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This brief describes early state plans to operationalize the medical frailty exemption for Medicaid work requirements and identifies key issues and questions states are facing, some of which may be answered in forthcoming CMS guidance.
This issue brief analyzes the percentage and characteristics of facilities that would meet the rule’s proposed requirements for the minimum number of RN and nurse aide hours to better understand the implications of the rule.
This issue brief identifies key themes in policy changes states are making under Appendix K authority to adapt Medicaid HCBS programs in light of the COVID-19 emergency.
As the 25th anniversary of Olmstead nears, more than one-in-10 working age adults have a disability and most do not receive public disability income. Over one-in-10 working-age adults reported having a disability in 2022. A disability is defined as having difficulty with hearing, vision, cognition, ambulation, self-care, or independent living, according to KFF's examination of data on people with disabilities from the American Community Survey. Fewer than a third of working-age adults with disabilities receive…
During the pandemic many states have experienced worsening direct care workforce shortages that have affected providers of home- and community-based long-term care services (HCBS), according to early findings of a new KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. Most states reported workforce shortages as the pandemic’s primary impact on HCBS provided in an enrollee’s home and in group homes. The pandemic has brought new attention among policymakers…
As the U.S. prepares for nationwide distribution of vaccines to combat COVID-19, some are asking whether people who get the first of two doses will return to complete the series. This analysis draws on Medicare Part D prescription drug claims data for the herpes zoster vaccine Shingrix, which also requires two doses, to shed light on this potential challenge of the leading COVID-19 vaccine candidates.
This issue brief draws on features of the various existing Medicaid home and community-based services (HCBS) programs to identify key policy questions raised by initiatives to streamline Medicaid HCBS, ameliorate institutional bias, and improve administrative simplification.
The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would…
This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…
This report describes and analyzes key Medicare+Choice provisions in the Balanced Budget Act and the accompanying regulations related to consumer protections. It explains how the BBA makes significant improvements for beneficiaries in the areas of access, appeals, and quality. It also explores areas that could be strengthened to better serve the needs of the Medicare population, including provisions pertaining to enrollment and disenrollment, information and education, Medigap coverage, and marketing. Report Report
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