Medicaid Services Manual Transmittal Letter

Revisions to Medicaid Services Manual (MSM) Chapter 600 – Physician Services are being proposed to add a new provider type (PT), Doulas. This isa result of the passage of Assembly Bill(AB) 256 and Senate Bill (SB) 420 during the 81st Legislative Session. Doula services include education, emotional and physical support during pregnancy, labor, delivery, and […]

Using Implementation Science to Promote Integration and Sustainability of Community Health Workers in the HIV Workforce

Community health worker (CHW) interventions are an evidence-based practice adopted by health care settings to increase retention in care and viral suppression for people living with HIV(PLWH) from racial/ethnic minority communities. However, disparate funding, unclear roles vis a vis other care team members, limited training and promotion opportunities, and a lack of standards for wages […]

New Jersey FamilyCare Comprehensive Demonstration Draft Renewal Proposal

This is a draft of a renewal proposal for New Jersey FamilyCare Comprehensive Demonstration, which governs the operations of significant components of New Jersey’s Medicaid program and Children’s Health Insurance Program (CHIP). This section in particular focuses on a Community Health Worker Pilot Program. The Division of Medical Assistance and Health Services (DMAHS), in partnership […]

Nevada State Plan Amendment 21-0012

This amendment proposes to add doulas, community health workers, and registered pharmacists with corresponding reimbursement methodologies to the Medicaid state plan.

Understanding Medicaid Section 1115 Waivers: A Primer for State Legislators

While the national health care debate continues, states continue to design and improve their Medicaid programs working within the flexibility allowed under existing federal Medicaid law, using longstanding tools such as Section 1115 waivers to best meet their state’s unique needs. This primer is designed to make that job easier by answering the eight most […]

MediCal Explained: What Are Alternative Payment Models?

Over the past decade, the Centers for Medicare & Medicaid Services (CMS) has increasingly used health care provider payment reforms that encourage better value in the health care system. These payment reforms are known as alternative payment models (APMs) and are defined as a provider payment method that uses financial incentives for the provision of […]