CMS Proposes to Continue Medicaid Eligibility System Funding at 90% Match

CMS issued a proposed rule to allow Medicaid agencies to continue receiving an enhanced 90% federal match for the development of eligibility and enrollment systems and a 75% match for maintenance and operations. The enhanced match was previously set to expire on December 31, 2015. To receive the 90% match, states must conform to seven standards and conditions, which have been strengthened in the proposed rule, including a new standard on states to complete critical Modified Adjusted Gross Income (MAGI) based system functionality. The proposed rule allows for a 90% match for states implementing a Commercial Off the Shelf (COTS) system, an increase from the 75% match currently provided. Finally, the rule allows the Federal government to reduce funding to 50% immediately upon discovering a deficiency in the system, eliminating the current one-year waiting period.

President Obama Signs Medicare Access and CHIP Reauthorization Act into Law

The President signed the Medicare Access and CHIP Reauthorization Act (MACRA) into law on April 16, permanently repealing Medicare’s sustainable growth rate (SGR) formula and extending CHIP funding through 2017. MACRA replaces SGR with a five year period of stable annual updates of 0.5% to physician payments, at which point a new “Merit-Based Incentive Payment System” would go into effect. Upon signing, the President praised Congress’ bipartisanship and stated that he is proud to sign into law a bill which will protect coverage for millions of Americans. Read Manatt’s in-depth analysis of MACRA.