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Distribution of CARES Act Funding Among Hospitals

This brief analyzes the distribution of $50 billion in CARES Act funding for providers and shows that the distribution formula selected by the Department of Health and Human Services favored hospitals with a relatively high share of revenue from private insurance. Hospitals that see a smaller share of patients with private insurance and instead see more patients with Medicare or Medicaid received less funding per hospital bed.

Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19

Recent federal legislation, the Families First Coronavirus Response Act, amended by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, authorizes a 6.2 percentage point increase in federal Medicaid matching funds to help states respond to the COVID-19 pandemic. This issue brief answers key questions about the new federal funds, drawing on two sets of frequently asked questions about the Families First Coronavirus Response Act and CARES Act issued by the Centers for Medicare and Medicaid Services (CMS).

Breaking Down the U.S. Global Health Budget by Program Area

The U.S. government is the largest donor to global health in the world. This fact sheet breaks down the U.S. global health budget by program area: HIV/PEPFAR; tuberculosis (TB); malaria/the President’s Malaria Initiative (PMI); the Global Fund to Fight AIDS, Tuberculosis, and Malaria; maternal & child health (MCH); nutrition; family planning & reproductive health (FP/RH); global health security; and neglected tropical diseases (NTDs).

Implications of CMS’s New “Healthy Adult Opportunity” Demonstrations for Medicaid

On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to Medicaid eligibility, benefits, delivery systems, and program oversight. In exchange, states would agree to a limit on federal financing in the form of a per capita or aggregate cap. States that opt for the aggregate cap and meet performance standards could access a portion of federal savings if actual spending is under the cap. This issue brief explains the key elements of the HAO guidance and considers the implications of the new demonstrations.

What You Need to Know About the Medicaid Fiscal Accountability Rule (MFAR)

On November 18, 2019, the Trump Administration released a proposed rule called the Medicaid Fiscal Accountability Regulation (MFAR). This brief provides some context on Medicaid financing, an overview of current state payment and financing rules, the provisions in the rule and potential implications for considerations.

Medicaid Program Integrity and Current Issues

Medicaid is a large source of spending in both state and federal budgets, making program integrity efforts important to prevent waste, fraud, and abuse and ensure appropriate use of taxpayer dollars. This brief explains what program integrity is, recent efforts at the Centers for Medicare and Medicaid Services (CMS) to address program integrity, and current and emerging issues.

Why it Matters: Tennessee’s Medicaid Block Grant Waiver Proposal

On November 20, 2019, Tennessee submitted an amendment to its longstanding Section 1115 Waiver that would make major financing and administrative changes to its Medicaid program. The Centers for Medicare and Medicaid Services (CMS) certified the waiver as complete and opened a federal public comment period through December 27, 2019. Most significantly, Tennessee is requesting to receive federal funds in the form of a “modified block grant” and to retain half of any federal “savings” achieved under the block grant demonstration. This brief provides a high-level overview of the proposed waiver changes and context for why these changes matter.

Two Medicaid-Related Initiatives That Help Promote Long-Term Care at Home and in the Community, Rather Than in Institutions, Are Set To Expire at the End of December

Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs. While there does not appear to be substantive disagreement over…