Medicaid

The Centers for Medicare & Medicaid Services (CMS) released their monthly report for May 2016 on Medicaid and CHIP application, eligibility determination, and enrollment data. States provides data to CMS on factors related to key application, eligibility and enrollment processes using the Medicaid and CHIP Performance Indicator Project. The data is then used to inform CMS on the operations of the programs in each state and to share state performance data publicly.

The Milbank Memorial Fund’s Reforming States Group, with the New York State Health Foundation, published an issue brief that is a practical guide for policymakers who want to know when and how states can use Medicaid to facilitate access to social services. It offers a road map of the legal authorities upon which policymakers can rely to extend Medicaid coverage to social interventions and provides examples of how Medicaid can be an important component in improving the health of populations.

Justice in Aging published three new fact sheets in collaboration with SAGE, SHIP National Network, and ACL. The new fact sheets are designed to help LGBT consumers learn how recent changes in Medicare and Medicaid may affect them. The Supreme Court’s legalization of same sex marriage changed how both programs evaluate the eligibility of same sex spouses. Additionally, Medicare is covering Gender Reassignment Surgery and issued new rules that protect transgender older adults from discrimination.

On Friday, July1, 2016, Mathematica Policy Research published a report summarizing the basic approach to rate-setting in Medicaid managed care and reviews the main options for structuring managed LTSS (MLTSS) rates. It presents examples from states with financial alignment demonstrations as well as long-standing MLTSS programs. The report concludes by highlighting the policy and operational considerations that should influence a state’s choice of strategy.

Gary Sullivan, a member of UnitedHealthcare in Tennessee, shares his perspective on the benefits he’s received from being a UnitedHealthcare member. Gary, who was a practicing attorney until his retirement, has been wheelchair-bound due to his muscular dystrophy for many years, and has significant need for help with activities of daily living.

This White Paper explains a proposed quality framework for managed care programs serving individuals with intellectual and/or developmental disabilities (ID/DD). The framework, developed by UnitedHealthcare's National Advisory Board, extends beyond traditional clinical measures to benchmark the quality of the "services and supports" delivered in these programs to measure how these programs address individuals' quality of life.

The Centers for Medicare & Medicaid Services (CMS) released their monthly report for April 2016 on Medicaid and CHIP application, eligibility determination, and enrollment data. States provides data to CMS on factors related to key application, eligibility and enrollment processes using the Medicaid and CHIP Performance Indicator Project. The data is then used to inform CMS on the operations of the programs in each state and to share state performance data publicly.

CMS posted two new reports with Medicaid LTSS expenditures data. The first report focuses on the most recent data available and recent trends such as 1) an increase in LTSS provided in managed care programs and 2) increased used of newer Medicaid LTSS options authorized in the Deficit Reduction Act and the Affordable Care Act. The second report, “Improving the Balance,” uses data from FY1981 through FY2014 and documents the transition of Medicaid LTSS from institutional services to HCBS.

The Department of Health and Human Services (HHS) published a report about the Minnesota Senior Health Options (MSHO) program. The Centers for Medicare and Medicaid Services (CMS) and the State of Minnesota started MSHO to coordinate the Medicare and Medicaid benefits their members receive, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports. The report includes documentation of MSHO's outcomes from years 2010 to 2012.

ADvancing States, in consultation with the Centers for Medicare and Medicaid Services (CMS) and the Administration for Community Living (ACL) published a fact sheet regarding coordination of benefits between Older Americans Act programs and Medicaid LTSS services.