Medicaid

This issue brief focuses on the special needs population of dual eligible’s as defined in the Special Needs Plan (SNP), a type of Medicare Advantage plan created by the Medicare Modernization Act of 2003 (MMA). The brief concludes how the SNP has failed this population and offers recommendations for improving dual-eligible SNPs’ prospects.

This document is from a poster session and it illustrates and explains "the Hilltop Crossover Framework" in relation to the coordination of Medicare and Medicaid services to those who are dually eligible. This framework outlines how these services and costs are related.

<i>NOTE: The effective date for this rule has been postponed to April 3, 2009 and the comment period has been reopened, pending review by the Obama administration. See "Interim Rule" below.</i> CMS issued a Final Rule giving states the flexibility to define the scope of medical assistance covered by Medicaid by offering coverage of benchmark or benchmark-equivalent benefit packages to certain recipients. The file contains the official text of the rule as entered into the Federal Registry.

The first in a series of reports, this study is a product of a larger effort by the state of Maryland and The Hilltop Institute to address questions related to the coordination of care for Medicaid recipients who are dually eligible for Medicare benefits. The report focuses on issues related to setting Medicaid payment rates. Although based on Maryland data alone, results from this study will be broadly relevant to other states as well.

This report summarizes available research to date regarding the effectiveness of peer support and presents State examples of peer support within three different Medicaid authorities (State Plan, 1915(b), and 1915(c)). State Medicaid Agencies and their partner mental health agencies can find guidance here for efforts to incorporate peer support into Medicaid programs.

PAS Center offers state-by-state participant and expenditure data for all of Medicaid and the three main HCBS programs: 1915(c) waivers, home health, and state plan personal care. The December 2008 update provides 2005 data complemented by survey results related to program policies and provider reimbursement rates.

Recessions deliver a one-two punch to Medicaid by undercutting available public funds and increasing demand for services. This policy brief presents several options for strengthening Medicaid during these periods. Options outlined include: directing federal funding support; quickly reauthorizing SCHIP; simplifying enrollment; easing burdens imposed by the process of proving citizenship; and expanding coverage to those hit hardest by recession.

One way Indiana communicates with HCBS waivers consumers is via this document. Updated periodically, it describes available waivers and what services they cover, eligibility requirements, quality assurance mechanisms and the rights of the consumer. It also provides instructions for applying, contact information for other HCBS resources, and tips on choosing good providers. The guide comes with a feedback and evaluation survey.

This report estimates that public financial and personal clinical outcomes can be improved by moving dual eligibles to capitated managed care. The authors view the clinical and eligibility characteristics of dual eligibles as well-matched to the strengths of integrated care programs. The document lays out the reasoning and data behind the estimate, recommends policy changes needed to make the transition, identifies potential barriers to implementation and offers examples from KY and MN.

This presentation on Medicaid Infrastructure Grants (MIG) presents information regarding what ADRCs need to know about work incentive programs for individuals with disabilities. The presentation was part of the ADRC TA program and was delivered in November 2008. Additionally, a link is included to an informational website for the Ticket to Work Incentives Improvement Act.