Medicare and Medicaid

Medicare and Medicaid provide health insurance for many people and often lead the way in terms of health insurance policy reform. Answer all questions.

1. CMS maintains an extensive list of Conditions of Participation (CoP).For what reason and how it is developed?
2. Who certifies providers' compliance with the CoPs?Explain "Deemed Status".Is the Joint Commission a regulatory agency?Why or why not? Is JCAHO accreditation mandatory? Why?
3. The role of waivers with CMS, How do these contribute to the development of State Medicaid Plans (SPAs)?

Links:

Medicare and Medicaid Conditions of Participation: https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/index.html?redirect=/CFCsAndCoPs/

Conditions of Participation for Hospitals https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol5/xml/CFR-2017-title42-vol5-part482.xml

Conditions of Participation for Home Health Services https://www.ecfr.gov/cgi-bin/text-idx?node=pt42.5.484&rgn=div5

Requirements for Long Term Care https://www.ecfr.gov/cgi-bin/text-idx?SID=cfbc43a1e632c88ff587201d326f5180&node=42:5.0.1.1.2.2&rgn=div6

Medicaid A Primer (CRS): http://www.ncsl.org/documents/health/MAPrimer.pdf

Medicaid and FMAP (CRS): http://www.ncsl.org/documents/health/MAFMAP.pdf

Medicaid and the Affordable Care Act: https://www.medicaid.gov/affordable-care-act/index.html

Medicaid Expansion: https://www.kff.org/health-reform/issue-brief/a-guide-to-the-supreme-courts-decision/

Davis v. Blue Cross of N. California: http://caselaw.findlaw.com/ca-court-of-appeal/1836359.html. Arbitration

LeRouge, C., & Garfield, M.J. (2013, December). Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced? International Journal of Environmental Research and Public Health. 10(12): 6472-6484, doi: 10.3390/ijerph10126472. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881125/