Tag Archives: medicaid

New website helps states share home and community-based services, plus how to report on this topic

Photo by Myfuture.com via Flickr.

The Centers for Medicare & Medicaid Services (CMS) has launched a new “one-stop-shop” for state Medicaid agencies and stakeholders to improve transparency and encourage innovation for home and community-based services (HCBS).

HCBS allow people enrolled in Medicaid to receive services and support in a preferred setting outside of an institution, such as in their home. While Medicaid law requires states to cover nursing facilities and other institutional care, it does not require them to cover the full range of HCBS. States must apply for HCBS waivers to provide these services in the home environment.

This new webpage grants state Medicaid agencies and stakeholders access to other states’ plans or proposals to enhance, expand, and strengthen these services across the country using new Medicaid funding under the American Rescue Plan Act of 2021 (ARP). (The landing page is very text-heavy; you can find individual state plans by scrolling down towards the bottom of that page).

Journalists can tap into this resource to hold states and agencies accountable
for delivering promised services.

Some key information available on this website includes: 

  • Each state’s initial spending plan and narrative; CMS approval status and response.
  • A Home and Community Based Settings Toolkit to assist states develop Home and Community-Based 1915(c) waivers or renewal application(s).
  • Detailed guidelines from on how American Rescue Plans funds can be used.
  • Information about aging and aging services in rural America.

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Federal law criticized for excluding certain Medicaid patients from psychiatric care

Photo: Alachua County via Flickr

Photo: Alachua County via Flickr

A federal law that has long led to severely mentally ill Medicaid patients not receiving needed care at many psychiatric facilities has outlived its presumed usefulness, according to a recent report.

A February 2021 analysis by the Manhattan Institute documents how a federal institutes for mental diseases (IMDs) exclusion enacted in 1965 discourages states from investing in patient care and restricts care and access. The IMD exclusion bars states from using the federal portion of Medicaid payments for services rendered “inside or outside” IMDs. They include hospitals, nursing homes or other facilities with 16 or more beds that primarily provide mental health care. The exclusion targets Medicaid patients ages 21 to 64 years old. Continue reading

Does care suffer as private equity firms buy struggling nursing homes?

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Photo: Gilbert Mercier via Flickr

Private equity firms are in the business of making money. On the surface, there is nothing wrong with that. However, a disturbing story in The Washington Post alleges that when private equity is involved in the buying and selling of nursing homes, things are often worse than they seem.

The story, by reporters Rebecca Tan and Rachel Chason, looks at Portopiccolo Group, which has a history of buying one- and two-star rated facilities. Continue reading

Biden’s health plan likely to travel a rough road in the Senate

Biden wearing mask at podium

Photo: Budiey via Flickr

President-elect Joe Biden has an ambitious plan to build upon the Affordable Care Act, in effect evolving “Obamacare” into “Bidencare.”

But depending on the outcome of the two Georgia Senate run-offs, Biden either will face a Republican-controlled Senate or a tied Senate in which Vice President Kamala Harris can cast a tie-breaking vote. On some issues, the Democrats might pick up a few Republicans, and on others, they could lose a few votes from their side. Continue reading

Supreme Court case on Affordable Care Act could have far-reaching effects on Medicaid expansion, pre-existing condition protections

Photo by dbking via Flickr

On Tuesday, the U.S. Supreme Court will hear oral arguments on whether it should strike down the individual mandate and the entire Affordable Care Act.

As always, SCOTUSblog has all the details on the case, California v. Texas and Texas v. California (both of which have been consolidated for oral arguments on whether the ACA’s requirement that Americans get health insurance is constitutional and, if not, whether the rest of the ACA can survive). Continue reading