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In January 2014, the Centers for Medicare and Medicaid Services (CMS) published a final rule that created new requirements for Medicaid home- and community-based services (HCBS) programs. This issue brief describes the settings rule, implementation of the rule across states and HCBS waivers, and what to watch as implementation continues.
This policy brief describes the relationship of the Americans with Disabilities Act and Medicaid services and the impact of the U.S. Supreme Court's Olmstead v. L.C. decision. Policy Brief (.pdf) Related Olmstead Materials
Medicaid’s Rehabilitation Services Option: Overview and Current Policy Issues In 2007, the President reintroduced a plan to place new restrictions on the types of services allowable under the Medicaid rehabilitation services option (called the rehab option) to yield federal budget savings of $2.29 billion over the next five years. Currently, 47 states plus the District of Columbia provide at least some type of mental health, substance abuse, and physical health services under the rehab option.…
This set of tables, prepared by the Urban Institue for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state by state data on Medicaid enrollment and expenditures for dual eligibles. Full Set of Tables (.pdf) Individual Tables:Implications of the Medicare drug law for full dual eligibles:Table 1: “Full” Dual Eligible Enrollment and Prescription Drug Expenditures, by State, 2002 (.pdf) Enrollment and spending data for full and partial dual eligibles:Table 2: Total…
With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. A total…
Medicaid covers nearly 60 million Americans. Because the population covered by the program is low-income, federal law limits the extent to which states can charge premiums and cost-sharing amounts, particularly for pregnant women, children and adults with incomes below poverty. Yet there is renewed interest in the use of premiums and cost-sharing in Medicaid given the continued focus on cost-containment due to ongoing state budget pressures as well as recently proposed changes to federal regulations…
This case study looks at Michigan's Money Follows the Person (MFP) demonstration program, which has enabled the state to accelerate existing transition activities and increase access to home- and community-based services (HCBS) by providing enhanced federal funds for each MFP participant’s 365-day enrollment period. Through MFP, Michigan is able to provide a comprehensive set of demonstration services in addition to existing HCBS waiver services so that each MFP participant receives the services necessary to transition…
This case study looks at Washington state's Money Follows the Person demonstration program, Roads to Community Living. The program is responsible for assisting over 2,400 Medicaid beneficiaries with complex long-term services and supports (LTSS) needs in transitioning out of institutions back to community-based care settings. Washington State has been a leader in Medicaid LTSS rebalancing efforts over the last two decades. According to the state, in the early 1990s, 82 percent of long-term care funding…
KFF examines how many Medicaid enrollees used Long-Term Services and Supports (LTSS) for aging, illness, or disability in 2020, how much Medicaid spent on these enrollees, and policy issues to watch in the coming years.
The Medicaid program is a source for many innovative practices in making long-term services and supports (LTSS) available to consumers. Jointly financed by the states and the federal government, Medicaid pays for 40 percent of LTSS spending the United States. Case management services have been integral to Medicaid community-based LTSS programs since their inception, but as the programs have grown and evolved, particularly as options for care have increased and consumers have taken a more…
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