Medicaid
MACPAC Summary, Part 2
On Friday, commissioners addressed several other HCBS-specific items. One session, ‘HCBS Spending and Utilization,’ focused on HCBS spending and utilization by demographic characteristics, taxonomy categories, and long-term services and supports (LTSS) subpopulations. This analysis examined data spanning 2019 to 2021 from the Transformed Medicaid Statistical Information System (T-MSIS), providing an update to MACPAC’s 2017 HCBS […]
Read MoreMACPAC Summary, Part 1
On December 12-13, the Medicaid and CHIP Payment and Access Commission (MACPAC) held their monthly convening. Several sessions were of relevance to the home care community, including managed care oversight, self-direction in home and community-based services (HCBS), findings from an extensive analysis of HCBS spending and utilization patterns, and findings on Medicaid payment policies that […]
Read MoreNORC Study Reveals Significant Coverage Loss among Dual Eligibles
On November 19, 2024, the NORC research center at the University of Chicago released a study examining the impact of Medicaid unwinding on individuals dually eligible for Medicare. Dual eligibles generally represent individuals with the highest level of need given that they qualify for Medicare on the basis of age and/or disability & qualify for […]
Read MoreCMS Training Series on the HCBS Provisions of Medicaid Access Rule
The Centers for Medicare & Medicaid Services (CMS) is continuing their training series on the home-and community-based services (HCBS) provisions of the Medicaid Access Rule. The Ensuring Access to Medicaid Services final rule (Access rule) advances access to care and quality of care, and will improve health outcomes for Medicaid beneficiaries across fee-for-service (FFS) and […]
Read MoreCMS Releases Annual Medicaid Home and Community-Based Services Data
On Thursday, November 21, 2024, the Centers for Medicare & Medicaid Services (CMS) released its annual Medicaid long-term services and supports (LTSS) report. This annual update is the most comprehensive national information available regarding Medicaid LTSS and home and community-based services (HCBS) enrollment, utilization, and expenditures. The data includes year-over-year national trends as well as […]
Read MoreMedicaid Updates with the National Alliance for Care at Home
Join Paradigm and Damon Terzaghi, Senior Director of Medicaid Advocacy at the National Alliance for Care at Home, for a deep dive into the latest federal Medicaid updates that directly impact home care agencies like yours. Gain critical insights into upcoming regulatory changes and how to best navigate the shifting political landscape. 🗓️ Key Topics We’ll […]
Read MoreCMS Releases Annual Updates to Medicaid Eligibility Standards
On Friday, November 15th, the Centers for Medicare & Medicaid Services (CMS) released an information bulletin that provided information about annual updates to the income standards for certain eligibility groups. Many eligibility criteria for older adults and people with disabilities are based on the Supplemental Security Income (SSI) program’s Federal Benefit Rate (FBR), and certain […]
Read MoreMedical Loss Ratio Data for Medicaid Managed Care Programs
On Friday, November 1, 2024, the Center for Medicare & Medicaid Services (CMS) released public information on medical loss ratio (MLR) data for Medicaid managed care programs. MLR is a calculation used to measure revenue received by a health plan that was used to pay for services and for quality improvement activities. Medicaid law and […]
Read MoreCMS Releases Updated Guidance on EPSDT
On Thursday, September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) letter that provided detailed guidance on the Medicaid early and periodic screening, diagnostic, and treatment (EPSDT) requirement. The EPSDT mandate applies to children under the age of 21 and is the most expansive coverage entitlement within […]
Read More