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- August 21, 2014
Recommendations for the Modernization of the Federal Medicaid Regulations
Read moreMedicaid managed care has changed significantly over the past decade and includes more vulnerable people who have disabilities, are older, or have limited English proficiency than ever before. Service delivery methods have evolved and technology advanced. Yet the managed care regulations have not been updated since 2002. These modernized…
- June 24, 2014
Promoting Community Living: Updates on HCBS & the ACA
Read moreThe Affordable Care Act (ACA) significantly expands Home and Community-based Services (HCBS) in the Medicaid program. Four HCBS programs - two brand new - promote and fund policies that help beneficiaries access needed services in the community and facilitate appropriate transitions from nursing homes to integrated settings. (1) Two…
- June 16, 2014
External Quality Review: An Overview
Read morePart of the overall quality strategy mandated by the Medicaid Act and regulations requires states to include annual independent external quality reviews (EQRs) in each managed care contract. This approach requires an independent organization to validate state selected performance measures, perform site visits and "otherwise evaluate the performance of…
- February 18, 2014
Health Advocate: Home and Community Based Settings — A Primer
Read moreThis issue of the Health Advocate provides an overview of Medicaid Home and Community Based Services (HCBS). HCBS programs are intended to support states in creating a comprehensive system of long-term care services in the community, as is consistent with the community integration mandate established by the Supreme Court…
- February 11, 2014
Q&A: Home and Community-Based Services-Final Rules
Read moreQ&A: Home and Community-Based Services-Final RulesMedicaid-funded home and community-based services are critical to community integration for older adults and individuals with disabilities. Defining the types of settings in which these services are provided is important in ensuring the services are not provided in settings that are institutional in nature,…
