CMS rule shines light on Medicaid cost sharing, eligibility and appeals process as Obamacare rolls out

Share this article:

The Centers for Medicare & Medicaid Services has proposed a rule to clarify ways in which Medicaid will be coordinated under the Affordable Care Act rollout.

The rule, released Monday, describes how the eligibility notification and appeals process might operate. Applicants and beneficiaries would receive a single notice regarding their eligibility status for Medicaid, Children's Health Insurance Program or a qualified Exchange health plan, generated by just one of those agencies.

In an effort to give states flexibility in the eligibility appeals process, the rule provides two options for how appeals might work, including allowing states to handle appeals. Applicants would retain the right to appeal to the federal level.

The rule would give states the ability to eliminate cost sharing limits for non-emergency use of emergency departments for certain Medicaid enrollees. States could also increase cost sharing related to non-preferred drugs.

Click here to read the rule. It will be published in the Federal Register on January 22.

Share this article:

More in News

ACO bill in House would waive 3-midnight requirement for skilled nursing care

Certain Accountable Care Organizations would be able to send Medicare beneficiaries to a skilled nursing facility without a prior hospital stay under a bipartisan bill recently introduced in the House of Representatives.

Increasing staff-to-patient ratios improves nurse safety, researchers find

A law setting mandatory nurse-to-patient staffing ratios has reduced the number of workplace injuries for registered nurses and licensed practical nurses in California, according to recently published findings.

Life Care Centers takes Gold in Transitions category

Life Care Centers takes Gold in Transitions category

Life Care Centers of America has won the Gold Award in the McKnight's Excellence in Technology Awards in the Transitions category.