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  • Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline: June 2004 – December 2006 Key Dates

    Report

    Key Implementation Dates for the Medicare Prescription Drug Benefit This timeline presents important dates and deadlines of key implementation activities related to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It runs from the beginning of 2005 through the end of 2006, the first year of the new Medicare drug benefit. Some of these dates are defined in the MMA statute, while others are from the final rule issued by the Centers…

  • Coverage of Preventive Services for Adults in Medicaid

    Issue Brief

    This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to cover such services for adults. The Affordable Care Act (ACA) provides states the opportunity to earn a one percentage point increase in their federal matching…

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Other Post

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries; describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care. Available in PDF format. Return to top Library Index

  • Profiles of Medicaid’s High Cost Populations

    Issue Brief

    This paper examines the role that Medicaid plays in addressing six populations (preterm birth babies, foster care children, individuals with spinal cord and traumatic brain injuries, individuals with mental illness, individuals with intellectual and developmental disabilities, and people with Alzheimer's disease) with serious health needs resulting in high costs. For each population profiled, the report describes the condition and the need for services and supports, as well as the role of Medicaid in meeting those…

  • Designing a Medicare Drug Discount Card: Implications of Policy Choices for Medicare Beneficiaries and Plan Sponsors

    Report

    This report analyzes key issues surrounding the implementation of a Medicare-endorsed prescription drug discount card program. Medicare prescription drug discount cards have been proposed as a short-term strategy for lowering prescription drug costs for Medicare beneficiaries. The report considers the implications for both discount card sponsors and beneficiaries of alternative program designs, including such features as the annual lock-in for consumers, exclusive formularies, providing comparative information to consumers about drug prices and discounts, administration of…

  • Learning From History: Deinstitutionalization of People with Mental Illness As Precursor to Long-Term Care Reform

    Report

    This report examines what policy lessons can be learned from the deinstitutionalization of people with mental illnesses and applied to potential long-term care reform for the elderly or those with significant disabilities. The study assesses the reforms that took place under deinstitutionalization, their impact and what mistakes were made. It also discusses the take-away lessons for long-term care policy, with a focus on planning, financing, living situations and the role of families, workplace issues, and…

  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • The Role of Health Coverage for People with Disabilities: Findings from 12 Focus Groups with People with Disabilities

    Report

    This report presents findings from focus groups conducted with people with a range of disabilities in an effort to understand the challenges they face and their experiences in the health-care system. To capture variations in experiences by source of health insurance, the groups include people covered under Medicare, Medicaid, and private insurance, as well as those no health insurance at all. The report highlights the ways in which various sources of insurance are working for…

  • Dementia and Medicare Managed Care: A Growing Challenge for Health Plans

    Report

    The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and the Medicare program's laws and regulations, and focuses on survey findings in six key areas: marketing, enrollment, health assessments, health care delivery, advance directives, and…