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  • Trump Officials Reject Medicaid Lifetime Limits in Kansas  The Hill by Peter Sullivan — The Trump administration announced Monday that it is rejecting Kansas's request to impose lifetime limits on Medicaid benefits, drawing a line against a new level of conservative changes to the program. The administration has already approved work requirements in Medicaid, a controversial move in itself, but Monday's decision indicates that time limits on Medicaid coverage go too far for the Trump administration. "We have determined that we will not approve Kansas' recent request to place a lifetime limit on Medicaid benefits for some beneficiaries," Centers for Medicare and Medicaid Services Administrator Seema Verma said Monday in a speech at a meeting of the American Hospital Association.

  • New Hampshire Medicaid Expansion Work Requirement Approved by Washington  Concord Monitor by Ethan DeWitt — Federal authorities have approved New Hampshire's request to add a work requirement to the Medicaid expansion program, the governor's office announced Monday, clearing away a major barrier for reauthorization of the program. In a letter to the state released Monday afternoon, the U.S. Centers for Medicare and Medicaid Services Administrator Seema Verma said the agency will greenlight a waiver sent by the state last year. The waiver means individuals between the ages of 19 and 64 will need to participate in at least 100 hours a month of "community engagement activities" — which can include employment, community service or job training. The mandate includes numerous exceptions, including for people with children up to age 12 and those with disabilities.

  • Illinois Wins Medicaid Flexibility Under Trump Modern Healthcare by Kristen Schorsch — Illinois Gov. Bruce Rauner has received federal approval to use $2 billion in Medicaid funding differently, a longtime goal that his predecessor Pat Quinn originally sought. The state plans to boost behavioral health services and combat the fast-paced opioid crisis as part of the new Better Care Illinois Behavioral Health Initiative. After all, about 25 percent of low-income and disabled people on Medicaid in Illinois have behavioral health needs, but they account for 52 percent of all spending, according to the state.

  • Medicaid Managed Care: Lots of Unanswered Questions (part 1)  Health Affairs by Jeff Goldsmith, David Mosley, and Anne Jacobs — Enrollment of the nation's 74 million Medicaid recipients in managed care plans continues to increase. By 2016, an estimated 71 percent of Medicaid recipients were receiving their care via private health plans, both investor-owned and nonprofit. The theory behind this shift is that managed care plans can do things that state Medicaid agencies cannot, such as use sophisticated network contracting, information technology, and utilization management systems to squeeze out low-value care and improve the health of beneficiaries. However, recent revelations about Medicaid managed care contracting raise legitimate policy questions. Recent reports that managed care contractors in California's vast 13.3 million-person Medi-Cal program earned $5.4 billion in profits on their contracts in 2014 and 2015 (the first two years of the Affordable Care Act coverage expansion) have raised questions about the value proposition for taxpayers.

  • GOP Senator Calls for Mandatory Medicaid Work Requirements  The Hill by Nathaniel Weixel — Republican Sen. John Kennedy (La.) on Thursday said Medicaid work requirements should be mandatory for states, and the Department of Health and Human Services (HHS) should take the lead to make it happen. During a hearing on the HHS budget, Kennedy said many Medicaid beneficiaries who aren't working "would like to know the dignity of work" noting he would like to see HHS work with Congress to put together a program that would institute a mandatory requirement that Medicaid beneficiaries work 20 hours a week. "I appreciate that [the Centers for Medicare and Medicaid Services] is willing to grant waivers, but why don't we take the next step?" Kennedy said, adding separately that "it's not going to be optional for governors." The Trump administration has been encouraging states to apply for waivers that would allow them to institute work requirements on Medicaid recipients — a policy that was denied by the Obama administration.

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