Guidance
Health Care Reform: State Allocations
May 11, 2012
Provides state-by-state allocations of health care reform funding. This document will be updated periodically to reflect the release of new grant awards.
Expansion of Recovery Audit Contractor (RAC)
October 1, 2010
The Centers for Medicare and Medicaid Services (CMS) issued preliminary guidance on Section 6411 of the Affordable Care Act (ACA), which requires states to establish programs to contract with RACs to audit payments to Medicaid providers by December 31, 2010. To view the guidance, click here: http://www.cms.gov/smdl/downloads/SMD10021.pdf
Medicaid Prescription Drug Provisions
September 28, 2010
CMS issued guidance to states that revises the previous instructions concerning the federal offset of Medicaid prescription drug rebates and provides additional information on the offset rebate methodology, rebates for Medicaid Managed Care Organization (MCO) drugs, and other related items. The guidance is available at: http://www.cms.gov/smdl/downloads/SMD10019.pdf
Fraud Prevention
September 20, 2010
CMS released a proposed rule that includes new provider screening and enforcement measures to help prevent fraud and strengthen Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). In addition, the proposed rule contains new authority to suspend payments to providers based on credible allegations of fraud. To view the regulations, see http://www.ofr.gov/OFRUpload/OFRData/2010-23579_PI.pdf
Medicaid Demonstration
September 17, 2010
CMS published a proposed rule to implement provisions in ACA that set forth transparency and public notice procedures for pilot and demonstration projects approved under section 1115 of the Social Security Act related to Medicaid and CHIP. Comments must be received by November 16, 2010. The proposed rule is available at: http://edocket.access.gpo.gov/2010/pdf/2010-23357.pdf
Hospice Care for Children
September 9, 2010
CMS issued guidance on the provision in ACA that removed the prohibition of receiving curative treatment upon the election of the hospice benefit by or on behalf of a Medicaid or CHIP-eligible child. To view the guidance, see: http://www.cms.gov/smdl/downloads/SMD10018.pdf
National Correct Coding Initiative
September 1, 2010
CMS issued guidance on the ACA provisions related to the mandatory state use of the NCCI. The guidance is available at: http://www.cms.gov/smdl/downloads/SMD10017.pdf
FDA Menu and Vending Machine Laws
August 25, 2010
The Food and Drug Administration released guidance on the effect of ACA on state and local menu and vending machine labeling laws. Additional information can be found at: http://edocket.access.gpo.gov/2010/pdf/2010-21067.pdf
Home- and Community-Based Services
August 6, 2010
CMS released a State Medicaid Director Letter (SMDL) to provide information on the changes included the health care reform law, effective October 1, 2010, to improve access to home- and community-based services. Click here to see the letter: http://inside.ffis.org/ff/ImprovedAccesstoHCBS_SMD_letterFinal_8-6-10_1.pdf
Preventive Care
July 19, 2010
The departments of HHS, Labor, and Treasury issued regulations requiring new private health plans to cover evidence-based preventive services and eliminate cost sharing requirements for such services: http://www.hhs.gov/ociio/regulations/prevention/index.html