Thirty states have been conducting Medicaid and CHIP automatic renewals incorrectly, leading to many individuals being wrongly removed from coverage. Because of this, nearly 500,000 children and other individuals will have their coverage reinstated.

Some states may not be following federal requirements for the Medicaid renewal process, resulting in many individuals being wrongly removed from coverage, CMS said. Children may especially be affected.

Pediatricians and anyone who works with children should proactively reach out to their patients with resources and information about how to maintain coverage. Ask them to make sure their contact information is updated in state databases. Tell them to expect and respond to any communication from the state about their enrollment status.

By the end of March, Medicaid/CHIP enrollment will have grown by 23.3 million members since the start of the pandemic, according to a Kaiser Family Foundation report. This is largely due to the continuous enrollment provision enacted during the pandemic, which barred states from disenrolling members and is set to expire March 31.

The implementation of patient-centric, value-based, wrap-around services that empower provider organizations to care for the whole person is essential to lowering healthcare costs and improving the lives of the super-utilizer population.

The proposed rule would limit renewals to once every 12 months, allow applicants 30 days to respond to information requests and require consistent renewal processes across states. Currently, the enrollment and renewal process is burdensome and deters many Americans from enrolling even when they’re eligible, CMS said.

Based on historical data, about 17.4% of Medicaid/CHIP enrollees will leave the program once the Covid-19 public health emergency ends. This is because the continuous enrollment requirement, which prohibited states from disenrolling Medicaid participants, will halt.

CMS will provide $80 million to 60 organizations that train ACA navigators — who help consumers find coverage on the federally funded marketplaces — in the 2022 plan year, up from 30 organizations that received $10 million this year.

Enrollment in Medicaid and the Children’s Health Insurance Program has reached a record high, with 80 million now covered through these programs. The spike was largely driven by the economic downturn brought on by the pandemic and a federal requirement that prevents states from removing people from the programs until the public health crisis is over.

Use of mental health and substance use services fell by double digits last year for adults and children covered by Medicaid and CHIP, according to a report by the Centers for Medicare and Medicaid Services. 

CMS has increased the Medicare payment rate by $12 for administering single-dose Covid-19 vaccines and by $35 for two-dose vaccines. The payment increase aims to support providers as they ramp up vaccine administration.

New proposed rules from HHS would require government health plans and health plans sold on the federal ACA exchanges to give patients free access and control over their health information by 2020 and to implement an HL7 FHIR-based API to open up data access to third party apps and developers.

CHIP, which covers 9 million children from low-income families that earn too much to qualify for Medicaid, is mostly federally funded. But states operate the program within federal guidelines.

Seema Verma, the head of the Centers for Medicare and Medicaid Services, said the agency is making Medicare Advantage encounter data available to researchers. She made the announcement this week at the Health Datapalooza conference this week.

CHIP has had a dramatic effect in lower income states like Alabama, where the childhood uninsured rate dropped from 20 percent in 1997 to under 3 percent in 2015.

Here are some of the major health issues that are certain to come up in 2017.