Oregon Section 1115 Waiver – UPDATE
Oregon Section 1115 Waiver
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Completed for the National Conference of State Legislatures and the Kaiser Commission on Medicaid and the Uninsured, by Health Management Associates. Compiled from Medicaid State Plans and Amendments approved by the Centers for Medicare and Medicaid Services, and from State websites, with verification by State and Territorial Medicaid officials in March 2003.
Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013.
Premium assistance programs use federal and state Medicaid and State Children’s Health Insurance Program (SCHIP) funds to purchase private coverage. Overall, few states have premium assistance programs, but interest in premium assistance remains high.
On April 19, 2004 the Kaiser Commission on Medicaid and the Uninsured held a Washington policy briefing on the basics of Medicaid financing. A webcast and transcript of the briefing are available. Presentation Slides (.pdf) The publications below provide background information on Medicaid financing and the latest on Medicaid waiver activity.
Medicaid Waivers: Lessons from California, a roundtable discussion hosted by the Foundation and the University of California, Berkeley Center for Health and Public Policy Studies on Wednesday, July 28, 2004, provided an overview of current Section 1115 waiver activity across the states, focusing on Health Insurance Flexibility and Accountability (HIFA) Initiative waiver efforts.
The Impact of Medicaid Reductions in Oregon: Focus Group Insights Oregon is one state that has significantly restructured its Medicaid program, known as the Oregon Health Plan (OHP), in response to budget pressures.
Over the last four years, the Commission has been tracking the national development of the three main Medicaid HCBS programs that states can operate. The Commission also began to survey the policies, such as eligibility criteria and waiting lists that states can use to control the growth of spending on the waiver programs.
Premium Assistance Programs: How Are They Financed and Do States Save Money? This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness; and cost savings.
This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid.
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