Yesterday, the Congressional Budget Office (CBO) released a letter confirming that the only path to follow the House’s instructions would require deep spending cuts in the Medicaid program. Last month, the House passed a budget resolution (H.R. 161) instructing the House Energy and Commerce (E&C) Committee, which has jurisdiction over Medicaid, to reduce federal spending by at least $880 billion. The letter… (Marceno, March 7, 2025) #Costs, #Coverage Decisions

The Medicare Payment Advisory Commission (MedPAC) held a meeting to discuss Institutional Special Needs Plans (I-SNPs). This was the second of three sessions this meeting cycle focused on long-stay nursing home residents, the first of which was an overview of the workplan in October 2024 (Impact summary). Chair Michael Chernew emphasized that the Commission will not have a chance to explore all of… (McClurg, March 7, 2025) #Post-Acute Care, #Special Needs Plans

Today, the National Governors Association (NGA)  released a statement expressing concern regarding Medicaid cuts that are currently being considered in Congress as part of Budget Reconciliation.  The statement is from NGA Chair Governor Polis (Colorado) and NGA Vice Chair Governor Stitt (Oklahoma) on behalf of the 55 states and territories NGA represents.  In addition to Medicaid, it also highlights concern… (Joyce, March 6, 2025) #Public Health, #Social Determinants of Health

On March 4, the Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin (CIB) rescinding CMS’ previous 2023 and 2024 guidance on Medicaid and Children’s Health Insurance Program (CHIP) coverage of health-related social needs (HRSN).  Per the announcement, CMS will now consider states’ applications to cover HRSN related services and supports on a case-by-case basis. In light of this recission, the recent… (Joyce, March 5, 2025) #Social Determinants of Health

President Trump issued an Executive Order (EO) titled “Implementing the President’s ‘Department of Government Efficiency’ Cost Efficiency Initiative.” This order mandates a comprehensive 30-day review of federal contracts, grants, and loans with the aim of reducing federal spending and reallocating funds to align with administration policies. The EO directs agencies to justify and publicly track payments under government contracts, introduce… (Colocho, March 5, 2025) #Grants, #Transparency

The U.S. Preventive Services Task Force (USPSTF) released a draft research plan on interventions for tobacco cessation in adults. This research plan aims to assess the effectiveness and potential harms of various tobacco cessation methods, including their impact on different populations. The draft plan is open for public comment from February 27, 2025, through March 26, 2025. The USPSTF draft… (Colocho, March 3, 2025) #Chronic Diseases, #Health Equity, #Mental and Behavioral Health, #Prevention, #Public Health, #Tobacco, #Wellness

The Medicaid and CHIP Payment and Access Commission (MACPAC) held a meeting to discuss automation and artificial intelligence (AI) in the prior authorization (PA) process. Commissioners were excited about the potential of AI to streamline PA but have concerns about bias and denials without proper clinical oversight. The Commission will not make recommendations this year, but will hold a panel discussion on… (McClurg, February 28, 2025) #Health Information Technology

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to revisit how Medicaid meets the unique health care needs of children in foster care, building on its 2015 examination of the intersection between Medicaid and child welfare. The session involved a comprehensive review of federal requirements and state strategies for delivering Medicaid benefits to children in foster… (Eisen, February 28, 2025) #Health Equity, #Pediatrics

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to explore interview findings on program design and administration of self-directed services in Medicaid Home- and Community-Based Services (HCBS), which allow individuals with long-term care needs to live independently in their communities. This discussion built on the December 2024 session that explored the new topic of work for… (Eisen, February 27, 2025) #Home Health

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to present draft policy options aimed at addressing the challenges faced by children and youth with special health care needs (CYSHCN) during the transition from pediatric to adult health care services. The session included an overview of the key challenges in care transitions, additional factors impacting these transitions,… (Eisen, February 27, 2025) #Pediatrics, #Quality