Category

Medicaid

Fact Sheet: Medicaid Non-Emergency Medical Transportation for Older Adults: A Critical Benefit at Risk

By | FACT SHEET, Health Care, Medicaid, Medicare, REPORTS

Non-Emergency Medical Transportation (NEMT) is a federally required Medicaid benefit. Within certain guidelines, each state Medicaid program is given significant discretion in crafting the NEMT benefit for Medicaid beneficiaries. This important program currently serves over 7 million Medicaid enrollees who, due to cognitive and physical changes, may have a reduced ability to drive or use public transportation. It is now under threat.

The Centers for Medicare and Medicaid Services (CMS) has signaled that it will propose a regulation in May 2019 to make the mandatory NEMT benefit optional for states. States could then choose to amend their Medicaid rules to eliminate or reduce the benefit.

A new Justice in Aging fact sheet provides advocates with information about why NEMT is important, how it is administered, and the current threat to this vital benefit, as well as information on where to go for more information and advocacy tips for preserving the NEMT benefit in their states.

Justice in Aging is working in coalition with partners like Community Catalyst to raise awareness about the importance of Medicaid transportation to ensure it remains a covered benefit.

Health Care for Elders with Limited English (in Chinese)

By | DUAL ELIGIBLES, Health Equity, IN THE NEWS, Medicaid, Newsroom

AARP TV: Health Care for Elders with Limited English (May 1, 2019)

There are currently about five million older adults with limited English proficiency in the United States, and the numbers are growing. It is important that LEP older adults know their rights in health care settings, and feel comfortable speaking up and asking for materials to be translated into their language or for translation services, if needed. This interview with Justice in Aging Senior Staff Attorney, Denny Chan talks to AARP about how LEP seniors can learn about and exercise their rights. This interview is subtitled in Chinese.

Health Care for Elders with Limited English (in English)

By | DUAL ELIGIBLES, IN THE NEWS, Medicaid, Newsroom

AARP TV: Health Care for Elders with Limited English (May 1, 2019)

There are currently about five million older adults with limited English proficiency in the United States, and the numbers are growing. It is important that LEP older adults know their rights in health care settings, and feel comfortable speaking up and asking for materials to be translated into their language or for translation services, if needed. This interview with Justice in Aging Senior Staff Attorney, Denny Chan talks to AARP about how LEP seniors can learn about and exercise their rights. This interview is in English.

 

CMS To Extend Existing Duals Demos, Invites Other States To Join

By | Health Care, IN THE NEWS, Medicaid, Medicare

Inside Health Policy (April 24, 2019)

The Centers for Medicare and Medicaid Services (CMS) has invited states that aren’t currently participating in the duals demonstration to talk with the agency about starting their own version, whether through the capitated financial alignment model, the managed fee-for-service model or some other state-specific model worked out with the agency. CMS also said it plans to allow states that are already in the demonstration to make some changes, if necessary, or to extend the ongoing-demo for multiple years. Justice in Aging attorney Georgia Burke was interviewed for the article and noted that she’s happy CMS intends to work with states to continue the ongoing demonstrations and hopefully drawing on lessons learned for new states to incorporate in their demos. She also praised CMS for encouraging multiple models, and touted CMS’ emphasis on stakeholder involvement and beneficiary protections. She also noted that passive demonstration enrollment and locking in participation are not a good idea because consumer choice is important. Justice in Aging will be looking for beneficiary ombudsman programs to be included in new demonstrations. This article is unavailable online. This is a summary.

Fact Sheet: CMS Regulations Set Ground Rules for D-SNP

By | DUAL ELIGIBLES, FACT SHEET, Health Care, Medicaid, Medicare, REPORTS

The Centers for Medicare and Medicaid Services (CMS) recently finalized rules implementing regulations governing minimum integration standards for Dual Eligible Special Needs Plans (D-SNPs) pursuant to the Bipartisan Budget Act of 2018. D-SNPs are Medicare Advantage plans that limit enrollment to individuals who are dually eligible for Medicare and Medicaid. With the permanent authorization of D-SNPs, we expect to see an increase of D-SNPs entering the market across the country.

Justice in Aging has analyzed the new regulations and created a new factsheet summarizing the major integration requirements including special considerations for advocates.

CMS Considering Regulation For D-SNP Look-Alike Plans

By | Health Care, IN THE NEWS, Medicaid, Medicare

Inside Health Policy (April 3, 2019)

The Centers for Medicare and Medicaid Services (CMS) is considering regulating duals special needs plan look-alikes because they get in the way of state efforts to integrate Medicaid and Medicare services through Medicare-Medicaid Plans or D-SNPs and are confusing for beneficiaries. The agency asked for advocates’ feedback on the impact of the D-SNP look-alikes—which don’t have to follow D-SNP requirements—on integration, beneficiary choice, competition, state Medicaid policy and other areas.

In a call letter CMS said state commenters were unanimous in saying that D-SNP look-alikes get in the way of the comments reinforce that the proliferation of D-SNP look-alike plans impedes progress toward developing products that meaningfully integrate Medicare and Medicaid benefits for dually eligible individuals. Justice in Aging attorney Georgia Burke was interviewed for the article and said, “we are pleased CMS has identified that the look-alikes are impeding progress toward integrating Medicare and Medicaid benefits and we hope CMS moves quickly to rein in the look-alikes.”

California Lawmakers Introduce a Trio of New Health Care Bills Focused on Older Adults

By | IN THE NEWS, Medicaid

Politico Pro: California Lawmakers Introduce a Trio of New Health Care Bills Focused on Older Adults (March 4, 2019)

The state of California has introduced three bills meant to help low-income seniors relying on Medi-Cal to cover health care costs. If passed, seniors over age 65 and people with disabilities would qualify for free coverage.

“Obamacare expanded coverage and affordability provisions for low-income people, but many of those benefits don’t apply to seniors once they reach age 65”, said Justice in Aging’s Senior Staff Attorney Claire Ramsey. “It’s about making Medi-Cal fairer and work better for older adults. We’re trying to stabilize their income and their financial security.” This article is behind a paywall. This is a summary.

Why The Possibility Of TennCare Converting To A Block Grant Has Opponents Growing Worried

By | IN THE NEWS, Long Term Care, Medicaid

Nashville Public Radio: Why The Possibility Of TennCare Converting To A Block Grant Has Opponents Growing Worried (March 13, 2019)

Health care advocates worry that Tennessee will be one of the first states to seek a block grant for its Medicaid program. A block grant is a lump sum that would allow the state greater flexibility in spending federal money. However it is capped and would not increase even if the Medicaid population grew. Currently, the federal government pays for two-thirds of the expenses of Tennessee’s 1.3 million beneficiaries.

“It would be a radical, catastrophic change to Medicaid,” said Justice in Aging’s Directing Attorney Eric Carlson. “The problem with the block grant is you eliminate everything… you’re eliminating all these protections. You’re locking down the revenue at a level that almost assuredly is insufficient.”

Issue Brief: Cal MediConnect-Unmet Need and Great Opportunity in

By | Health Care, ISSUE BRIEF, Medicaid, mltss

CalMediConnect, launched in 2014, is California’s dual eligible demonstration and seeks to integrate Medicare and Medicaid benefits under one health plan. One of its purposes is to better meet the needs of dual eligibles by increasing access to long-term services and supports (LTSS) and providing other value-added services, known in the demonstration as Care Plan Options (CPO). However, evaluation data and beneficiary experience indicate that more can be done to provide care for dual eligibles enrolled in the program. Justice in Aging recently obtained data via a Public Records Act request from California’s Department of Health Care Services that includes LTSS referrals and the number and type of CPO services plans are providing members.

Our issue brief, Cal MediConnect: Unmet Need and Great Opportunity in California’s Dual Eligible Demonstration, provides a brief overview of the Cal MediConnect program and examines the health plan referral data for LTSS and CPO services obtained through the Public Records Act request. It concludes with recommendations for policymakers on ways to strengthen Cal MediConnect through improving access to LTSS and CPO services. These recommendations are of interest to those following Cal MediConnect as well as advocates and stakeholders in other states with their own dual eligible demonstrations.

Read the brief.

Fact Sheet: Make the Expanded Spousal Impoverishment Protection Permanent

By | FACT SHEET, Health Care, Home & Community Based Services, Medicaid, REPORTS

Married seniors and adults with disabilities overwhelming want to live at home and age in place. Increasingly, federal and state Medicaid rules have prioritized home and community-based services (HCBS) which allow people to stay in their homes and in their communities. Congress recently helped these efforts by expanding a Medicaid eligibility rule, known as the spousal impoverishment protection, to individuals eligible for HCBS. The protection makes it possible for an individual who needs a nursing home level of care to qualify for Medicaid while allowing their spouse to retain a modest amount of income and resources. However, the expansion of the spousal impoverishment protection is set to expire on March 31, 2019 unless Congress acts. This means that individuals who qualified under the expanded protection may lose access to Medicaid and to their HCBS and may be left with no choice but to move into institutional long-term care, away from their spouses.

Letting the spousal impoverishment protection expire will hurt families and force more people out of their homes and their communities. We urge Congress to make the expanded spousal impoverishment protection permanent so seniors and people with disabilities can age in place and with dignity.

Justice in Aging has created a fact sheet on the importance of the expanded HCBS spousal impoverishment protection and calling on Congress to make it permanent so seniors and people with disabilities can age in place and with dignity.