Medicaid

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How State Agencies Can Anticipate and Meet the Needs of Adults with Intellectual and Developmental Disabilities and Their Aging Caregivers

The Centers for Medicare & Medicaid Services has released a set of resources aimed at supporting state Medicaid and partner agencies in designing and delivering supports and services to meet the needs of adults with intellectual and developmental disabilities (I/DD), as well as their aging parents and caregivers. These resources cover a variety of topics, including strategies for how state Medicaid agencies can anticipate the needs of adults with I/DD, ways states can design and implement person-centered planning to support adults with I/DD, and state policies and practices to support aging caregivers of adults with I/DD.

Short URL: http://www.advancingstates.org/node/74648

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Enhancing Employment Opportunities and Outcomes Within Medicaid Home- and Community-Based Services

This recently published brief by the Association of University Centers on Disabilities explores how Medicaid, particularly Medicaid home- and community-based services (HCBS) funding, can enhance employment opportunities for individuals with disabilities and older adults. It highlights the importance of competitive integrated employment (CIE) in improving wages, income, and financial outcomes for people with disabilities. The brief provides policy recommendations on leveraging Medicaid and Medicaid HCBS programs to ensure individuals with disabilities have access to both employment and essential long-term supports and services, reducing the need to choose between work and healthcare.

Short URL: http://www.advancingstates.org/node/74645

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Amid a Mental Health Crisis in the U.S., A New KFF Report Examines the Steps that State Medicaid Programs Are Taking to Help Shore Up the Availability of Crisis Services

A new report by the Kaiser Family Foundation (KFF) presents findings from a survey and analysis of state Medicaid programs regarding crisis services. The survey reveals that while most states cover at least one core crisis service, there are gaps in coverage, particularly for adults under fee-for-service Medicaid. Additionally, the analysis explores the delivery, administration, and integration of behavioral health care within state Medicaid programs, highlighting the disproportionate share of adults with mental illness and substance use disorders covered by Medicaid. The report underscores the need for continued study and strategic policies to address access gaps and increased utilization of behavioral health services.

Short URL: http://www.advancingstates.org/node/74637

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CMS Releases Latest Enrollment Figures for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP)

On Tuesday, May 30, CMS released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of February 2023, over 65.6 million people are enrolled in Medicare; nearly 34 million are enrolled in fee-for-service Medicare and more than 31.6 have a Medicare Advantage plan. Over 93.3 million enrollees have Medicaid and CHIP; more than 86.1 million individuals have Medicaid and nearly 7.2 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

Short URL: http://www.advancingstates.org/node/74635

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Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability Report

The CMS OMH report, “Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability”, presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability...

Short URL: http://www.advancingstates.org/node/74633

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Medicare Fraud Prevention Week Begins June 5

June 5-11th marks the celebration of Medicare Fraud Prevention Week (MFPW), and the Senior Medicare Patrol (SMP) is actively participating in raising awareness and combating fraud. With Medicare fraud costing an estimated $60 billion annually and impacting beneficiaries' well-being, the SMP is dedicated to educating and empowering individuals to protect themselves against scams. Throughout the week, each day will be specifically targeted to a group of people who can help to prevent fraud, including: Medicare beneficiaries Caregivers Families Partners and professionals Health care providers Community members

Short URL: http://www.advancingstates.org/node/74624

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The Unwinding of Medicaid Continuous Enrollment: Knowledge and Experiences of Enrollees

The Kaiser Family Foundation (KFF) has released a brief that gauges Medicaid enrollee’s knowledge of and preparedness for the Medicaid renewal process and possible disenrollment from the Medicaid program. The findings are based on a survey of health insurance consumers fielded between February 21, 2023, and March 14, 2023. Key findings indicate that most Medicaid enrollees were not aware that states are now permitted to resume disenrolling people from the Medicaid program, and nearly half of the Medicaid enrollees indicated they have not been through a renewal process, including two-thirds of older adults. The brief also notes that fewer older adults indicate they have provided updated contact information to their state Medicaid agency.

Short URL: http://www.advancingstates.org/node/74622

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Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program Notice for Proposed Rulemaking (CMS-2434-P)

CMS’ recent rule, released on May 23, proposes to lower the cost of prescription drugs covered by Medicaid by increasing price transparency. The proposed regulation would give CMS and states additional tools, like a drug price verification survey, which would verify drug prices to increase transparency about why the costs of certain drugs are expensive for Medicaid and help states better negotiate what the Medicaid program pays for high-cost drugs. CMS also proposes that contracts between states, Medicaid-managed care plans, and third-party contractors, such as pharmacy benefit managers (PBMs), reflect transparent reporting of drug payment information among third-party contractors...

Short URL: http://www.advancingstates.org/node/74621

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Medicare and LGBTQ+ Older Adults: Resources for Advocates

The latest resource from Justice in Aging focuses on Medicare and LGBTQ+ older adults, addressing the challenges they face in accessing and utilizing their Medicare benefits. The publication includes two fact sheets to provide essential information and tips for LGBTQ+ older adults with Medicare and their advocates. The first fact sheet, "Marriage, Medicare, and Medicaid: What Same-Sex Couples Need to Know," covers Medicare coverage rules for spouses and the impact of spousal income on programs affecting Medicare costs. The second fact sheet, "Medicare & Transgender Older Adults: What Transgender People Need to Know," addresses critical issues related to gender identification, surgeries, transition-related drugs, and sex-specific procedures.

Short URL: http://www.advancingstates.org/node/74614

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Melissa & Ann: Navigating America’s Tangled Health Care Safety Net

Arnold Ventures has introduced a new project titled "Melissa & Ann: Navigating America's Tangled Health Care Safety Net," a compelling photo essay featuring the lives of two women living in Southern California who are dually enrolled in Medicare and Medicaid. Through the lens of award-winning photographer Isadora Kosofsky, this project sheds light on the daily triumphs, challenges, and complexities faced by older adults and people with disabilities navigating the health care system. By sharing these intimate stories, Arnold Ventures aims to inspire policymakers to prioritize improving care for the diverse population of low-income older adults and people with disabilities who are dual-eligible for Medicare and Medicaid.

Short URL: http://www.advancingstates.org/node/74613

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