CMS Releases New Report on Medicaid Expenditures for Long-Term Services and Supports; Webinar Scheduled for July 31

Last week, the Centers for Medicare & Medicaid Services (CMS) released the 2013 Medicaid Expenditures for Long-Term Services and Supports Report. This report documents progress the Medicaid program has made to promote community living for older adults and people with disabilities.  CMS and Truven Health will host a webinar to discuss the report findings Friday, July 31, from 3 – 4 p.m. (EDT).  To register, click here.

New Resource Related to Home and Community-Based Services Settings Rule

Last week, the Centers for Medicare & Medicaid Services (CMS) released Frequently Asked Questions (FAQs) related to Home and Community-Based Services (HCBS) Settings Rule. The guidance focuses on the process for states to use in overcoming the presumption that certain settings have the characteristics of an institution, and highlights the heightened scrutiny review that CMS will give such information submitted from states.

Home and Community Based Services Bill Introduced in the Senate

Last week, Senator Chuck Grassley (R-IA), together with Senator Ron Wyden (D-OR) and Senator Bob Casey (D-PA), introduced S. 1604, Transition to Independence Medicaid Buy-In Option, bipartisan legislation which would, as stated in Sen. Grassley’s press release, “create a demonstration project to encourage states to improve opportunities for individuals with disabilities to obtain employment in the community, gaining self-determination, independence, productivity, and integration and inclusion.” Ten states, over a period of five years, would receive bonus payments for meeting benchmarks which are outlined in the bill’s technical summary.

Managed Care Regulations released

Last week, the Centers for Medicare & Medicaid Services (CMS) released a notice of proposed rulemaking toward modernization of the Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations and to update the programs’ rules and strengthen beneficiary services.  For more information, including summaries of key provisions of the proposed rule, visit medicaid.gov. Staff from The Arc will be reviewing the regulations and providing comments. The deadline to submit comments is July 27, 2015.

The Arc Calls on Advocates to Support Lifeline Programs

Medicaid, Social Security Disability Insurance (SSDI), and other lifeline programs for people with I/DD are under attack. The House and Senate passed a concurrent budget resolution that calls for significant cuts, setting in motion a process to restructure the Medicaid program. It’s time to act! We are calling on our advocates to engage their Members of Congress in support of these critical programs.  Please register your concerns by responding to the action alert posted above.  To assist you with engaging in other activities, The Arc has created a toolkit with tips and key messages to convey.   The Memorial Day recess and the July 4th recess are excellent times to step up our activities by writing, calling or visiting your Member of Congress.

The Arc Calls on Advocates to Support Lifeline Programs

Medicaid, Social Security Disability Insurance (SSDI), and other lifeline programs for people with I/DD are under attack. The House and Senate passed a concurrent budget resolution that calls for significant cuts, setting in motion a process to restructure the Medicaid program. It’s time to act! We are calling on our advocates to engage their members of Congress in support of these critical programs.  Please register your concerns by responding to the action alert posted above.  To assist you with engaging in other activities, The Arc has created a toolkit with tips and key messages to convey.   The Memorial Day recess and the July 4th recess are excellent times to step up our activities by writing, calling or visiting your Member of Congress.

New Report Released by the Centers for Medicare and Medicaid Services

Last week, the Centers for Medicare and Medicaid Services (CMS) released a report titled “The Right Supports at the Right Time: How Money Follows the Person (MFP) Programs Are Supporting Diverse Populations in the Community.” This report examines how six MFP grantees are serving populations with diverse needs in the community and the factors that have contributed to their performance on key outcome measures. The report is available here.

U.S. Supreme Court Rules That Providers Cannot Sue to Enforce Payment Levels

On March 31, in Armstrong v. Exceptional Child Center, Inc., the U.S. Supreme Court decided that the Constitution’s Supremacy Clause cannot be used by private providers of Medicaid-funded community services for people with developmental disabilities to sue the state of Idaho for setting payment rates too low. The providers of habilitation services had sued Idaho for violating a provision of the Medicaid program that requires states to set rates that ensure adequate access to services.  The United States Court of Appeals for the Ninth Circuit upheld the providers’ right to sue Idaho under the Supremacy Clause.

The issue of provision of adequate rate-setting is a major one for Medicaid beneficiaries, including people with I/DD. Unfortunately, the Supreme Court decided that the Supremacy Clause does not confer a private right of action, and that Medicaid providers cannot sue to enforce the Medicaid provisions requiring states to “assure that payments are consistent with efficiency, economy, and quality of care” while “safeguard[ing] against unnecessary utilization of … care and services”. Some court observers believe that this decision could further narrow the rights of beneficiaries to use other means to protect individual rights. It remains to be seen how this decision will be interpreted in the lower courts and in future Supreme Court decisions.

HCBS Settings Rule

Last week, the deadline for states to submit their transition plans to CMS outlining how they will come into compliance with the HCBS Settings Rule passed. Several states have yet to submit their final plans; in fact some states are still collecting public comment in response to their proposals. CMS has not yet approved any of the transition plans which have been submitted for consideration. Federal resources and state by state details, including draft and final plans, can be found at www.hcbsadvocacy.org. The Arc will continue to monitor this issue.

HCBS Settings Rule

Last week, the Centers for Medicare & Medicaid Services (CMS) provided updated portions of the CMCS Home and Community-Based Services (HCBS) Toolkit: the HCBS Basic Element Review Tool for Statewide Transition Plans and the HCBS Content Review Tool for Statewide Transition Plans. The full HCBS toolkit, including the updated portions, is available online at http://www.medicaid.gov/hcbs/