assistance Options
This brief prepared by Manatt Health Solutions examines some of the legal, policy and operational issues states should contemplate while considering the possibility of using “premium assistance” to purchase coverage for Medicaid-eligible adults in the Exchange.
Estimated Financial Effects of Expanding Oregon’s Medicaid Program under the Affordable Care Act (2014-2020)
This analysis estimates the potential costs and benefits of Medicaid expansion for the State of Oregon. It assesses the effect on state general funds, other state funds and the overall impact on health care expenditures.
Financial Sustainability of Medicaid and Exchange Integrated Eligibility Systems: State Cost Allocation Methodologies
This brief and companion chart, prepared by Center for Health Care Strategies, reviews cost allocation methodologies states use to determine how exchange development expenses are charged to different agencies.