Medicaid

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.

This brief examines Medicaid's key role in meeting the long-term care needs of seniors in the United States, particularly those with limited incomes. Medicaid is the nation's primary payer of long-term services and supports, and state Medicaid programs provide a range of long-term care services. The brief includes state-by-state data on Medicaid enrollment and expenditures for elderly beneficiaries.

As 2014 approaches, many states are preparing for implementation of the major provisions of the Affordable Care Act (ACA) law, including a new streamlined Medicaid enrollment system and, at states' option, the expansion of Medicaid. It has been found that nearly all states are pressing forward with information technology and process improvements to develop faster, streamlined Medicaid enrollment systems, whether or not the state elects to expand Medicaid coverage under the law.

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.

This brief provides a short summary of Medicaid eligibility and benefits for people with disabilities today and explains how they will be affected by the ACA in light of CMS's new regulations. Provisions of the new Exchange regulations are discussed briefly to the extent that they related to Medicaid eligibility determinations for people with disabilities.

This brief provides a summary of the CMS’s March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility and enrollment coordination. The rule (effective Jan. 1, 2014) lays out procedures for states to implement expansion and streamline and integrate eligibility and enrollment system. Achieving this goal will require substantial process and system changes among state Medicaid agencies and close coordination between Medicaid and other insurance affordability programs.

This issue brief revisits the use of SSA work supports among the nearly three-quarters of Buy-In Participants who also receive Social Security Disability Insurance (SSDI). To better understand who might benefit most from program outreach, this report explores variation in use rates by age, education, and disabling health condition. It also examines the relationship between work-support use, employment, and earnings.

In light of the 26 states that have applied to the Centers for Medicare and Medicaid Services for permission to integrate Medicare and Medicaid for dual eligibles, the webinar explained the processes involved in the demonstrations, with a focus on how the new systems will affect both assisted living and long-term services and supports. Visit the website to download a recording and slides from the presentation.