Medicaid

The Kaiser Commission of Medicaid and the Uninsured published an issue brief on the system design of Medicaid's current home and community-based (HCBS) programs.

On Friday, April 8, the Centers for Medicare & Medicaid Services (CMS) released a final rule in the Federal Register to extend the deadline to October 1, 2016, for state submissions of the access monitoring review plan to CMS. The deadline was originally set for July 1, 2016. CMS published the final rule with comment period, Medicaid Program; Methods for Assuring Access to Covered Medicaid Services, on November 2, 2015.

The Centers for Medicare and Medicaid (CMS) Center for Program Integrity (CPI) Provider Enrollment Operations Group (PEOG) released the Medicaid Provider Enrollment Compendium (MPEC). The Compendium is a policy manual that contains sub regulatory guidance and clarifications regarding how state Medicaid agencies are expected to comply with regulations at 42 CFR § 455.

The Centers for Medicare & Medicaid Services (CMS) released the Community First Choice (CFC) Final Report to Congress. This CFC benefit allows states the option of adding home and community-based attendant services and supports to their State plans. The CFC report is required by the Affordable Care Act. The findings from four states that have implemented the Community First Choice benefit -- California, Montana, Maryland, and Oregon-- are described in the report

On March 15, the Medicaid and CHIP Payment and Access Commission released the March 2016 Report to Congress on Medicaid and CHIP. The authorizing statute of MACPAC requires the commission to submit a report to Congress by March 15 and June 15 each year. This report focuses on three aspects of Medicare: Support for safety-net hospitals; delivery of care for people with behavioral health conditions; and coverage for low and moderate income children.

The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) released a data book that presents information of dually-eligible beneficiaries. The information includes demographics, other personal characteristics, expenditure, and health care utilization of the dual-eligibles. This data book is the third in a series that serves to create a better understanding of this population and how they tend to use available services.

This white paper examines the progress that is being made in the Aging Network. This paper covers key developments that are re-shaping the network as well as efforts to better measure the quality and value of its programs and services. The paper also includes: Case studies highlighting the work of the aging network in Florida, Massachusetts and California, discussion of quality initiatives and congressional actions, and concluding observations.

The Centers for Medicare & Medicaid Services (CMS) began the Financial Alignment Demonstration in 2013 to improve care coordination. GAO was asked to examine care coordination under this demonstration. On January 19, The Government Accountability Office publicly released a report with their recommendations for CMS. GAO recommends that CMS develop new measures and align the current measures to improve oversight of care coordination.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.

The AARP Public Policy Institute published a report that examined what state Medicaid agencies need in order to effectively monitor the performance of managed long-term services and supports (MLTSS) programs. Eight states with long-term experience operating and overseeing MLTSS were used to analyze monitoring capacities and develop promising practices. The states were: Arizona, Massachusetts, Minnesota, New Mexico, New York, Tennessee, Texas and Wisconsin.