Medicaid Waivers

The Administration on Aging (AoA) has a new page on its website that highlights program and funding opportunities within the Affordable Care Act that relate to the mission and vision of AoA and the Aging Network. Topics covered include Medicare and Medicaid, prevention, and webinars and technical assistance resources.

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

This bulletin provides information that CMS hopes will be helpful to States as they work to implement section 3309 of the Affordable Care Act which eliminates Part D cost-sharing for full benefit dual eligible individuals receiving home and community-based services. The effective date for Section 3309 is January 1, 2012.

This bulletin clarifies earlier guidance the Centers for Medicare & Medicaid Services provided in a May 31, 2011 Informational Bulletin and accompanying Frequently Asked Questions on section 6501 of the Patient Protection and Affordable Care Act (ACA). Section 6501 of the ACA amends a section of the Social Security Act and requires State Medicaid agencies to terminate the participation of any individual or entity if terminated under Medicare or any other State Medicaid plan.

State aging & disability agencies are operating in an era of state agency reorganization, re-conceptualization of state government, & restructuring of long-term services & supports delivery systems & financing. Key elements driving continued change include the economic environment, ACA implementation, uncertainty in the federal budget particularly with the failure of the Congressional Super Committee, changes in state level leadership, & the 2012 elections.

The latest HCBS data from The Kaiser Commission on Medicaid and the Uninsured and the University of California at San Francisco analysis of The Centers for Medicare & Medicaid Services (CMS) Form 372 have been added and are available for all states and the nation for 2008. This website allows you to do an interactive search. Review the updated topics including total HCBS waivers, participants by waiver type, home health expenditures, and personal care participants.

This brief describes key features of Georgia’s MFP program & highlights recent experiences. Through MFP, Georgia has achieved a 2 percent growth in annual spending on home & community-based services. With the extension of MFP under the ACA, the state plans to continue the program through 2016 with hopes to transition more than 2,000 individuals with the help of over $93 million in enhanced federal matching funds. Also, review brief profiles on several Georgia residents enrolled in the program.

Developing home & community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of Medicaid long-term care dollars still go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 19% in 1995 to 43% in 2008. More than 3 million people were served by Medicaid HCBS programs in 2008 and hundreds of thousands of people are on waiting lists.

Medicaid officials in every state are enacting a variety of cost cutting measures as states’ spending is projected to increase 28.7% in FY2012 to make up for the loss of federal stimulus money. The survey finds cost containment actions ranging from restrictions on payments to providers & benefits, to new copayments for beneficiaries & additional efforts to contain the costs of prescription drugs. States are also trying to make their programs more efficient through a number of procedures.