Medicaid

MACPAC, the non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP), released its June 2023 Report to Congress on Medicaid and CHIP. The report features the agency’s recommendations in four areas: payment policy for safety net hospitals, integrated care for people who are dually eligible for Medicaid and Medicare, coverage for adults leaving incarceration, and access to Medicaid home- and community-based services (HCBS)...

On June 7, Justice in Aging published an issue brief titled “An Equity Framework for Evaluating and Improving Medicaid Home and Community Based Services.” In recent decades, long-term care has shifted from institutional settings to home and community-integrated settings. While access to HCBS has been steadily increasing over time, systemic inequalities due to racism, sexism, ageism, classism, etc. have led to large disparities in HCBS for diverse communities. This issue brief evaluates several ways in which the current setup of HCBS can cause inequities to arise. This includes program design, provider availability, awareness of HCBS, implicit bias in services, and provision of HCBS...

The Centers for Medicare & Medicaid Services has released a set of resources aimed at supporting state Medicaid and partner agencies in designing and delivering supports and services to meet the needs of adults with intellectual and developmental disabilities (I/DD), as well as their aging parents and caregivers. These resources cover a variety of topics, including strategies for how state Medicaid agencies can anticipate the needs of adults with I/DD, ways states can design and implement person-centered planning to support adults with I/DD, and state policies and practices to support aging caregivers of adults with I/DD.

The Centers for Medicare & Medicaid Services has released a set of resources aimed at supporting state Medicaid and partner agencies in designing and delivering supports and services to meet the needs of adults with intellectual and developmental disabilities (I/DD), as well as their aging parents and caregivers. These resources cover a variety of topics, including strategies for how state Medicaid agencies can anticipate the needs of adults with I/DD, ways states can design and implement person-centered planning to support adults with I/DD, and state policies and practices to support aging caregivers of adults with I/DD.

The Centers for Medicare & Medicaid Services has released a set of resources aimed at supporting state Medicaid and partner agencies in designing and delivering supports and services to meet the needs of adults with intellectual and developmental disabilities (I/DD), as well as their aging parents and caregivers. These resources cover a variety of topics, including strategies for how state Medicaid agencies can anticipate the needs of adults with I/DD, ways states can design and implement person-centered planning to support adults with I/DD, and state policies and practices to support aging caregivers of adults with I/DD.

This recently published brief by the Association of University Centers on Disabilities explores how Medicaid, particularly Medicaid home- and community-based services (HCBS) funding, can enhance employment opportunities for individuals with disabilities and older adults. It highlights the importance of competitive integrated employment (CIE) in improving wages, income, and financial outcomes for people with disabilities. The brief provides policy recommendations on leveraging Medicaid and Medicaid HCBS programs to ensure individuals with disabilities have access to both employment and essential long-term supports and services, reducing the need to choose between work and healthcare.

A new report by the Kaiser Family Foundation (KFF) presents findings from a survey and analysis of state Medicaid programs regarding crisis services. The survey reveals that while most states cover at least one core crisis service, there are gaps in coverage, particularly for adults under fee-for-service Medicaid. Additionally, the analysis explores the delivery, administration, and integration of behavioral health care within state Medicaid programs, highlighting the disproportionate share of adults with mental illness and substance use disorders covered by Medicaid. The report underscores the need for continued study and strategic policies to address access gaps and increased utilization of behavioral health services.

On Tuesday, May 30, CMS released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of February 2023, over 65.6 million people are enrolled in Medicare; nearly 34 million are enrolled in fee-for-service Medicare and more than 31.6 have a Medicare Advantage plan. Over 93.3 million enrollees have Medicaid and CHIP; more than 86.1 million individuals have Medicaid and nearly 7.2 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

The CMS OMH report, “Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability”, presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability...

June 5-11th marks the celebration of Medicare Fraud Prevention Week (MFPW), and the Senior Medicare Patrol (SMP) is actively participating in raising awareness and combating fraud. With Medicare fraud costing an estimated $60 billion annually and impacting beneficiaries' well-being, the SMP is dedicated to educating and empowering individuals to protect themselves against scams. Throughout the week, each day will be specifically targeted to a group of people who can help to prevent fraud, including: Medicare beneficiaries Caregivers Families Partners and professionals Health care providers Community members