Economy

Some states seek to change Medicaid eligibility requirements, plan to expand coverage

Some states seek to change Medicaid eligibility requirements, plan to expand coverage”

At the same time, total Medicaid spending grew by 3.9 percent in fiscal 2017, a slight acceleration from 3.5 percent growth the prior year, though slower than the 10.5 percent growth in 2015.

Although Medicaid's future path remains uncertain, most states plan to raise their provider rates for their programs this fiscal year, according to a Kaiser Family Foundation survey of state directors. Several states are going in the opposite direction with standards which could restrict eligibility, such as work requirements and elimination of retroactive eligibility. The trend is one of the reasons that state Medicaid spending increased 3.5% between fiscal years 2016 and 2017.

Other expanded benefits include OR becoming the first Medicaid program to cover oral contraceptives prescribed by a pharmacist and four states-Louisiana, New York, South Dakota and Virginia-which added cancer screening benefits such as paying for genetic testing for the BRCA breast cancer gene mutation. "Overall, we had more states that increased rates than decreased rates, suggesting a bit more economic stability", said Kathy Gifford, a principal at Health Management Associates, which helped conduct the survey. Virginia also added coverage lung cancer screening with low dose computed tomography without prior authorization, and NY will cover digital breast tomosynthesis screening services in 2018.

States also signaled some concerns about potential budget crunches ahead, given that phasing out of federal contributions for expanded Medicaid programs as well as Congress' failure thus far to reauthorize the Children's Health Insurance Program and the uncertainty about Medicaid funding levels created by the GOP push to repeal and replace Obamacare. The survey found states are also increasingly requiring MCOs to "provide care coordination pre-release to incarcerated individuals" and "use alternative payment models to reimburse providers".



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