CMS Issues Two More Medicaid Guidance Docs: EHB, Emergency Triage and Transport

ANCOR is sharing two announcements by the Centers for Medicare and Medicaid Services (CMS) because Medicaid payments for emergency transportation and how essential health benefits are defined are highly relevant issues to people with disabilities.

As written by CMS:

“CIB: Medicaid Opportunities in the Emergency Triage, Treat, and Transport (ET3) Model

The Centers for Medicare & Medicaid Services (CMS) is issuing an Informational Bulletin that describes ways in which state Medicaid agencies can support the implementation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary, five-year Center for Medicare and Medicaid Innovation (Innovation Center) payment model designed to reduce unnecessary transport to the Emergency Department (ED).  The Informational Bulletin provides a framework that states may use to assess their individual regulatory landscape and Medicaid payment structure to determine readiness to implement ET3-aligned interventions, and identifies flexibilities within federal guidelines which states may leverage to design ET3-aligned interventions. The Informational Bulletin also describes targeted learning opportunities for state Medicaid programs interested in implementing ET3-aligned innovations that will be available through the ET3 Model Learning System.

• CIB: Medicaid Opportunities in the Emergency Triage, Treat, and Transport (ET3) Model”

“CIB: New State Flexibilities and Requirements regarding Alternative Benefit Plans (ABP) and Essential Health Benefits (EHB)

CMS is issuing an Informational Bulletin to inform states about new flexibilities for defining essential health benefits (EHB) in Medicaid Alternative Benefit Plans (ABP) effective January 1, 2020. The bulletin explains three new options available to states when choosing the benchmark plans used to define EHB in its ABP. States with existing ABPs may continue to use the benchmark plan they currently use to define EHB for ABPs, but states selecting new benchmark plans to define EHB for ABPs are required to use one of the new options beginning on or after January 1, 2020. The bulletin also provides a reminder to states on state plan amendment (SPA) submissions and ABP public notice requirements.

CIB: New State Flexibilities and Requirements regarding Alternative Benefit Plans (ABP) and Essential Health Benefits (EHB)”