Medicaid

This KFF policy watch examines three key questions to monitor as states navigate the unwinding of the Medicaid continuous enrollment provision initiated during the COVID-19 public health emergency. Examining changes in Medicaid enrollment, the report notes a nearly 10% decline in Medicaid enrollment nationally, with significant state-level variations. As states progress through renewals, the article emphasizes the unpredictable trajectory of Medicaid enrollment at the process's conclusion, acknowledging the potential return to pre-pandemic levels. Confronting challenges posed by procedural disenrollments and new enrollments, the report explores the implications for Medicaid participation and broader trends in healthcare coverage...

ADvancing States is pleased to publish findings from the 2022 national survey of Adult Protective Services (APS) Programs in the report Adult Protective Services in 2022: Responding to Evolving Needs in a Changing Environment. ADvancing States conducted this survey to assess the current state of APS programs and identify trends related to topics such as caseload, staff retention, and client assessment. Additionally, there was a special focus placed on clients experiencing self-neglect. Since the prior ADvancing States APS report was published, Adult Protective Services in 2012: Increasingly Vulnerable, the field of APS has experienced a variety of new opportunities and challenges...

Justice in Aging has released a fact sheet focusing on Medicaid-funded assisted living facilities and their compliance with federal laws. This resource equips residents and their representatives with advocacy tools to ensure facilities follow the law and treat residents appropriately. Although this guide focuses on assisted living, the relevant federal laws cover any similar residential setting reimbursed through Medicaid HCBS. Accordingly, this guide’s advice generally applies also to HCBS-funded facilities for persons with disabilities, such as group homes and adult residential facilities...

Colin Alexander Health Law Fellowship - Justice in Aging Justice in Aging is currently accepting applications for its Colin Alexander Health Law Fellowship for Summer 2024. They are seeking a rising 3L (current 2L) law student who is passionate about advocating for low-income and underserved populations and possesses strong legal research and writing skills. This full-time, remote, paid fellowship will involve working on various projects related to Medicare, Medicaid, and healthcare programs affecting older adults. The selected fellow will receive a $8,000 stipend, mentorship from experienced attorneys, and the opportunity to craft a post-graduate fellowship application.Applications should be submitted to hiring@justiceinaging.org by...

A recent report by the U.S. Department of Health and Human Services used Medicare data to identifiy certain characteristics or risk factors that placed nursing home residents at an increased risk of discharge. Characteristics included residents with severe behavioral symptoms, residents with psychiatric and mood disorders, residents with impairments that required more staff time, residents transitioning to Medicaid.

On Friday, November 11, 2022 HHS announced that it will again extend the COVID-19 Public Health Emergency (PHE). Based on commitments to provide at least 60 days’ notice prior to allowing the PHE to lapse, HHS had until Saturday, November 12, to provide states with notice that the PHE would either be extended or end in January. This means that unwinding protocol will not yet begin, and that the PHE policies such as Medicaid FMAP increases; continuous eligibility; and the 1135, Appendix K, and Emergency SPAs will remain in effect.

This brief includes a checklist of eight key questions that can help state purchasers and other payers develop a robust payment and spending strategy focused on advancing health equity. Each question includes concrete state examples for adopting health equity-focused payment methods. This brief is a product of Advancing Health Equity, a national initiative supported by the Robert Wood Johnson Foundation that is working with states to pursue payment innovations that support health equity.

Late yesterday CMS released a State Medicaid Director Letter (SMDL 22-003) providing guidance for the first-ever HCBS Quality Measure Set, the first of two planned guidance documents from CMS. The HCBS Quality Measure Set is included in the SMD, starting on page 14. The list of measures includes the NQF number (if applicable), measure steward, and data collection method, as well as information on whether each measure addresses section 1915(c) waiver assurances and/or can be used to assess access, LTSS rebalancing, and/or community integration and HCBS settings requirements.

This KFF issue brief describes the anticipated enrollment changes in pathways based on old age or disability (“non-MAGI”) after the Public Health Emergency (PHE) ends, state enrollment and renewal policies for non-MAGI groups as of January 1, 2022, and state plans for resuming normal operations when the PHE ends.

On Thursday, February 24, 2022, CMS released a CMCS Informational Bulletin with the updated 2022 Federal Poverty Level Standards. The 2022 guidelines reflect the 4.7 percent price increase between calendar years 2020 and 2021. After this inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family and household sizes. The informational bulletin also includes a 2022 Dual Eligible Standards chart that displays the new standards for the Medicare Savings Program categories.