On April 9, the Centers for Medicare and Medicaid Services (CMS) released a final rule weakening consumer protections in the Affordable Care Act. The final rule increases the amount by which insurers can increase premiums without regulatory approval, from 10% to 15%. Furthermore, it exempts student health plans from this process. The rule also broadens the circumstances when plans are allowed to spend less than 80% of premiums on providing care without being required to reimburse beneficiaries. Additionally, it allows states to narrow the scope of essential health benefits that plans are required to cover. Learn more about the final rule here.
Last week, the House and Senate advanced the most important spending bills for disability programs – Labor, Health and Human Services, Education, and Related Agencies (L-HHS-ED). Both would maintain overall sequestration funding levels and include a number of substantial cuts to programs, earning the promise of a veto by President Obama.
L-HHS-ED – Senate – The Senate bill passed the Appropriations Committee along party lines on June 25. The bill’s discretionary funding level is $3.6 billion below the Fiscal Year (FY) 2015 enacted level and includes numerous policy riders that would limit the activities of federal agencies. Several federal agencies would receive significant cuts and a small number would receive increases. Notable examples include:
- LABOR: Includes a 4% cut for Workforce Innovation and Opportunity Act (WIOA) programs.
- HHS: Includes a 28% cut for the Centers for Medicare and Medicaid Services (CMS) program management that would restrict the agency’s ability to operate the Affordable Care Act programs, Medicare, and Medicaid.
- EDUCATION: Includes a $1.1 billion cut for the Department. However, the IDEA state grant program would receive a nearly 1% increase.
L-HHS – House – The House bill passed the full Appropriations Committee along party lines on June 24 and would provide discretionary funding at $3.7 billion below the FY 2015 level. The bill also includes numerous policy riders. The House bill included spending cuts and select increases similar to those in the Senate bill:
- LABOR: Includes a 2% cut for the Employment and Training Administration that helps to implement Workforce Innovation and Opportunity Act (WIOA) programs.
- HHS: Includes a $344 million cut for CMS.
- EDUCATION: Includes a cut of $2.8 billion to the Department of Education. However, this includes an increase of $12 billion (4.3%) for IDEA grants to states.
See the funding levels for specific disability related programs.
Last week, the Centers for Medicare & Medicaid Services (CMS) released Frequently Asked Questions (FAQs) related to Home and Community-Based Services (HCBS) Settings Rule. The guidance focuses on the process for states to use in overcoming the presumption that certain settings have the characteristics of an institution, and highlights the heightened scrutiny review that CMS will give such information submitted from states.
Last week, the Centers for Medicare & Medicaid Services (CMS) released a notice of proposed rulemaking toward modernization of the Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations and to update the programs’ rules and strengthen beneficiary services. For more information, including summaries of key provisions of the proposed rule, visit medicaid.gov. Staff from The Arc will be reviewing the regulations and providing comments. The deadline to submit comments is July 27, 2015.
Last week, the Centers for Medicare and Medicaid Services (CMS) released a report titled “The Right Supports at the Right Time: How Money Follows the Person (MFP) Programs Are Supporting Diverse Populations in the Community.” This report examines how six MFP grantees are serving populations with diverse needs in the community and the factors that have contributed to their performance on key outcome measures. The report is available here.
Last week, the deadline for states to submit their transition plans to CMS outlining how they will come into compliance with the HCBS Settings Rule passed. Several states have yet to submit their final plans; in fact some states are still collecting public comment in response to their proposals. CMS has not yet approved any of the transition plans which have been submitted for consideration. Federal resources and state by state details, including draft and final plans, can be found at www.hcbsadvocacy.org. The Arc will continue to monitor this issue.
Last week, the Centers for Medicare & Medicaid Services (CMS) provided updated portions of the CMCS Home and Community-Based Services (HCBS) Toolkit: the HCBS Basic Element Review Tool for Statewide Transition Plans and the HCBS Content Review Tool for Statewide Transition Plans. The full HCBS toolkit, including the updated portions, is available online at http://www.medicaid.gov/hcbs/
The Arc is pleased to share a new Q&A document designed to be a resource to assist advocates understand the impact of the HCBS Settings Rule as the March 17, 2015 deadline for states to submit a transition plan to the Centers for Medicare and Medicaid Services (CMS) approaches. The document provides answers to frequently asked questions about the Rule as well as links to primary source documents and additional information members of The Arc may find helpful as they advocate for the full inclusion and community participation of people with I/DD.
Marilyn Tavenner, the chief administrator for the federal agency that oversees Medicaid, Medicare and most of the Affordable Care Act is resigning at the end of the month. She was confirmed overwhelmingly by the Senate in May, 2013 and oversaw the roll out of the Affordable Care Act. Prior to her announcement, several other key leaders at CMS had resigned including Cindy Mann, who was the Deputy Administrator and Director of the Center for Medicaid and CHIP Services. Under the leadership of Ms. Tavenner and Ms. Mann, several important initiatives were advanced and there was increased openness to working with advocates and stakeholders.
Last week, the Centers for Medicare & Medicaid Services (CMS) announced several changes to the Medicaid.gov website including a new home page with quick links including federal policy guidance and other new technical assistance resources. Additionally, they have expanded State Medicaid and CHIP profiles to provide a more complete picture of the many policy and programmatic features that make up each state’s Medicaid and CHIP programs. New elements include a state-specific list of approved state plan amendments and waivers and links to detailed Medicaid managed care profiles.