The Centers for Medicare & Medicaid Services yesterday released two rules, one final and one proposed, to address eligibility and appeals processes for the Medicaid and CHIP programs. The final rule completes the agency’s work related to appeals, notices and Medicaid eligibility changes under the Affordable Care Act. Among the many provisions, the rule would provide pregnant women with continuous eligibility for pregnancy related services until the end of the month of the post-partum period. It also would provide continuous eligibility for hospitalized children through the end of the inpatient stay if he/she would otherwise lose eligibility due to age. The final rule takes effect Jan. 20. The proposed rule includes provisions to align the eligibility appeals processes between the Health Insurance Marketplaces and Medicaid, such as allowing Medicaid beneficiaries the same fair hearing appeals time frame allowed individuals through the Marketplaces. Comments are due on the proposed rule by Jan. 30. 

Related News Articles

Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
Annual premiums for employer-sponsored family health coverage in 2025 increased 6% over last year to $26,993, according to KFF’s annual Employer Health…
Headline
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans…
Headline
The AHA today released the Health Plan Accountability Update for the third quarter of 2025. The update covers the latest developments in Medicare…
Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…
Headline
Lindsey Fauveau, M.D., medical director of breast surgical oncology at Woman’s Hospital, shares how the hospital’s state-of-the-art mobile unit brings 3D…