March 10, 2025
Medicaid Coverage of Enclosed Beds DME Workgroup Tool Now Publicly Available
The MED DME Workgroup Tool: Medicaid Coverage of Enclosed Beds examines the use of enclosed beds—specialized safety devices designed to prevent injury for children with conditions like autism spectrum disorder (ASD) or developmental disabilities. It highlights the rising use of enclosed beds—specialized safety devices for children with conditions like autism spectrum disorder (ASD) or developmental […]
March 10, 2025
Enhancing Global Billing Practices for Medicaid Pregnancy Services Policy Brief Now Publicly Available
The MED Policy Brief: Enhancing Global Billing Practices for Medicaid Pregnancy Services examines the use of global obstetric billing in 37 state Medicaid programs, a bundled payment model covering prenatal, delivery, and postpartum care. It identifies practical challenges, such as inadequate compensation for complex pregnancies, limited data transparency due to bundled coding, and care fragmentation […]
March 3, 2025
New MERCI Accelerated Approval Drug Briefs
The Center for Evidence-based Policy is excited to announce the release of the second set of briefs from its Medicaid Evidence and Review of Cost Initiative (MERCI) project. Focused on drugs approved through the FDA’s accelerated approval pathway, each MERCI drug brief is a case study which includes the clinical trial evidence used for FDA […]
February 19, 2025
Interoperability and Prior Authorization Rule Workgroup: Background Material
The Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule establishes new prior authorization requirements that apply broadly to “items and services” other than drugs. State Medicaid and CHIP programs and managed care plans must meet prior authorization policy requirements by 2026 and must implement new application programming interface (API) technologies […]
January 27, 2025
MERCI Blog Post on Milbank Memorial Fund Site
Susan Stuard from the Center recently authored a new blog on the Medicaid Evidence and Review of Cost Initiative (MERCI) project for the Milbank Memorial Fund. The article highlights issues with the FDA’s accelerated drug approval process affecting Medicaid coverage. Medicaid must cover all FDA-approved drugs, even with limited trial data, increasing risks for patients. […]
September 5, 2024
Washington State Health Plans in Support Primary Care Reform Work
With support from the Center for Evidence-based Policy, eight Washington health plans and the state’s Health Care Authority (HCA) signed a memorandum of understanding (MOU), committing to multi-payer primary care transformation. The MOU outlines individual and collective payer efforts to support the state’s Primary Care Transformation Initiative (PCTI). Under the initiative, health plans will align their plan […]
August 20, 2024
New Scorecard Reveals Wide Differences From State-to-State in Women’s Health and Reproductive Care
A new Commonwealth Fund scorecard comparing state health system performance on women’s health and reproductive care reveals big differences across the U.S., with particularly wide gaps on measures of mortality among reproductive-age women and access to essential health services. The 2024 State Scorecard on Women’s Health and Reproductive Care was completed with analytic support from researchers […]
July 16, 2024
Evidence-based Innovation Award
This Award recognizes a team or State official for using evidence to innovate and achieve improvements for their State populations.
July 3, 2024
Washington State Health Technology Clinical Committee Report on Bariatric Surgery
We recently completed a systematic review of metabolic and bariatric surgeries for individuals with a BMI ≥ 25 kg/m2 (BMI ≥ 23 kg/m2 in some Asian populations). This work was presented to the Washington State Health Technology Clinical Committee to assist in their coverage determination. The report and associated documents are available on the Washington […]