Monthly Archives: December 2023
Knicole Emanuel Presents Webinar January 25, 2024!
A Guide to the RAT-STATS Statistical Software in Medicare and Medicaid
Hosted by: Lorman
Click here to register for the webinar on January 25, 2024, from 1:00pm-2:30pm!
Join Nelson Mullins Raleigh partner Knicole Emanuel for a webinar hosted by Lorman on Jan. 25., 2024. Emanuel will be a speaker at the session entitled “A Guide to the RAT-STATS Statistical Software,” where attendees will learn about key considerations in interpreting sample size results for how to interpret and critically assess key factors influencing the extrapolation process, how to apply theoretical knowledge through practical exercises using RAT-STATS, how to develop a critical mindset for evaluating the reliability and replicability of results; and informed decision-making.
This webinar is available to attend live with available credits for ACHE, HFMA, AHIMA, and NASBA. There will also be an OnDemand Course for this presentation available.
CMS Issues Interim Rule in Response to State Medicaid Disenrollment Trend
When the COVID-19 Public Health Emergency (PHE) ended in April 2023, the Families First Coronavirus Response Act’s Medicaid continuous enrollment condition also came to an end. The condition had allowed States to claim a temporary monetary incentive for not disenrolling persons enrolled in Medicaid during the PHE, among other conditions. When this monetary incentive disappeared, many States moved quickly to disenroll recipients from the Medicaid program. In response to this trend, the Centers for Medicare & Medicaid Services (CMS) published an interim final rule (Rule) on Dec. 6, implementing reporting requirements and enforcement authorities created by the Consolidated Appropriations Act of 2023.
The Rule seeks to limit the extent to which states are removing Medicaid recipients from the program by instituting punishments for states that kick recipients out of the program for procedural reasons as opposed to eligibility considerations. For example, some states had been using procedural or administrative issues, such as the failure to renew within the required timeline or not updating contact information, as justification for disenrollment. Any noncompliance or failure to reinstate eligibility for affected individuals could subject the state to enforcement authorities, including requiring states to submit and participate in a corrective action plan, suspending disenrollments from Medicaid for procedural reasons, imposing fees on the state via civil money penalties, and applying a reduction to the State’s Federal Medical Assistance Percentage.
In order to promote transparency and hold States accountable for adhering to redetermination requirements, the Rule also requires that States submit to CMS a report on the activities of the State relating to eligibility redeterminations conducted between April 1, and June 30, 2024. The reports require several specific data elements, such as the number of eligibility renewals initiated or the number of individuals determined eligible for a qualified health plan, and CMS intends to make such reports public. Failure to follow reporting requirements could similarly result in enforcement actions taken against the State by CMS, including the application of a reduction to the State specific FMAP.
The regulations became effective on December 6, with public comments due by February 2, 2024. If you have questions about implications or requirements associated with the Rule, reach out to one of the authors.
By Cara N. Ludwig, Knicole Emanuel, Shane M. Duer, JD, CIPP/US
Medicaid Expansion Set To Take Effect In North Carolina Today!
The AP (11/30, Schoenbaum) reports that “hundreds of thousands of adults in North Carolina” are set to receive Medicaid benefits, “a development that boosters say will aid hospitals and local economies in addition to the long-term uninsured.” As of Friday, “more than 600,000 North Carolinians are ultimately expected to qualify, with roughly half to be automatically enrolled.” The AP notes that “a 2022 report from the National Center for Health Statistics estimated North Carolina’s uninsured population at 17.6%, significantly above the national average of 12.6%.”