Medicaid long-term services and supports

States, Feds Not Adequately Monitoring Medicaid MLTSS

With more states delegating their programs of Medicaid managed long-term services and supports to managed care entities, state Medicaid programs and the federal government are not adequately overseeing the work of those managed care plans. As a result, they sometimes fail to notice quality and access problems for beneficiaries, according to the U.S. Government Accountability Office. When states delegate to managed care plans decisions about the amount and types of services that adults and children with physical, cognitive, and mental disabilities will receive, federal guidelines require states to monitor those decisions for appropriateness. In too many cases, the GAO has [...]

admin2020-12-21T06:00:34+00:00December 21, 2020|Medicaid long-term services and supports|

CMS Reports on Medicaid Long-Term Care Spending

The Centers for Medicare & Medicaid Services has issued a report on FY 2016 spending for Medicaid-covered long-term services and supports. The highlights of the $167 billion in state and federal spending include: Home and community-based services have accounted for almost all Medicaid long-term services and supports growth in recent years. Home and community-based services spending increased 10 percent in FY 2016, greater than the five percent average annual growth from FY 2011 through 2015. Institutional spending remained close to the FY 2010 amount. Institutional service spending decreased two percent in FY 2016 following an average annual increase of [...]

admin2018-06-08T06:00:16+00:00June 8, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid long-term services and supports|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that advises Congress, the administration, and the states on Medicaid and CHIP issues, met publicly in Washington, D.C. last week. The following is MACPAC’s own summary of its two days of meetings. The April 2018 meeting began with session on social determinants of health. Panelists Jocelyn Guyer of Manatt Health Solutions, Arlene Ash of the University of Massachusetts Medical School, and Kevin Moore of UnitedHealthcare Community & State discussed state approaches to financing social interventions through Medicaid. In its second morning session, the Commission reviewed a draft [...]

admin2018-04-23T06:00:05+00:00April 23, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. last week to discuss a number of Medicaid and CHIP meetings. The following is MACPAC’s summary of this meeting. MACPAC’S March 2018 meeting began with a review of two draft chapters with recommendations that will be included in MACPAC’s June 2018 report, the first to improve operation of the Medicaid drug rebate program and the second to improve the clarity of substance use disorder (SUD) confidentiality regulations. At the opening session the Commission reviewed a draft chapter on Medicaid drug policy and later voted to approve [...]

admin2018-03-08T06:00:35+00:00March 8, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid regulations for the disabled|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. to discuss a variety of Medicaid and Children’s Health Insurance Program issues. MACPAC, the non-partisan legislative branch agency that performs policy and data analysis and makes recommendations to Congress, the administration, and the states, addressed a number of issues during the meeting. Among them it discussed Medicaid managed long-term services and supports (MLTSS) and voted to recommend that states be given the opportunity to seek permission to make Medicaid beneficiary enrollment in managed care plans mandatory through revisions of their state plan amendment rather than by [...]

admin2018-01-30T06:00:58+00:00January 30, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid managed care|

Conflicts of Interest Mar HCBS

States’ efforts to provide home- and community-based services to elderly and disabled Medicaid beneficiaries who need assistance to continue living independently continue to be plagued with conflicts of interest that the Centers for Medicare & Medicaid Services is not adequately addressing. Or so concludes a new study published by the U.S. Government Accountability Office. According to the GAO, …conflict of interest remain in regard to HCBS providers and managed care plans. HCBS providers may have a financial interest in the outcome of needs assessments, which could lead to overstating needs and overprovision of services. CMS has addressed risks associated with [...]

admin2018-01-22T06:00:23+00:00January 22, 2018|Medicaid, Medicaid long-term services and supports|

GAO: Improvement Needed in MLTSS Oversight

The Centers for Medicare & Medicaid Services needs to improve the job it does overseeing state Medicaid programs of managed long-term services and supports. According to a new report by the U.S. Government Accountability Office, 22 states use MLTSS programs to help qualified seniors continue living independently in the community and to save money on nursing home costs. CMS’s oversight of these efforts, and of the use of federal funds, is inconsistent and often falls short when monitoring key considerations such as provider network adequacy, critical incidents, and appeals and grievances. To address these concerns, the GAO recommends that CMS [...]

admin2017-09-21T06:00:37+00:00September 21, 2017|Medicaid, Medicaid long-term services and supports|

States Lag in Reducing Nursing Home Utilization

States are not making adequate progress toward keeping seniors and the disabled out of nursing homes by making greater use of home and community-based services. Or so concludes a new study from AARP. According to the study, only nine states and Washington, D.C. spend more on home and community-based services and long-term services and supports than on nursing homes. Minnesota leads the nation, spending 69 percent of its long-term-care money on home and community-based services. Other leaders include Washington state (65 percent), New Mexico (64 percent), and Alaska (63 percent). Alabama pulls up the rear with only 14 percent. The [...]

admin2017-06-19T06:00:20+00:00June 19, 2017|Medicaid, Medicaid long-term services and supports|