Medicaid Waivers

Justice in Aging has released an issue brief intended to equip state oral health, aging, and disability advocates with education and advocacy tips on how to leverage Medicaid waivers to expand access to oral health and address disparities in access to dental treatment. The issue brief begins with an explanation of Medicaid waivers, including what they do and who they impact. This is followed by state-specific examples illustrating how Medicaid waivers can both expand the scope of coverage available and address barriers to care.

The Centers for Medicare & Medicaid Services (CMS) has posted proposed updates to the 1915(c) Waiver Application and Technical Guide for public comment. Comments are due to CMS by Monday, November 13. CMS is proposing technical updates and revisions throughout both documents to align with current requirements, such as adding an option for states to indicate whether HCBS can be delivered via telehealth, removing references to Statewide Transition Plans, and integrating settings criteria with person-centered service planning requirements.

On Thursday, October 21, 2021 CMS launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for home and community-based services. Through this new webpage, state Medicaid agencies and stakeholders can access information about states’ plans to enhance, expand, and strengthen home and community-based services across the country using new Medicaid funding made available by the American Rescue Plan Act of 2021 (ARP).

CMS released a SHO letter with updated guidance to assist states in planning for resuming normal state Medicaid, CHIP, and BHP operations for the eventual end of the public health emergency. The SHO provides updated guidance regarding the extended timeframe for states to complete pending work in eligibility and enrollment to up to 12 months after the PHE ends and redetermination of eligibility requirements states must complete after the PHE for all beneficiaries before taking adverse actions.

NASHP has published an Appendix K interactive map, supported by The John A. Hartford Foundation, to track each state’s new flexibilities in modified 1915 (c) and 1115 waivers. States are using these waivers and amendments to ensure that their older adults and family caregivers are receiveing the LTSS services they need during the pandemic.

The Institute for Medicaid Innovation has released a new report on how amendments and waivers are used to support innovative Medicaid program payment and delivery system models. The report is the second release in IMI’s “Introduction to Medicaid” series. The resource outlines 5 ccommon Medicaid waivers including a comparison table of all waivers implemented throughout the country. The report also explores the current use of 1135 waivers to respond to the COVID-19 pandemic.

The AARP Public Policy Institute recently launched a three-year initiative which aims to transform long term care in the United States. LTSS Choices will be a series of reports, blogs, videos, podcasts, and virtual convenings that seek to catalyze reform and spark ideas to modernize LTSS, long term services and supports. The goal is a long-term care system that provides a wide range of choices to meet the dynamic needs and preferences of consumers and their families.

CMS recently released a Report to Congress highlighting approaches five state programs implemented to address housing instability and improve treatment outcomes for people with Substance Use Disorder. Initiatives mentioned in the report focus on: providing housing-related supports that facilitate access to community resources; sharing data across systems to identify and target those in need for resources; and partnerships building across state and local health and housing systems and providers.

ACL and the Lewin Group released a report highlighting key takeaways from the AARP 2020 LTSS State Scorecard on state efforts in establishing high-performing ADRC/NWD systems. The report compares current data with results from the 2017 LTSS State Scorecard. The report provides scores based on five domains in ADRC/NWD system functions. The report also shares promising practices/lessons learned from five states – Alabama, Georgia, Massachusetts, Ohio, and South Dakota.

The GAO released a report on the impacts of the 2013 regulation that revised the domestic service employment and companionship services under the Fair Labor Standards Act (FLSA). This rule, which became effective in 2015, had the effect of extending minimum wage and overtime protections to a broader range of home care workers, many of whom provide Medicaid-funded home and community based services (HCBS).