State/Agency Information

One of a series designed to provide guidance on the implementation of the American Recovery and Reinvestment Act of 2009, this letter addresses the “prompt pay” requirements contained in section 5001(f)(2). States must comply with timely claims processing requirements in the Medicaid program, or potentially lose their eligibility for the increased Federal medical assistance percentage (FMAP) for certain expenditures. More detailed technical guidance is attached to this letter.

This issue of "In Focus" explores health technology especially how it relates to Transformation Grants. States that received grants from the Centers for Medicare and Medicaid Services (CMS) to advance the use of electronic health records and e-prescribing programs confronted challenges other states are likely to face as they implement health information technology initiatives using funds from the Stimulus Bill.

More than 130 policymakers, health services researchers, practitioners, and policy experts discussed the measures and evidence to examine whether the expansion of home and community-based services has produced desired outcomes (quality, choice, cost, satisfaction and safety) in the long term for older adults and persons with disabilities. The day was divided into four sessions: (quality, consumer-direction, targeting candidates, determining cost-effectiveness). View the agenda and presentations.

Guidance is offered for states in interpreting the sections of ARRA that impact Medicaid and CHIP. Program elements affected include tax credits, income used to calculate benefit levels, Federal Medical Assistance Percentage, Transitional Medical Assistance, protections for Native Americans, and transfers of assets. The attachment lays out program changes organized by ARRA section.

The study analyzes the long term care (LTC) system in WV and projects costs and savings associated with two models of efforts to transition people out of institutions. The system analysis looks at service delivery in both institutional and community-based settings, levels of access, financing, and quality. The appendices include examinations of care models and rebalancing efforts of other states.

Integrated Care Programs launched in five states in 2005 to coordinate acute and long-term services received by people enrolled in both Medicare and Medicaid. States were granted $100,000 and technical assistance focused on performance measurement, rate setting and risk adjustment, and administrative simplification. Here, state programs are evaluated, federal progress in integrated care is surveyed, and future considerations are identified.

Quantitative and qualitative data are pulled together for a summary of the enrollment and implementation experiences of state DMIE projects through December 2008. The Kansas, Minnesota, Texas, Hawaii and District of Columbia programs are profiled and then a national summary and implications are presented. Another report tentatively scheduled for the spring of 2010 will analyze whether the program improved outcomes for individuals and evaluate the implementation and phase-down activities.

The key details of the partnership between the Veterans Health Administration and the Administration on Aging, created to provide consumer-directed care to veterans, are given. The document summarizes the partnership structure, standards, and target population. It also discusses the referral, follow-up, and rate setting procedures for the defined set of services and goods to be offered.

This program (HWD) is Washington’s implementation of Medicaid Buy-In. The report evaluates HWD’s impact on employment and earnings, Medicaid coverage, and receipt of food stamps by comparing enrollees to traditional Medicaid participants. They found significant outcome improvements for the HWD group in several categories.

Nearly every state provides at least some funds for services for low-income older adults or people with disabilities who have too many assets to qualify for Medicaid. AARP reports on how much each state spends on both multiservice and single-service programs. It also compares funding sources, eligibility criteria, services, cost management strategies, consumer direction, and other characteristics.