Eligibility

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An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

Section 1115 waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states significant flexibility in how they operate programs and can have a significant impact on program financing. As such, waivers have important implications for beneficiaries, providers, and states. This brief provides an overview of Section 1115 waiver authority, the waiver approval process, and recent waiver activity and discusses the implications.

Short URL: http://www.advancingstates.org/node/53112

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Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities

In 2014, most homeless people will become Medicaid-eligible under the Affordable Care Act. Many homeless people have physical and behavioral health conditions for which they seek care through frequent use of emergency rooms and inpatient hospitalization, at considerable cost in public resources. Medicaid reimbursement is an important source of funding for services that help homeless people succeed in housing and stop such inappropriate use of crisis health services.

Short URL: http://www.advancingstates.org/node/53101

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A National Review of Home and Community Based Services (HCBS) for Individuals with Autism Spectrum Disorders

Autism spectrum disorders are among the fastest-growing developmental disability diagnosis in the US. This growing number highlights the need to learn more about the services & supports that are currently available for adults with ASD, & consider those that will be needed throughout their adult lifespan. The purpose of the study was to investigate how people with ASD are being served across states in HCBS, including service eligibility, state trends specific to autism services & lessons learned.

Short URL: http://www.advancingstates.org/node/53094

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Rethinking Medicaid Program Integrity: Eliminating Duplication and Investing in Effective, High-Value Tools

Medicaid program integrity is among the highest priorities of the nation’s Medicaid Directors and is a key component of every initiative and program states conduct. Program integrity is about creating a culture where there are consistent incentives to provide better health outcomes within a context that avoids over-or underutilization of services. Directors seek to promote economy, efficiency, accountability, and integrity in the management and delivery of services.

Short URL: http://www.advancingstates.org/node/53078

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Medicaid.gov Website

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).

Short URL: http://www.advancingstates.org/node/53071

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Using Medicaid Funding to Support the Employment of People with Disabilities: A Federal Framework

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.

Short URL: http://www.advancingstates.org/node/53061

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The Center for Medicare and Medicaid Innovation: Activity on Many Fronts

In its first year of operation, the Center for Medicare and Medicaid Innovation has a long list of accomplishments, yet some observers express concern that its fast-paced approach may be overwhelming to smaller delivery systems. A status report of the Innovation Center’s activities to date is provided, including delineating the goals envisioned by Congress, detailing the new tools it was given, and emphasizing how the enhanced authority compares with CMS’ traditional demonstration programs.

Short URL: http://www.advancingstates.org/node/53043

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Building a Relationship between Medicaid, the Exchange and the Individual Insurance Market

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.

Short URL: http://www.advancingstates.org/node/53042

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A Roadmap to a 21st-Century Disability Policy

Despite decades of increases in program participation and spending, the disability support infrastructure in the United States and the economic independence of people with disabilities have eroded. Rather than tighten eligibility or reduce program benefits, this issue brief proposes gradual programmatic reforms and evidence-based structural changes to improve the economic status of Americans with disabilities.

Short URL: http://www.advancingstates.org/node/53040

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On the Verge: The Transformation of Long Term Services and Supports

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Short URL: http://www.advancingstates.org/node/53034

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