Medicaid Waivers

The Leavitt Partners released a report reviewing the Medicaid non-emergency medical transportation (NEMT) benefit, focusing on the program integrity of the benefit. . The report examines challenges and opportunities for Medicaid directors in improving Medicaid NEMT program integrity.

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.

This report highlights Medicaid waiver policies that could result in many people losing coverage, even as states incur greater costs. This report offers a detailed assessment of emerging waiver trends, providing insights into its critical implications. The report also describes how examining the research literature and evaluations of programs that impose similar policies can provide guidance on predicting the coverage and cost impacts of emerging waivers on Medicaid beneficiaries and states.

This issue brief highlights Medicaid HCBS enrollment and spending data from the Kaiser Family Foundation's 17th annual state survey. The report found that nearly all Medicaid HCBS enrollment (86%) and spending (93%) went to services provided at state option. This optional nature of most HCBS covered populations and services puts individuals at risk of losing services if the current structure of Medicaid financing were to change.

This paper focuses on how state-funded home and community-based services programs can support low-income older adults. It highlights promising practices that support maximum independence for low-income older adults and/or people with physical disabilities and their family caregivers. The paper explores programs across nine states, including Washington state’s emerging innovation: the Medicaid Transformation demonstration.

This brief highlights the importance of ongoing litigation around the ACA and discusses Medicaid demonstration waiver activities. It also addresses the recent passage of bi-partisan legislation with new tools and financing that states can use to strengthen their response to the opioid crisis. Finally, the brief reviews issues including Medicaid financing for Puerto Rico and USVI; Medicaid and public charge changes; and reforms in benefits, payment and delivery systems.

This report summarizes the Medicare Parts A & B actuarial savings analysis of the Washington managed fee-for-service (MFFS) demonstration for 2015 and 2016. The Washington Health Home MFFS demonstration aims to improve service quality and integration while reducing costs of care for high-risk, high-cost dually eligible beneficiaries. For 2015, Washington demonstrated a final gross Medicare savings of $30 million. The preliminary gross Medicare savings for 2016 are $42 million.

This recently released report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019. The report focuses on changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

As part of Mathematica’s ongoing evaluation project of section 1115 demonstrations, they have released their interim findings on MLTSS programs. This preliminary report looked closely MLTSS programs in New York and Tennessee and found mixed results regarding the goals of reducing hospitalizations and rebalancing care. Mathematica aims to release a final report on the effectiveness of MLTSS in 2019.