All States/Territories

On January 11, Mathematica published a blog titled “A Quick Guide to Choosing Federal Medicaid Authorities to Address Health-Related Social Needs.” This blog explores the three most common federal Medicaid authorities that enable states to offer health-related social needs (HRSN) services to Medicaid-enrolled individuals: Section 1915 HCBS waivers, Managed Care In Lieu of Services (ILOS), and Section 1115 demonstrations. It also discusses key factors to contemplate as a state Medicaid official when choosing how to cover HRSN services, emphasizing considerations such as the intended population, types of services, and program features.

On January 17, the Centers for Medicare & Medicaid Services (CMS) released the “CMS Interoperability and Prior Authorization Final Rule” (CMS-0057-F) to improve the electronic exchange of health information and prior authorization process for medical items and services. The final rule applies to Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) Fee-for-Service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally Facilitated Exchanges (FFEs). This final rule establishes requirements for certain payers to streamline the prior authorization process generally starting January 2026 and complements the Medicare...

The Medicaid and CHIP Payment and Access Commission (MACPAC) recently released the 2023 edition of their “MACStats: Medicaid and CHIP Data Book,” which presents the most current data available on Medicaid and the State Children’s Health Insurance Program (CHIP). These programs provide a safety net for low-income populations who otherwise would not have access to health care coverage and cover services other payers often do not. This data book compiles the broad range of Medicaid and CHIP statistics that MACPAC regularly updates on macpac.gov into a single, end-of-year publication. MACPAC’s purpose is to bring together in one place federal and state data on Medicaid and CHIP that come from multiple data sources...

Older adults may worry about their memory and other thinking abilities, such as taking longer to learn something new. These changes are usually signs of mild forgetfulness — or age-related forgetfulness — and are often a normal part of aging. However, more serious memory problems could be due to mild cognitive impairment, dementia such as Alzheimer’s disease, or other factors beyond normal aging. Many older adults can become more forgetful as they age, which is why it is important to learn the differences between age-related forgetfulness and signs of dementia. The National Institute on Aging (NIA) recently released an infographic to help differentiate between age-related forgetfulness and signs of dementia.

Last week, the U.S. Department of Health and Human Services (HHS) launched a new online resource hub with Medicaid and CHIP Renewal and Transition Resources for Partners. This virtual hub provides key resources in one centralized location so all partners (e.g., states, beneficiary and provider organizations, and advocates among others) can better assist people with Medicaid or Children’s Health Insurance Program (CHIP) renew their health coverage or find other coverage options that may be a better fit for them. This hub contains the following resources: Resources to help others with coverage Outreach materials by population category Key government actions taken to support Medicaid renewals and transitions...

The Centers for Medicare & Medicaid Services (CMS) reports that over 20 million Americans have signed up for 2024 individual market health insurance coverage through the Marketplaces since the start of the 2024 Marketplace Open Enrollment Period (OEP) on November 1. This includes 15.5 million Marketplace plan selections in the 32 states using the HealthCare.gov platform for the 2024 plan year and 4.8 million plan selections in the 18 states and the District of Columbia with state-based Marketplaces (SBMs) that are using their own eligibility and enrollment platforms, through December 23, 2023 (Week 8). Total nationwide plan selections include 3.7 million consumers (18% of total) who are new to the Marketplaces for 2024...

The United States Office of Management and Budget (OMB) recently released updated guidance requiring federal agencies to improve their digital accessibility for people with disabilities. Currently, 61 million Americans live with a disability, but nearly half of the most popular Federal Government websites are not fully accessible to all Americans. The new guidance establishes the required leadership, goals, and a renewed focus to improve digital accessibility across the federal government...

The National Center for Assisted Living (NCAL) recently announced the publication of its annual Assisted Living State Regulatory Review. This report summarizes key selected state requirements for assisted living licensure or certification. It provides information for every state and the District of Columbia on topics such as which state agency licenses assisted living, recent legislative and regulatory updates affecting assisted living, scope of care, limitations of services, staffing, and training. The report also includes requirements for communities that offer older adults and people with disabilities housing and person-centered supportive and/or health care services but may use a different term than assisted living...

The LEAD Center recently released the latest issue of the LEAD On! Newsletter titled “Good Jobs and Competitive Integrated Employment: Strategies for Success.” Various federal departments, including the Departments of Labor, Transportation, Energy and Commerce, rallied around the Investing in America (IIA) agenda, which has created access to good jobs for all America’s workers, including those with disabilities. This newsletter features several resources from the ODEP-funded LEAD Center to promote Good Jobs as Competitive Integrated Employment, including a recently released fact sheet.

On January 5, KFF released a brief examining the characteristics of nursing facilities and the people living in them between 2015 and 2023. This brief utilizes data from Nursing Home Compare, a publicly available dataset that provides a snapshot of information on quality of care in each nursing facility, and CASPER (Certification and Survey Provider Enhanced Reports), a dataset that includes detailed metrics collected by surveyors during nursing facility inspections. This analysis is relevant to aging and disability networks as it coincides with the Centers for Medicare & Medicaid Services (CMS) proposed rule that would create new requirements for staffing levels in nursing facilities.