AHA recommends changes to Medicaid/CHIP enrollment rule   02/21/2013
The AHA today expressed concern that hospitals, which are eager and willing to help enroll their patients in Medicaid, may be discouraged from doing so given the Centers for Medicare & Medicaid Services' proposed implementation of the presumptive eligibility determinations under the Patient Protection and Affordable Care Act. Commenting on the agency's proposed rule that would streamline the enrollment process for Medicaid, the Children's Health Insurance Program and insurance exchanges, the association urged CMS to issue guidance specifying how states must work with hospitals that elect to make presumptive eligibility determinations, saying the AHA is "concerned that hospitals will not have sufficient information to effectively determine Medicaid eligibility on a presumptive basis." Additionally, the letter urged CMS to clarify that coverage restrictions on Institutions for Mental Diseases do not apply to the Medicaid expansion population, among other recommendations.
CMS awards ACA funds for State Innovations Models   02/21/2013
The Centers for Medicare & Medicaid Services today awarded six states a portion of more than $250 million to test proposals to improve health care delivery and payment for Medicare, Medicaid and Children's Health Insurance Program beneficiaries. Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont will use the Patient Protection and Affordable Care Act funds to test multi-payer payment and service delivery models, including approaches already under way at CMS, as part of the State Innovations Models initiative. Another 19 states received awards to plan and design proposals.
Choosing Wisely campaign expands list of procedures to question   02/21/2013
Seventeen medical specialty societies today identified 90 common tests and procedures that may be overused or unnecessary for certain patients based on the evidence, and encouraged physicians and patients to choose their use wisely. Among other treatments, the procedures include non-medically indicated inductions of labor or cesarean deliveries before 39 weeks of pregnancy; stress echocardiography for patients with no symptoms and low risk of coronary disease; CT scans to evaluate minor head injuries in children; and electroencephalography for patients with recurrent headaches. Since last April, 25 medical societies have identified more than 130 tests and procedures to question as part of the Choosing Wisely campaign, initiated by the American Board of Internal Medicine Foundation. For each society's list, visit http://choosingwisely.org. Additional specialty societies are expected to announce lists later this year.
SAMHSA center offers ACA behavioral health information   02/21/2013
The Substance Abuse and Mental Health Service Administration yesterday announced a resource center to answer questions on how the Patient Protection and Affordable Care Act will affect behavioral health care, and provide updates on the status of ACA implementation. The Information Resource Center will link people with relevant federal websites, documents and guidance materials, and is developing a frequently asked questions feature that will cover the most sought after topics. Questions may be emailed to CFRI.info.samhsa@samhsa.hhs.gov and should receive a response within 48 business hours, the agency said. SAMHSA's Center for Financing Reform and Innovations also offers a monthly newsletter that includes updates on ACA implementation related to behavioral health.