Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. Thanks to the Administration’s whole-of-government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from an emergency phase.
via the Centers for Medicare & Medicaid Services (CMS), by email:
Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.
Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children’s Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition– Frequently Asked Questions (FAQ)
...Since the onset of the novel coronavirus disease of 2019 (COVID-19) Public Health Emergency (PHE), state Medicaid agencies have made policy, programmatic, and systems changes to respond effectively to the pandemic. State Medicaid agencies also have made changes to qualify for the temporary Federal Medical Assistance Percentage (FMAP) increase under section 6008 of the Families First Coronavirus Response Act (FFCRA), including satisfying a continuous enrollment condition for most Medicaid beneficiaries who were enrolled in the program as of or after March 18, 2020.1 Similarly, during the COVID-19 PHE, some states have been granted 1115 demonstration authority to provide continuous enrollment for Children’s Health Insurance Program (CHIP) beneficiaries in addition to other flexibilities that have had this effect.
About a week and a half ago I received the following email (posted w/permission w/identity removed):
Hello Mr Gaba. Last year I had a BCBS insurance through marketplace and this year I switched to a Physicians Health Plan offering, also through the marketplace. I thought I had done due diligence. I was interested in switching to the University of Michigan system. As I shopped for plans the PHP website listed literally hundreds of potential pcp's near me in Ann Arbor. But as I began to try and sign up with a new doctor and called the number listed for each doc (usually the same U-M switchboard number) I found that none of the docs listed were, in fact, accepting new patients.
At the moment I cannot find a new pcp through my new health insurance. Is this legal? Have I any recourse? Where can I find info on what to do? They suggest that I try to get my former doctor to fill out a prior approval or out of network form...Hoping you can direct me to somewhere; thank you for any direction you can offer me.
January 11, 2023: CMS marked another important maternal health milestone by approving Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage expansions in Alabama and a Medicaid postpartum coverage expansion in North Dakota through the American Rescue Plan (ARP). Nationally, more than 439,000 people across 28 states and the District of Columbia now have access to Medicaid and CHIP coverage for a full 12 months following pregnancy — up from just 60 days before the ARP. Postpartum coverage extensions form one of the cornerstones of CMS’ Maternity Care Action Plan — part of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. Click here and here to learn more about Alabama’s approvals, and here to learn more about North Dakota’s approval.
Short-term, limited duration (STLD) health insurance has long been offered to individuals through the non-group market and through associations. The product was designed for people who experience a temporary gap in health coverage.1 Unlike other products that are considered “limited benefit” or “excepted benefit” policies – such as cancer-only policies or hospital indemnity policies that pay a fixed dollar benefit per inpatient stay – short-term policies are generally considered to be “major medical” coverage; however, short-term policies are distinguished from other comprehensive major medical policies because they only provide coverage for a limited term, typically less than 365 days. Short-term policies are also characterized by other significant limitations, including the types of services covered, often with a dollar maximum.
As part of Biden-Harris Administration efforts to strengthen Medicaid, new guidance will help states expand access to health care services and tackle unmet social needs
Today, the United States Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is releasing guidance on an innovative opportunity for states to address health-related social needs for people with Medicaid coverage through the use of “in lieu of services and settings” in Medicaid managed care. This option will help states offer alternative benefits that take aim at a range of unmet health-related social needs, such as housing instability and food insecurity, to help enrollees maintain their coverage and to improve their health outcomes. The Biden-Harris Administration is committed to protecting and strengthening Medicaid. Today’s action is CMS’ latest step to drive innovation in the Medicaid program, strengthen access to care, improve population health, and reduce health disparities.
via the Centers for Medicare & Medicaid Services (CMS), by email:
Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.
Medicare
As of September 2022, 65,103,807 people are enrolled in Medicare. This is an increase of 160,823 since the last report.
34,984,295 are enrolled in Original Medicare.
30,119,512 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.
50,574,579 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS).
Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS).
Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.
