Medicaid

MITA provides a common framework for all Medicaid stakeholders to focus on opportunities to build common and shared services by decoupling legacy systems and processes, and liberating data previously stored and contained in inaccessible silos. The newest version takes into account new legislative requirements outlined in the Health Information Technology for Economic and Clinical Health Act, the Children's Health Insurance Program Reauthorization Act, and the Affordable Care Act.

Have you seen the new site sponsored by CMS? This space offers a resource center for states, up to date information about the affordable care act and additional federal policy guidance. The waiver section organizes information by state, program name, waiver authority and status of a application. This chart gives an overview of the four primary types of waivers and demonstration projects: Section 1115, Section 1915(b) Managed Care, Section 1915(c) HCBS, and Concurrent Section 1915(b) and 1915(c).

State Medicaid agencies fund supports & services for individuals with disabilities. As national public policy recognizes & emphasizes the ability of individuals with disabilities to work, states are integrating employment supports into the continuum of long-term care in Medicaid. This brief discusses federal legislative & regulatory framework for funding employment supports in Medicaid, highlights examples of state innovations & best practices to promote positive employment outcomes.

A growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility to many uninsured low-income adults, including those with disabilities. This issue brief looks at issues related to the development and implementation of managed care programs with the capacity to serve Medicaid beneficiaries with disabilities.

This issue brief looks at issues related to the development and implementation of managed care programs with the capacity to serve Medicaid beneficiaries with disabilities. Drawing on existing research on Medicaid managed care and people with disabilities, the brief highlights policy considerations related to setting plan payment rates, developing adequate provider networks and delivery systems, and ensuring sufficient beneficiary protections and plan oversight.

The 9 million individuals enrolled in both Medicare and Medicaid often receive care that is fragmented, poorly coordinated, and high-cost. Integrating their care is difficult because of the challenges associated with aligning the programs' financial incentives and reimbursement processes. This brief explores considerations for establishing reimbursement rates and performance incentives for the capitated and managed fee-for-service financial models.

Overview provided about individuals and families who can be expected to receive assistance under insurance affordability programs, which include Medicaid, CHIP, advance premium tax credits and cost-sharing reductions, and Basic Health Programs. Particular focus is placed on the characteristics of individuals whose incomes place them at or near the Medicaid/exchange dividing line. The authors identify opportunities for greater collaboration and alignment in key areas.

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 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.

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.