CMS

March 2-4, 2009 state program staff, CMS staff, and technical assistance providers met in Baltimore to discuss Money Follows the Person and other strategies for helping people move out of nursing homes. Speakers presented on topics ranging from service integration, housing finance strategies, mentoring, quality, and many others.

Medicaid expenditures are often presented as a percentage of state or Federal spending. Here, they are illustrated in terms of market shares for 30 markets defined by provider category of service. In 21 markets, Medicaid plays a small role, but in the other 9, such as long-term care and mental health, Medicaid is the dominant payer. Some of the other markets researched include adult day, waiver, case management and home health services.

CMS offers guidance to states on how to avoid payments to excluded entities and the consequences of failing to prevent these payments. The letter stresses that it is the states’ responsibility to clearly communicate to providers that it is their obligation to screen employees and contractors for exclusion prior to hiring or contracting. It also provides the location of the List of Excluded Individuals/Entities which can be used to prevent improper payment.

<i>NOTE: The effective date for this rule has been postponed to April 3, 2009 and the comment period has been reopened, pending review by the Obama administration. See "Interim Rule" below.</i> CMS issued a Final Rule giving states the flexibility to define the scope of medical assistance covered by Medicaid by offering coverage of benchmark or benchmark-equivalent benefit packages to certain recipients. The file contains the official text of the rule as entered into the Federal Registry.

This presentation on Medicaid Infrastructure Grants (MIG) presents information regarding what ADRCs need to know about work incentive programs for individuals with disabilities. The presentation was part of the ADRC TA program and was delivered in November 2008. Additionally, a link is included to an informational website for the Ticket to Work Incentives Improvement Act.

Determining how to optimally balance our demand for the best health care with limited funding represents one of the most challenging policy dilemmas facing the U.S. To help understand how to best accomplish this task, the document authors forecast Medicaid expenditures and enrollment for the next ten years. The data are organized by enrollment groups and service settings/categories.

In an effort to address integration across CMS Home and Community-based Services Programs, CMS worked with its National Quality Contractor to develop an this matrix. The Grid highlights specific quality requirements across HCBS program authorities that include program standards, measures, accountability, and sources of financing for quality activities. The tool is expected to be a helpful resource for planning purposes and for providing technical assistance to states and researchers.

This letter is another in a series of CMS communications that support state efforts to improve the quality of services and supports provided through the Medicaid Home and Community-based Services waiver program. This communication announces three new items designed to assist states in enhancing oversight and operations: GAO Mortality Study in Developmental Disabilities, HCBS Quality Requirements Grid: A Technical Assistance Tool and the National HCBS Quality Enterprise award to Thomson Reuters.

Transitioning out of a care facility can be a challenging time for patients and their caregivers. This checklist will help these people and their support workers plan ahead of the discharge to ensure everyone involved understands the patient’s needs and can avoid any interruption in care. The resource also includes instructions and contact information for finding appropriate support from local, state, and federal agencies.

A final rule that would allow more Medicaid beneficiaries to be in charge of their own personal assistance services, including personal care services, instead of having those services directed by an agency, was published in the Oct 3, 2008 Federal Register. The rule, effective Nov. 3, 2008, guides states that wish to allow beneficiaries who need help with activities of daily living to hire, direct, train or fire their own personal care, workers including qualified family members.