MACStats: Medicaid and CHIP Data Book
This 2020 edition of the MACStats: Medicaid and CHIP Data Book presents the most current data available on Medicaid and the State Children’s Health Insurance Program (CHIP), two programs that provide a safety net for low-income populations who otherwise would not have access to health care coverage and that cover services other payers often do […]
Louisiana Title XIX State Plan Approval
This document is a letter from the Office of the Secretary for Louisiana Department of Health to the Director of Medicaid and CHIP Operations Group approving Louisiana Title XIX State Plan Material. The purpose of this State Plan Amendment is to implement coverage of community health worker (CHW) services to address health related chronic diseases.
Kentucky House Bill 525: An Act relating to community health workers – Unofficial Draft
This is a draft of Kentucky House Bill 525, which calls for the Kentucky House to create a new section of KRS Chapter 205 to require Medicaid reimbursement for certain services provided by certified community health workers; create new sections of KRS Chapter 309 to establish community health worker certification; amend KRS 205.6497 to require […]
Research interests, experience, and training of Community Health Workers: a mixed Method Approach
The Affordable Care Act includes a call for community health care workers (CHWs) to be integrated into health care delivery systems to improve health care quality. In recent years, there have been increasing calls for community-based participatory research (CBPR) and patient-centered outcomes research (PCOR), as such types of research hold much potential for identifying interventions […]
Don’t change who we are but give us a chance: confronting the potential of community health worker certification for workforce recognition and exclusion
For community health workers (CHWs) and promotores de salud (CHWs who primarily serve Latinx communities and are grounded in a social, rather than a clinical model of care), the process of certification highlights the tension between developing a certified workforce with formal requirements (i.e., certified CHWs) and valuing CHWs, without formal requirements, based on their […]
Medi-Cal Explained: How Health Centers are Paid
CommunityhealthCentersand Federally QualifiedHealth Centers in California are an integral part ofthe delivery system and provide access to care formillions in vulnerable populations. This systemis often referred to as the “safety net.” FederallyQualified Health Centers (FQHCs) are paid for thecare they provide to Medi-Cal enrollees througha complicated structure governed by state andfederal law. This issue brief […]
Optional Targeted Case Management Services – Basis, Scope, and Purpose
The Consolidated Omnibus Budget Reconciliation Act (P.L. 99-272, COBRA) added §§1915(g)(1)and (g)(2) to the Act. These sections add optional targeted case management services to the list of services that may be provided under Medicaid. Section 1895(c)(3) of the Tax Reform Act of 1986(P.L. 99-514) added case management services to the list of services in §1905 […]
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 […]
State Medicaid Approaches to Doula Service Benefits
Maternal mortality rates continue to increase in the United States, with significant racial, ethnic, and socioeconomic disparities in birth outcomes. States are using a variety of approaches to provide doula services within their Medicaid programs to address inequities. Doulas provide continuous physical, emotional, and information support to people before, during, and shortly after child birth. […]
The MassHealth Proposed Demonstration Extension 2022-2027: Building on Success, Focusing on Equity
MassHealth is Massachusetts’ combined Medicaid program and Children’s Health Insurance Program (CHIP), providing coverage to more than one in four Massachusetts residents. Each state runs its own Medicaid program and those programs must meet certain federal standards unless the state obtains a “demonstration waiver” from the Centers for Medicare and Medicaid Services (CMS), the federal […]