Rule Implements|Provisions of Obamacare

     WASHINGTON (CN) – The Centers for Medicare and Medicaid Services (CMS) is considering new statutory eligibility provisions and changes that would provide states more flexibility to coordinate Medicaid and the Children’s Health Insurance Program (CHIP).
     A more coordinated effort would allow for improvements in the areas of “eligibility notices, appeals and other related administrative procedures with similar procedures used by other health coverage programs authorized under the Affordable Care Act,” the CMS stated.
     The agency, which exists under the U.S. Department of Health and Human Services, said the proposed provisions and changes would also modernize and streamline existing rules while doing away with ones that are obsolete.
     It also updates Medicaid “eligibility pathways; revises the rule relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; implements other CHIPRA eligibility-related provisions, including eligibility for newborns whose mothers were eligible for and receiving Medicaid or CHIP coverage at the time of birth; and amends certain provisions included in the ‘State Flexibility for Medicaid Benefit Packages’ final rule published April 30, 2010; and implements specific provisions including eligibility appeals, notices and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges.
     CMS also has proposed updates that would simplify complex Medicaid premium and cost sharing requirements. The idea is push the most effective use of services while assisting states in identifying cost sharing flexibilities.

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