Policy alerts, briefs, letters & papers

On September 28, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter which introduces the Medicaid Transportation Coverage Guide. The guidance highlights existing policies and also includes new policies to address scenarios for extended wait times and long-distance trips, and scenarios where non-Medicaid eligible parents, family members, or other caregivers may require transportation to participate in a Medicaid-eligible child’s care. CMS encourages states to use the document as a guide when developing and updating policies and procedures that facilitate robust transportation programs, noting that Medicaid transportation is a critical service that has a direct impact on health outcomes.

On Thursday, September 28, the AARP Public Policy Institute released the 2023 edition of its LTSS State Scorecard, which uses data from a wide range of sources to describe how state long-term services and supports (LTSS) systems are performing. Released every three years since 2011, the Scorecard measures LTSS systems across five different dimensions: affordability and access; choice of setting and provider; safety and quality; support for family caregivers; and community integration. The upcoming release of this year's LTSS Scorecard will also explore new focus areas, including equity, workforce, and the impact of COVID-19. Furthermore, the 2023 Scorecard will introduce "Innovation Points," a novel feature offering an innovative approach..

The National Conference of State Legislatures, a partner of the State Exchange on Employment & Disability, recently published a policy brief titled, “Trends in Disability Employment Legislation.” This resource explores key trends from the 2022 and 2023 state legislative sessions aimed at improving employment opportunities for individuals with disabilities. These trends encompass incentivizing inclusive hiring practices, promoting competitive integrated employment, eliminating subminimum wages for workers with disabilities, addressing the impact of long COVID on the workforce, and enhancing mental health support in the workplace.

With Ageism Awareness Day just around the corner on October 7, members of the American Society on Aging (ASA) are actively using social and printed media to spotlight ageism and advocate for change. The September-October edition of ASA's "Generations Today" publication focuses on the portrayal of aging in media, marketing, and culture. Articles within the issue emphasize the pressing need for transformations in journalism, advertising, and entertainment that better reflect and represent older individuals.Readers are encouraged to join the Ageism Awareness Day movement, connect with ASA, and be part of the transformative efforts to address aging more positively, as discussed in the publication’s content.

Trust for America’s Health (TFAH), with partnership and funding from The John A. Hartford Foundation, recently published a brief titled “Ensuring Age-Friendly Public Health in Rural Communities: Challenges, Opportunities, and Model Programs.” This brief, the second in a series of publications dealing with the health and wellness of older adults, outlines the status of older adults living in rural environments and opportunities for public health to support them. It highlights existing innovations that engage rural older adults and offers recommendations to ensure all older persons, regardless of geographic location, have access to age-friendly public health systems...

AARP recently released an article exploring the evolving landscape of telehealth within Medicare, spotlighting its transformation amid the COVID-19 pandemic. With telehealth adoption soaring to 40% among Medicare beneficiaries in 2020, the article accentuates the significance of audio-only visits and the imminent legislative choice regarding post-2024 coverage. AARP also discusses the importance of these virtual services in ensuring comprehensive healthcare access while addressing potential challenges like accessibility, cost implications, and concerns of misuse.

The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) presents an analysis focusing on the status of women with disabilities within the labor market. Drawing from various surveys and data sources, the report explores disability prevalence, employment trends, earnings, poverty rates, occupational distributions, telework patterns, and barriers to employment, with special attention to the effects of the COVID-19 pandemic. This resource provides insights into the evolving dynamics of labor market participation, shedding light on the experiences and challenges faced by women with disabilities.

This week, the Centers for Medicare & Medicaid Services (CMS) announced that Appendix K flexibilities currently scheduled to end on Nov. 11, 2023 may be extended, if a state takes action by Nov. 11, 2023 to permanently incorporate desired Appendix K provisions into their 1915(c) programs. The applicable Appendix K flexibilities will remain in place until the effective date of the 1915(c) waiver amendment or renewal...

KFF’s brief, “Key Facts About Medicare Part D Enrollment and Costs in 2023”, analyzes enrollment and costs for the Medicare Part D benefit in 2023 and trends. Medicare Part D provides outpatient prescription drug coverage through a standalone Medicare Part D plan (PDP) to supplement Original or Traditional Medicare, or through a Medicare Advantage Prescription Drug plan (MA-PD) or other Medicare Health Plan with drug coverage. The analysis notes that in 2023 over half of those with Medicare Part D coverage are enrolled in a Medicare Advantage plan with a Part D benefit. Enrollment in the MA-PD plans continues to outpace enrollment in PDPs. MA-PD enrollment grew by 47% between 2019 and 2023 while PDP enrollment fell by 12%.

The Centers for Medicare & Medicaid Services (CMS) recently introduced the Transitional Coverage for Emerging Technologies (TCET) pathway, a voluntary expedited Medicare coverage process for certain FDA-designated Breakthrough Devices. This new pathway aims to support innovation while ensuring faster and more consistent access to emerging medical technologies for Medicare beneficiaries. The TCET pathway offers manufacturers increased pre-market engagement with CMS and a high level of flexibility to address evidence gaps for coverage. This initiative seeks to develop reliable evidence for informed healthcare decision-making and to ensure high-quality care for Medicare beneficiaries.