Medicaid

The Affordable Care Act authorized the Medicaid Health Home State Plan Option, which allows states to design health homes to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions. States will receive enhanced federal funding to support the rollout of this new integrated model of care. This link directs to the Health Home Resource Center that provides technical assistance services for states as they submit their proposals for these health homes to CMS.

A representative sample of 1,019 adults ages 40 or older were interviewed regarding their experiences and beliefs about their need for long-term care services, what such care would cost, and how such issues fit into their concerns about growing older. This report outlines survey findings. Findings include, 58% of participants underestimate the cost of nursing homes, 41% have discussed long-term care preferences with family and 51% support a government sponsored long-term care insurance program.

An updated fiscal outlook of state and local governments projects an ever increasing gap between receipts and expenditures through 2060, absent any policy changes. The report found that this decline in the state and local government sectors' operating balance is primarily due to rising health related costs of state and local expenditures on Medicaid and the cost of health care compensation for state and local government employees and retirees.

SAMHSA has updated its definition of recovery as it pertains to substance use and mental disorders. This working definition and set of guiding principles reflects the increased role peer supports and Peer Specialists have been playing in mental health programming. This document provides a summary of SAMHSA’s new definitions, as well as a checklist for effectively using peer supports in a variety of mental health programs.

This report examines the importance of Medicaid as a safety net for financing long-term services and supports (LTSS). Most older adults will require some form of LTSS, but paid LTSS can be very expensive. Unpaid, family caregiving has enormous economic value and currently accounts for the greatest portion of LTSS provision. However, if an individual needs paid LTSS, and can't afford LTSS insurance, Medicaid is often needed after an individual spends down their assets.

This checklist prepared by the National Academy for State Health Policy (NASHP) highlights the ACA Medicaid requirements that will take effect in the next two years, nearly all of which will apply to states regardless of whether the state chooses to expand Medicaid eligibility.

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.

CMS released a letter to State Medicaid Directors discussing mutual obligations and accountability of both state and federal governments for the integrity of the Medicaid program and the development, application, and improvement of safeguards vital to ensure proper and appropriate use of federal and state dollars. The letter also discusses a new requirement that states submit upper payment limit (UPL) demonstrations on an annual basis, and guidance on the format and method of UPL demonstration.

New guidance establishes a one percentage point increase in the federal medical assistance percentage (FMAP) for certain preventive services. States must cover their standard Medicaid benefit package, all recommended preventative services, administration, adult vaccines, and can not impose cost-sharing on these services in order to claim the one percentage point.

As increasing numbers of state Medicaid agencies implement both MFP and MLTSS programs, it is important to understand how they can work together to achieve common goals -- shifting the balance of LTSS from institutional care to HCBS settings. This report examines how 5 states have structured the interface between the two programs, including overlap in eligible groups, design of Medicaid payment rates to managed care organizations (MCOs); and how MFP and MCO staff share or divide responsibility.