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The Henry J. Kaiser Family Foundation

How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will…

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The Henry J. Kaiser Family Foundation

Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to…

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The Henry J. Kaiser Family Foundation

Health Insurance Market Reforms: Rate Review

Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the…

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The Henry J. Kaiser Family Foundation

Medicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS’s March 23, 2012 Final Rule

This brief provides a summary of the Centers for Medicare and Medicaid Services’ (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan. 1, 2014, lays out procedures for states to implement the Medicaid expansion…

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The Henry J. Kaiser Family Foundation

Quick Take: An Update on the ACA & HIV: Medicaid Health Homes

We recently wrote about the different ways in which the Affordable Care Act (ACA) changes pathways to health insurance coverage for people with HIV, and chronicled these specifics, as well as several outstanding questions, in a policy brief.  As we noted, among the many provisions of the ACA designed to…

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The Henry J. Kaiser Family Foundation

Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group…

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The Henry J. Kaiser Family Foundation

State Exchange Profiles: Alabama

Final update made on December 4, 2012 (no further updates will be made) Establishing the Exchange Despite previously supporting Alabama’s implementation of a state-based health insurance exchange, Governor Robert Bentley (R) announced on November 13, 2012, the state will default to a federally-facilitated exchange.1 Prior to the decision, Governor Bentley…

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The Henry J. Kaiser Family Foundation

Medicaid’s Role for Women Across the Lifespan: Current Issues and the Impact of the Affordable Care Act

This issue brief, Medicaid’s Role for Women Across the Lifespan: Current Issues and the Impact of the Affordable Care Act, discusses the importance of Medicaid for women and examines how changes under the health reform law will affect the program and women covered by Medicaid. The brief explores Medicaid’s role for women across their lifespans including reproductive health services, care for chronic conditions and disabilities, and long-term care services. And it provides new state-level data on enrollment and coverage policies on services of importance to women.

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The Henry J. Kaiser Family Foundation

Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and…

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The Henry J. Kaiser Family Foundation

Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses…

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