Medicaid Waivers

CMS will provide individualized technical assistance to the states on managed care program operations, including planning and procurement, benefit design and serving the needs of complex populations, access and quality, and the use of data for program oversight and management. The Medicaid Managed Care Technical Assistance Center is part of CMS's larger efforts to provide comprehensive information and guidance on Medicaid managed care program operations.

This compilation includes information about state 1915(c) Home and Community-Based Medicaid waivers, which provides the largest federal source of funding assistance for respite. New waiver tables have been added to this compendium for the following states: DC, Oregon, South Dakota, Utah, Washington, West Virginia, Wisconsin and Wyoming. Individual tables were also added to the Search Results pages for each of these states in the National Respite Locator under Respite Funding and Eligibility.

Presented at the 27th National Home and Community-Based Services (HCBS) Conference, this presentation discussed HCBS beginnings and momentum, including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP), data and metrics to build community-based services, and using metrics to move forward.

This poster describes the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid LTSS via HCBS waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses.

This survey reports on trends in Medicaid spending, enrollment and policy initiatives for FY 2012 and FY 2013. The report describes policy changes in reimbursement, eligibility, benefits, delivery systems and long-term care, as well as detailed appendices with state-by-state information, and a more in-depth look through four state-specific case studies of the Medicaid budget and policy decisions in Massachusetts, Ohio, Oregon and Texas.

The Workforce Investment Act (WIA) is the largest source of federally-funded employment and training services. WIA allows states to apply for waivers of WIA regulations to provide greater flexibility in serving the needs of local populations. The Department of Labor approved more than 750 state-requested waivers of statutory and regulatory requirements between 2008-2010. This report evaluates selected waivers during the time period to examine the possible effects of waiver implementation.

This document is the result of an 18-month process undertaken by the Alaska Commission on Aging to include the elder/senior communities of Alaska for input on the direction of senior services. Alaska’s state plan draws on values of respect, cultural-sensitivity, and dignity. The plan lists the different Older Americans Act programs implemented in Alaska with descriptions. Some of these are home and community-based services and the nutrition, transportation, and support services grant programs.

A statistical model was developed to assess the effect of rebalancing on overall spending for long-term services and supports (LTSS). The model indicates that spending is affected by the way rebalancing is implemented: Gradual rebalancing can reduce spending by about 15 percent over ten years. Because many states continue to experience budget crises, policy makers must think carefully before altering spending patterns for LTSS and adopt strategies to successfully reduce overall spending.

States provide long-term care services in homes and community-based settings through 1915(c) home and community-based services (HCBS) waiver programs. To ensure strong oversight of waiver programs, this report reviews documents from CMS's most recent quality review of waiver programs from 25 States, as well as information gathered from structured interviews with staff from the 10 CMS regional offices. The report also identify five recommendations to meet assurances related to quality of care.

Section 1115 waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states significant flexibility in how they operate programs and can have a significant impact on program financing. As such, waivers have important implications for beneficiaries, providers, and states. This brief provides an overview of Section 1115 waiver authority, the waiver approval process, and recent waiver activity and discusses the implications.