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  • Washington Highlights

    CMS Administrator Announces Changes to Medicaid Program

    Mary Mullaney, Director, Hospital Payment Policies

    Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma Nov. 7 announced that CMS wants to give states more freedom under the Medicaid program to design innovative programs that best meet the needs of the people they serve. Administrator Verma noted that CMS would like to provide states the ability to include additional requirements under the Medicaid program, including beneficiary work requirements, instituting premiums, and time limits for coverage eligibility. In order to give states the freedom to re-design their Medicaid programs to include additional beneficiary obligations, CMS announced the following new policies and initiatives:

    • Update Section 1115 demonstration information on Medicaid.gov to provide states with a clearer indication of how their reform strategies align with the core objective of the Medicaid program – to serve the health and wellness needs of the nation’s vulnerable and low-income individuals and families;
    • Streamline and improve the Medicaid Section 1115 demonstration, state plan amendment, and 1915 waiver processes to:

    • Reduce the burden of the application process by revising the Demonstration Application template;

    • Increase efficiency during the approval process to expedite the process, including the establishment of a “fast track” process;

    • Promote transparency of the review process by improving communication with states and offering technical assistance in advance of formal submission of the demonstration application; and

    • Implement enhancements to monitoring and evaluation of section 1115 demonstrations; and

    • Develop Medicaid and Children’s Health Insurance Program (CHIP) scorecards to provide greater transparency and accountability of the Medicaid program by tracking and publishing state and federal Medicaid outcomes.