Medicaid Issues

Worked with AL state medical assoc to extend Medicaid in postpartum period to 12 months.

2022 CA expanded Medicaid access to all income-eligible (138% poverty) Californians regardless of immigration status, including undocumented.

Medicaid must pay care for pediatrics at Medicare rates.

2024: increase Medicaid to Medicare rates for all specialties treating Pediatric Medicaid Patients. FL has not expanded Medicaid eligibility under the Affordable Care Act. More individuals are utilizing federal health exchange plans.

None active. Potential inclusion of Medicaid expansion in larger certificate of need legislation.

No EM-specific legislation.

015 Iowa privatized Medicaid, now run by multiple MCO companies. Significant claims denials and delays and reimbursement rate issues since. Constant fixes pursued; a third MCO company is coming online in 2023.

MassHealth’s priority in this session is its eligibility redetermination process: Starting April 1, 2023, MassHealth will begin the eligibility redetermination process, renewing all 2.3M members over the following 12 months. This will generally be the first time members are at risk of losing their coverage since February 2020.

In preparation for this effort, MassHealth has increased staffing significantly to handle a greater volume of calls and applications, improved our systems to automatically renew as many members' coverage as possible, and is working in close collaboration with health plans, providers, and other stakeholders.

Grassroots efforts planned this year to renegotiate Medicaid reimbursement (already a two-tiered system). December 2023 Update: only in budget proposal in February 2024.

MNACEP is part of a coalition working on opportunities to leverage additional Federal money for both Medical education and patient care.

The upcoming 2024 session will mark the introduction of the Medicaid "Technical Amendments" Bill, with ongoing deliberations among leadership regarding potential creative expansions to the Medicaid program. Mississippi's Medicaid program is heavily codified, and lawmakers are likely to consider several changes - from tweaks to major reforms - in 2024 as they extend the statute's "sunset" provision.

Considering in 2023 the extension of postpartum care to 12 months.

Expanding postpartum to 12 months.

No changes since ACA expansion.

Approximately 33% of the New Mexicans are covered under Medicaid, the highest in the country. This payer mix leads to lower annual reimbursement compared to other states for routine and common medical care.¹

Federal OIG Audit from 2014-2015 found overpayment to capitated payments for CB services. Recommendations by the OIG were made and there is a dispute in recapturing the overpayments.²

NC is one of the few States that has not expanded Medicaid. Although Leadership in both the House and Senate agree we should - they are in a battle over what other issues to add to the bill. House Bill 76 has been filed, and we expect a Senate bill with other Health Care issues attached.

Ohio ACEP met with Medicaid and submitted comments on the Medicaid Fee Schedule. Due to these efforts, Medicaid is increasing reimbursement of CPT codes 99281–99285 by roughly 6%.

Critical care fees will increase roughly 24-57%. Additionally, Medicaid made significant increases in reimbursement for transportation services.

Oregon's current OHP 1115 Medicaid Demonstration runs from Oct. 1, 2022 through Sept. 30, 2027. It advances OHA's goal of eliminating health inequities by 2030, exploring different ways to affect health outcomes for communities and groups that have been disproportionately affected by health inequities in our state.

PA is an expansion state: PACEP leads Medicaid support as part of a broad coalition of provider and delivery organizations; educational sessions to PA Assembly and PA US Congressional delegations.

Very active in advocating for increased reimbursement, however due to the current local catastrophe regarding the deterioration of one of our main bridges into Providence (*currently under investigation by DOJ) all increased funding is on hold. (Rates have not been updated in many years.)

Just passed medicaid expansion as a ballot measure, but has yet to take effect.

No expansion of Medicaid (TennCare). Please refer to Mental Health.

Have not adopted Medicaid expansion.

Legislation was proposed to increase Medicaid rates to at least Medicare equivalents for services delivered by all physicians, including emergency physicians.

1/1/24: Increase for Medicaid reimbursement in 2024 budget and permanently, implemented Jan 1. Medicaid rates now 40% of Medicare fee schedule (applied to 99281-99285 only).

Gov repeatedly supports expansion, doesn't get legislative traction; Achieved an increase in Medicaid reimbursement for emergency services in 2021, implemented in 2022. We are working now for another increase in the budget coming up to be implemented in 2024.