Front Page

Earlier this year, the U.S. Supreme Court’s decision in Gobeille v. Liberty Mutual dealt a blow to the 18 existing state-run all-payer claims databases (APCDs) by holding that ERISA prevents states from compelling self-funded insurers to report to their data systems. In response to the Court’s decision, a number of state APCDs and/or payers have […]

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  • Publications

    A growing number of states are administering Medicaid managed care contracts that include both medical and dental services. In 2015, Kentucky identified dental services as one of seven key areas where the state wanted to achieve measurable improvement in its Medicaid managed care contracts. This case study examines the history of dental managed care in […]

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    April 29, 2016 | Filed under: Front Page, Kentucky, Medicaid, Oral Health, Publications
  • State Health Policy Blog

    On April 25, the Centers for Medicaid and Medicare Services (CMS) released a long-awaited final rule that updates the regulations for managed care organizations in the Medicaid and Children’s Health Insurance Programs (CHIP). These new requirements represent the first major updates to Medicaid and CHIP managed care since 2002. In the intervening years, the percentage […]

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  • State Health Policy Blog

    Governor Paul LePage signed into law “An Act to Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program” (now PL 2015, c. 488) on April 19, 2016, making Maine the second state to pass legislation on the issue this year. In March, Massachusetts passed the nation’s first law limiting first-time opioid prescriptions. Maine’s […]

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  • Publications

    As the scope of State Medicaid agencies becomes wider and more complex, states are increasingly turning to managed care organizations (MCOs) to cover Medicaid enrollees, including those with complex needs. This shift from a fee-for-service, volume-based payment model requires states to effectively manage MCOs and other vendors. With states facing tight budgets, limited staff, and […]

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    April 19, 2016 | Filed under: Front Page, Medicaid, Ohio, Payment Reform, Publications, Tennessee
  • Publications

    As the newly insured use their coverage, increased scrutiny is being drawn toward the experiences of consumers who are receiving care. One issue of growing concern is the accumulation of medical debt, even among the insured. According to a recent study from the Kaiser Family Foundation, more than a quarter of adults in the United […]

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    April 11, 2016 | Filed under: Front Page, Publications
  • State Health Policy Blog

    Engaged in multi-payer payment reforms? Seeking information about the cost of care? About the rate of opioid prescribing? Assessing carriers to generate needed revenue to support state activities like vaccines for children? You might soon hit a federal stoplight. The Supreme Court’s recent decision in Gobeille v Liberty Mutual, which denied the state’s ability to […]

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  • Publications

    States have made great strides in providing children in families with low-to-moderate income appropriate and affordable health coverage over the past two decades through Medicaid and the Children’s Health Insurance Program (CHIP). The Affordable Care Act (ACA) created new coverage options for other populations, including parents who were previously uninsured. However, the ACA also includes […]

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    March 29, 2016 | Filed under: Children's Health, Front Page, Publications
  • State Health Policy Blog

    According to 2014 Census data more than half (61 percent) of all children in the United States are covered by private insurance, and 43 percent have public coverage (some children with private insurance are also enrolled in Medicaid.) Over the years many efforts, including much of the children’s coverage work at NASHP, have focused on […]

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    March 28, 2016 | Filed under: Children's Health, Front Page, State Health Policy Blog
  • Publications

    Every open enrollment affords the health insurance marketplaces new opportunities to introduce innovative ways to improve their systems while lowering costs. For the 2015-16 open enrollment season, DC Health Link, the District of Columbia’s health insurance marketplace, levied such an opportunity by transferring their marketplace onto a new open source code solution. Agile, efficient, and cost effective, open […]

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