Maine

This is one in a series of annual reports on participation in the Medicaid Buy-In program. It provides updates on both national- and state-level trends in enrollment, employment, and earnings among the 35 reporting Medicaid Infrastructure Grant (MIG) states with a Buy-In program in 2011. Additionally, it addresses recent changes to state program rules and policies, and identifies factors that have affected recent Buy-In program enrollment, as reported by the states in an annual questionnaire.

This GAO report examines (1) the extent to which Medicaid enrollees have private insurance, and (2) the state and CMS initiatives to improve third-party liability (TPL). Given the findings in the report, GAO recommends that CMS routinely monitor and share information regarding key TPL efforts and challenges, as well as provide guidance on state oversight of TPL efforts conducted by Medicaid managed care plans.

The Affordable Care Act (ACA) provides new but limited opportunities to promote or fund specialized transportation services for older people and adults with disabilities. This paper explains how states can use these largely untapped options to expand services for targeted low-income populations with mobility needs. It also presents two case studies illustrating how the Atlanta region and the state of Connecticut are making this work.

As almost half of the States have implemented MLTSS programs, community-based organizations, will be significantly impacted. At the 2013 HCBS conference, ADvancing States, with support from the SCAN Foundation, held a day-long intensive to discuss these impacts. This report outlines 5 discrete roles that CBOs are well-suited to play in MLTSS programs using as a reference point CMS’ 2013 guidance on MLTSS program design and implementation. To request a hard copy version, email Ali Diaz at adiaz@advancingstates.org.

This study focuses on understanding the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and those that predict nursing home entry. This volume of this report is a descriptive examination of the number and characteristics of Medicare beneficiaries who transition to dual coverage in the coming year.

This report is a comprehensive account of the number of individuals in each state who received Medicaid-funded LTSS in calendar year 2010 based on the Medicaid Analytic eXtract (MAX). The MAX data source is a set of Medicaid administrative data files designed to facilitate Medicaid research. The report identifies the number of people by population group who received institutional and non-institutional services. With some exceptions, State and national data are included.

In this report, the GAO examined claims, expenditure, and quality data from Dual Eligible Special Needs Plans (D-SNPs) during 2009. The GAO notes that D-SNPs with higher levels of Medicare and Medicaid integration performed better on quality outcomes but did not reduce utilization of costly Medicare services. The GAO concludes that CMS projected savings from the Financial Alignment Demonstration and other initiatives to integrate care for dual eligible beneficiaries may be overstated.

The OIG report examines state standards and requirements for network adequacy and access to care. The report was based on surveys and interviews of state officials, CMS employees, and External Quality Review Organizations. In the report, OIG notes that state standards on access to care vary widely, and that state oversight of health plans also varies. Based on its findings, OIG offers recommendations to CMS in the report.

This white paper provides an inventory of all current MLTSS programs and a projection of future programs as of July 2012. The report includes state-by-state results and synthesizes findings across states, reporting national enrollment, characteristics of contractors and multiple program features.

This State Long-Term Services and Supports (LTSS) Scorecard is a multidimensional approach to measure state-level performance of LTSS systems that assist older people, adults with disabilities, and their family caregivers. This second edition of the State LTSS Scorecard measures LTSS system performance across five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions.