Affordable Care Act (ACA)

Both of these large state waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will result in better care for individuals, better population health, and reductions in costs through system improvements. They have a number of key similarities and differences as summarized in the side-by-side table within this fact sheet.

MITA provides a common framework for all Medicaid stakeholders to focus on opportunities to build common and shared services by decoupling legacy systems and processes, and liberating data previously stored and contained in inaccessible silos. The newest version takes into account new legislative requirements outlined in the Health Information Technology for Economic and Clinical Health Act, the Children's Health Insurance Program Reauthorization Act, and the Affordable Care Act.

Have you seen the new site sponsored by CMS? This space offers a resource center for states, up to date information about the affordable care act and additional federal policy guidance. The waiver section organizes information by state, program name, waiver authority and status of a application. This chart gives an overview of the four primary types of waivers and demonstration projects: Section 1115, Section 1915(b) Managed Care, Section 1915(c) HCBS, and Concurrent Section 1915(b) and 1915(c).

The Money Follows the Person (MFP) Demonstration supports state efforts to help Medicaid beneficiaries living in long-term care facilities transition back to community-based residences and to make community-based long-term care services and supports more accessible. This report uses aggregate data from annual financial reports and service claims records submitted by grantees to examine the costs and types of community-based services received by participants in the MFP program.

States serve a large number of people with dementia & caregivers in their Aging Networks & LTSS systems. This involves accommodating the needs of a population experiencing a variety of physical, cognitive, & behavioral symptoms from dementia, along with other medical conditions. This brief discusses why states should be concerned about dementia capability in their LTSS systems, describes the components of model dementia-capable systems, & reports how states have addressed dementia capability.

State Medicaid agencies fund supports & services for individuals with disabilities. As national public policy recognizes & emphasizes the ability of individuals with disabilities to work, states are integrating employment supports into the continuum of long-term care in Medicaid. This brief discusses federal legislative & regulatory framework for funding employment supports in Medicaid, highlights examples of state innovations & best practices to promote positive employment outcomes.

On February 22, 2012, the Centers for Medicare & Medicaid Services (CMS) put on display at the Federal Register a final rule that establishes a process to promote State & Federal transparency for Medicaid & Children’s Health Insurance Program (CHIP) demonstrations. The rule is designed to ensure public input in the development, review, & approval of Medicaid and CHIP demonstration projects under section 1115 of the Social Security Act. The final rule will be effective starting April 27, 2012.

A growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility to many uninsured low-income adults, including those with disabilities. This issue brief looks at issues related to the development and implementation of managed care programs with the capacity to serve Medicaid beneficiaries with disabilities.

This issue brief looks at issues related to the development and implementation of managed care programs with the capacity to serve Medicaid beneficiaries with disabilities. Drawing on existing research on Medicaid managed care and people with disabilities, the brief highlights policy considerations related to setting plan payment rates, developing adequate provider networks and delivery systems, and ensuring sufficient beneficiary protections and plan oversight.

This guide lays out information about each federal program that provides or could provide respite funding or support. It is meant to be used by state Lifespan Respite Care Programs & their partners to help identify the funding sources that could be the building blocks for the state’s Lifespan Respite systems, help serve the underserved, build respite capacity & quality and help recruit & retain respite workers, and identify individuals who administer funds for future partnerships.