More Medicaid Work Rules Decisions on Horizon

2018-07-12 | , CQ Roll Call

July 12, 2018 - The nation’s Medicaid chief indicated Thursday that her agency will soon announce whether it will allow more states to require adults covered by the government insurance program to work.


It should become clear “very shortly” whether the Centers for Medicare and Medicaid Services will continue to approve state Medicaid work requirement proposals, agency Administrator Seema Verma said during a wide-ranging conversation with reporters Thursday. At least seven states are awaiting such decisions.


Verma’s comments come less than two weeks after a federal judge blocked Kentucky’s plan to institute a work mandate and make other changes to its Medicaid program, saying in part, that the Trump administration did not fully consider how the changes would impact tens of thousands of Kentuckians.


Verma declined to directly address the Kentucky court case on Thursday but doubled down on the administration’s commitment to work requirements.


“We’re looking at what we need to do to address the court’s concerns, but it doesn’t change our commitment to giving states flexibility,” she told reporters at an event hosted by the nonprofit Alliance for Health Policy.


CMS has so far approved work requirements in Kentucky, Arkansas, Indiana and New Hampshire.


Navigator Funding
During the briefing, Verma stood by the administration’s decision to cut funding for navigator grants under the 2010 health care law (PL 111-148, PL 111-152) for a second year in a row.


The navigator system isn’t cost effective in helping people enroll in exchange coverage, and the agency is focusing on other ways to achieve the same results, such as leveraging insurance agents and brokers, she said. Navigators are groups that help consumers understand and apply for insurance on the health law’s exchanges.


The administration announced Tuesday it would award $10 million in navigator grants, down from $36 million for the 2018 plan year. 


Consumer advocates decried the move, calling it another attempt to undermine the health law and make it harder for people to access coverage.


Verma, however, said there is less need for such programs over the years as people become more familiar with the law and emphasized that this year’s exchange enrollment was strong despite cuts to navigator funding.


“We think there are other ways to help people enroll in programs,” she said.


Payment Rules
In the coming weeks, the agency is also expected to issue proposed rules updating payments for doctors and other types of medical providers.


The goal is to foster competition but also continue to cut down on burdensome and costly red tape, Verma said. CMS recently proposed removing quality measures from certain hospital payment programs, estimating the move will save nearly 2 million hours of hospital time and more than $70 million. And a proposed rule released Wednesday would eliminate four reporting measures for facilities that treat end-stage renal disease, which the agency says will save $12 million.


Providers should be on the front lines with patients, not sitting in hospital basements doing paperwork, Verma said.


“But in no way, shape or form are we moving away from quality, program integrity and transparency,” she said.


Verma added that she expects CMS to take action by the end of the year to address provider concerns around the Stark Law, which restricts doctors from referring patients to businesses in which they have a financial stake.


She declined to explicitly discuss recent comments by an HHS official hinting at additional steps the administration may take to tackle drug prices. She indicated, however, that some of the agency's upcoming proposed payment rules could include elements relating to drug pricing.

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