CMS

The Centers for Medicare & Medicaid Services issued a State Health Official letter that provides guidance on legislative changes to the modified adjusted gross income (MAGI)-based methodologies used for determining Medicaid and CHIP eligibility. In order to implement the changes to MAGI-based methods, states may need to update eligibility policies and procedures and make changes to eligibility systems logic.

The Centers for Medicaid & Medicare Services released a report that profiled the 10 states with the greatest change in Long-Term Services and Support (LTSS) system balancing. The report highlights characteristics of the 10 states and compares their change in LTSS system balancing with other states and provides a national overview on LTSS system balancing. State profiles consist of characteristics and strategies states utilized in their progress towards rebalancing their LTSS systems.

CMS released a bulletin addressing frequently asked questions regarding Electronic Visit Verification (EVV) requirements to beneficiaries receiving in-home care. This bulletin responds to questions surrounding beneficiaries with live-in caregivers, services delivered partially in the beneficiary's home, the provision of medical supplies, equipment, and appliances as a component of the Medicaid home health benefit, and the use of web-based timesheets as an EVV method.

CMS released an informational bulletin that provides guidance regarding new constructions and the HCBS heightened scrutiny process. The 2014 Medicaid HCBS regulation’s settings regulation requires an in-depth assessment, called heightened scrutiny, for certain providers that are presumed to be institutional. This guidance provides clarification and flexibility to states, including an overview of three potential scenarios for how newly constructed settings could receive Federal funding

CMS has released a notice with information about the process for states to apply for a “good faith effort” (GFE) exemption, which provides up to one year of extra time to come into compliance with Electronic Visit Verification.

CMS provided the president and Congress a report detailing the center’s action plan to provide support and technical assistance to states delivering supports to Medicaid beneficiaries with substance use disorder (SUD). The report outlines how CMS plans to implement requirements of Section 1018(a) of the SUPPORT for Patients and Communities Act in 2020-2021.

ACL, CMS, and the Department of Labor’s Office of Disability Employment Policy (ODEP) have released a Q&A document to help grantees, stakeholders, and self-advocates better understand the Medicaid buy-in program. The Medicaid buy-in program includes Medicaid eligibility groups that serve workers with disabilities who are earning income and whom states may charge premiums as a condition of Medicaid eligibility.

This fact sheet provides an overview of the safe use of prescription opioid pain medications. It discusses the process of safety reviews at the pharmacy, as well as the Drug Management Programs to help patients who are at risk for prescription drug abuse. It is important to note that safety reviews and Drug Management Programs generally don’t apply to those who have cancer, get hospice, palliative, or end-of-life care, or those who live in a long-term care facility.

The Centers for Medicare & Medicaid Services released their monthly report for November 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

The Centers for Medicare & Medicaid Services released their monthly report for October 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.