Medicaid

This report presents the Medicaid Commission's recommendations for the long-term sustainability of the Medicaid program. Review the recommendations about Long-Term Care, Benefits Design, Eligibility, Health Information Technology, Quality and Care Coordination. The Commission strongly recommends increased state flexibility in many areas to tackle more locally influenced issues.

This article outlines three potential models which may be adopted by states looking to develop programs designed to serve those individuals who are dually eligible for Medicare and Medicaid benefits. The article also discusses possible contractual issues important to state Medicaid agencies as well as environmental factors which may influence the choice of models and potential program's prospects for success.

CMS offers guidance to states on how to avoid payments to excluded entities and the consequences of failing to prevent these payments. The letter stresses that it is the states’ responsibility to clearly communicate to providers that it is their obligation to screen employees and contractors for exclusion prior to hiring or contracting. It also provides the location of the List of Excluded Individuals/Entities which can be used to prevent improper payment.

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.