Milestone: Establish Medicaid non-payment policies for health care-acquired conditions
Providers can prevent many health care-acquired conditions. Medicaid agencies can create an incentive for providers to increase their efforts to prevent these conditions by ceasing to pay for their treatment—ultimately reducing their occurrence.
*Milestone details:
*Full name: Establish Medicaid non-payment policies for health care-acquired conditions.
*Relevance to the ACA:
According to the ACA, states will no longer receive federal matching dollars for any payments made through the Medicaid program for medical expenses associated with certain health care-acquired conditions with the stipulation that the prohibition on payment for health care-acquired conditions shall not result in a loss of access to care or services for Medicaid beneficiaries (§2702 effective July 1, 2011).
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Maine
This report by the New York State Health Foundation details the challenges and opportunities NY faces in implementing reform, including Exchange, benefit design, and payment issues. The report includes discussion of NY's existing Medicaid "never event" nonpayment policy (page 74, page 79 of the PDF). Access the report here: http://www.statereforum.org/sites/default/files/nyroadmappaper_aug2010.pdf