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September 2, 2022

Around the nation: CMS proposes changes to enrollment process for CHIP, Medicaid, and BHPs

Daily Briefing

    CMS proposed changes to the enrollment process for CHIP, Medicaid, and Basic Health Programs (BHPs), in today's bite-sized hospital and health industry news from Connecticut, the District of Columbia, and Maryland.

    • Connecticut: Cigna on Tuesday named David Brailer as its new EVP and chief health officer, effective early September. As the organization's first chief health officer, Brailer will find new ways to drive value through the company's products, technologies, and services. He will report to Cigna chairman and CEO David M. Cordani and will serve on the Enterprise Leadership Team. "I am thrilled to have Dr. Brailer join our company at a time when advancing our strategy to make health care more affordable, predictable, and simple has never been more important," Cordani said. "Our customers, patients, and clients are counting on us to lead breakout change and improvement in health care. With his proven expertise in care delivery, information technology, innovation, and public policy, Dr. Brailer is an invaluable addition to our team." (Cigna news release, 8/30)
    • District of Columbia: The Department of Justice (DOJ) charged former lab owner Daniel Hurt with allegedly submitting 350,000 fraudulent claims, totaling $53.3 million, to Medicare between January 2019 and October 2021. Hurt, who owned labs in Texas, Florida, and California, allegedly received at least $26.9 million of the Medicare reimbursement. According to DOJ, Hurt hid the payments in fake marketing contracts. He is also facing charges in cases pending in federal courts in Pennsylvania and Florida. (Kacik, Modern Healthcare, 8/31)
    • Maryland: CMS on Wednesday issued a proposed rule that would change the enrollment process for CHIP, Medicaid, and BHPs—a move that could improve access to care for millions of Americans. Under the proposed rule, commonsense eligibility and enrollment requirements would be standardized. For instance, renewals would be limited to once every 12 months, with renewal forms that have certain pre-populated information. Ultimately, the proposed rule would create a clear, uniform renewal process in all states. "This proposed rule will ensure that these individuals and families, often from underserved communities, can access the healthcare and coverage to which they are entitled—a foundational principle of health equity," said CMS Administrator Chiquita Brooks-LaSure. "Medicaid and CHIP provide essential health care to millions of families across the country, and we are making it easier to enroll children and others in health insurance and to maintain coverage," said HHS Secretary Xavier Becerra. "With these steps, we're delivering on our promise to make high-quality health care more accessible and affordable for all Americans." (Goldman, Modern Healthcare, 8/31; CMS press release, 8/31)

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