| Medicaid

Please clarify that if a state opts to pay out to providers the rate increase

Read more about Please clarify that if a state opts to pay out to providers the rate increase

The final rule specifies that such payments must be made no less frequently than quarterly, as does the final preprint issued by the Centers for Medicare & Medicaid Services (CMS).

If a physician presents a certificate for CMS 2370-F eligibility from one of the defined

Read more about If a physician presents a certificate for CMS 2370-F eligibility from one of the defined

States may accept the certificate and need not verify. The Centers for Medicare & Medicaid Services (CMS) expects states to make physicians aware that they are responsible for providing accurate information.

AL-20-0006

Read more about AL-20-0006

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to increase reimbursement rates for Nursing Facilities during the COVID-19 state of emergency for all costs associated with staffing, supplies, social distancing standards, cleaning fees, etc. AL noted that this increase equates to approx. $20 per diem rate add-on payment for all NF's.

What is required under section 4004(i) of the Affordable Care Act? How does CMS assist states to meet these requirements?

Read more about What is required under section 4004(i) of the Affordable Care Act? How does CMS assist states to meet these requirements?

Section 4004(i) requires the Department of Health and Human Services (HHS) to provide guidance to states and health care providers regarding preventive and obesity-related services that are available to Medicaid enrollees, including obesity screening and counseling for children and adults.

It also requires states to design public awareness campaigns to educate Medicaid enrollees regarding the availability and coverage of preventive and obesity-related services, with the goal of reducing incidences of obesity.

What are preventive services and obesity-related services under section 4004(i) of the Affordable Care Act?

Read more about What are preventive services and obesity-related services under section 4004(i) of the Affordable Care Act?

Preventive services include immunizations, screenings for common chronic and infectious diseases and cancers, clinical and behavioral interventions to manage chronic disease and reduce associated risks, and counseling to support healthy living and self-management of chronic conditions, such as those associated with obesity. A list of preventive health care services recommended as Grade A or B by the U.S.

Are there guidelines for the state public awareness campaigns under section 4004(i) of the Affordable Care Act? Are funds available for this provision?

Read more about Are there guidelines for the state public awareness campaigns under section 4004(i) of the Affordable Care Act? Are funds available for this provision?

Affordable Care Act Section 4004(i)(2) calls for "state public awareness campaigns to educate Medicaid enrollees regarding availability and coverage of preventive and obesity related services with the goal of reducing incidences of obesity." The statute tasks states with designing the public awareness campaign because states have a better understanding of what outreach efforts will best meet the needs of their state Medicaid and CHIP population.

Would a state that has already shared information about Medicaid coverage of preventive services with

Read more about Would a state that has already shared information about Medicaid coverage of preventive services with

Yes, if a state has undertaken an initiative to provide information on Medicaid coverage of preventive services since the passage of the Affordable Care Act in March 2010 then they have met this requirement.

Supplemental Links:

This FAQ was released as part of a larger set. View the full set. (PDF, 86.67 KB)

How will a state determine a child's household composition when the child leaves the home

Read more about How will a state determine a child's household composition when the child leaves the home

CMS regulations at 42 CFR 435.603(f)(2) provide that the parents would be included in the child's household in this situation. However, if the parents do not intend to continue to claim the child as a tax dependent for the following tax year, states may alternatively use the option provided at 435.603(h)(3) to consider the child's move to the live with another caretaker relative as a "reasonably predictable change in income" and apply the non-filer rules to the child at 435.603(f)(3).

Is there a difference between the definition of Indian/Native American for Medicaid and the Exchange. Can you clarify what the difference is?

Read more about Is there a difference between the definition of Indian/Native American for Medicaid and the Exchange. Can you clarify what the difference is?

For purposes of eligibility for coverage through the Marketplace, the Affordable Care Act defines Indians as individuals who are members of a federally recognized Indian Tribe. The definition of Indian currently in use for Medicaid beneficiaries follows a broader definition that includes descendants of Indians and all American Indians and Alaska Natives.

What are some examples of income that is not considered taxable, and therefore excluded from MAGI?

Read more about What are some examples of income that is not considered taxable, and therefore excluded from MAGI?

Supplemental Security Income (SSI), Temporary Assistance to Needy Families (TANF), Veterans' disability, Workers' Compensation, child support, federal tax credits, and cash assistance are common types of income that are not taxable. Please see Question 5 below for additional details on veterans' benefits.

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