American Medical News Quotes Deborah Bachrach on Maintenance-Of-Effort Requirement
"States Eye Leveraging Health Reform Ruling to Cut Medicaid Eligibility"
American Medical News
July 23, 2012 - American Medical News interviewed Manatt's Deborah Bachrach, a special counsel in the firm's Healthcare Division, on "maintenance-of-effort" requirements, which were established under the most recent federal stimulus law and later extended under the health reform law.
As reported by American Medical News, several states are reading the U.S. Supreme Court's decision on the Affordable Care Act's (ACA's) Medicaid expansion to also mean that states no longer need to go through a waiver process to tighten current Medicaid eligibility standards.
Maine is one state that is challenging the validity of the maintenance-of-effort requirements, which call for states to maintain certain eligibility levels for all existing adult Medicaid beneficiaries until 2014, and all children in Medicaid and the Children's Health Insurance Program until 2019.
Bachrach told the publication that as soon as Maine certifies it is operating a health insurance exchange through which consumers can buy private insurance, the eligibility maintenance-of-effort requirement goes away. "But until then, it's in place, as much as the other provisions of the ACA that related to Medicaid. All the requirements to streamline eligibility, to interface with the exchange, the extra dollars for primary care rates ... those hold and nothing changes," she said.
The U.S. Department of Health and Human Services will have 90 days in which to respond to or ask about Maine's state plan amendment. "During that time period, I would envision a dialogue with the state," Bachrach added.
Read the article here.