Medicaid Proposed Rules Focus on Changes to HCBS Waivers, Dual Eligibles

The U.S. Department of Health and Human Services (HHS) today announced four initiatives to improve coordinated care for people with Medicaid and Medicare and help the disabled stay within their communities.

“Medicaid programs provide health coverage for millions of low-income Americans who otherwise would lack access to healthcare,” HHS Secretary Kathleen Sebelius said in a release. “With these new resources and flexibilities, states will have new options to make their Medicaid programs work better for the people they serve, while helping lower their costs.”

All states will receive increased flexibility to provide home- and community-based services (HCBS) for more people living with disabilities. The proposed rules suggest changes to HCBS waiver provisions, allowing individuals to participate in the design of their own array of services and supports, including such things as personal care and respite services for caregivers.

States are also eligible to receive more money to develop simpler and more efficient information technology (IT) systems to modernize Medicaid enrollment, HHS announced.

In addition, 15 states will receive up to $1 million each in federal funding to develop better ways to coordinate care for dual eligibles. The goal of the program is to eliminate duplication of services for these patients, expand access to needed care, and lower costs.

The 15 states that will receive these funds are California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington, and Wisconsin.

Read more

Proposed rule: Home and Community-Based Services (HCBS) Waivers (PDF format)

Proposed rule: Federal Funding for Medicaid Eligibility Determination and Enrollment Activities (PDF format)

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