States are moving forward with changes to their Medicaid programs amid uncertainty about federal financing, according to a Medicaid budget survey.
The survey was conducted by the Kaiser Family Foundation and Health Management Associates, in collaboration with the National Association of Medicaid Directors, for state fiscal years 2017 and 2018. Participants included Medicaid officials in all 50 states and Washington, D.C.
Here are five findings from the survey.
1. Some states are seeking section 1115 Medicaid waivers for fiscal year 2018 that will allow them to test different Medicaid eligibility policies. Eligibility policies proposed by states include implementing work requirements for beneficiaries, eliminating retroactive eligibility, and no longer allowing Medicaid expansion coverage for people with incomes above 100 percent of the federal poverty level, according to the survey. Arkansas, Indiana, Iowa, Maine, and Utah are among states seeking waivers.
2. Twenty-one states are requiring managed care organizations to screen beneficiaries for social needs in fiscal year 2018 compared to 19 states in fiscal year 2017. The survey found states are also increasingly requiring MCOs to "provide care coordination pre-release to incarcerated individuals" and "use alternative payment models to reimburse providers."
3. Three states said they are planning for new provider taxes in fiscal year 2018 and 13 states plan provider tax increases, according to the survey.
4. The survey showed 26 states expanded or enhanced covered Medicaid benefits in fiscal year 2017 and 17 states plan to expand or enhance benefits in fiscal year 2018, "most commonly for behavioral health/substance use disorder services and dental services."
5. Thirteen states said they changed copayment requirements in either of the fiscal years. According to the survey, this included new or increased copayments for enrollees with income above 100 percent of the federal poverty level, for nonemergency use of a hospital emergency department, and pharmacy.
Read the full survey results here.