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- December 5, 2014
Q&A Relatives as Paid Providers
Read moreMany states allow parents or other legally responsible relatives to become paid providers of Medicaid-funded home and community based services for their children or other relatives. State policies on this issue vary and often differ by program and population served. This Q&A provides an overview of the federal program…
- September 10, 2014
Letter to CMS re: Modernization of Medicaid Managed Care Regulations
Read moreNHeLP has created a set of moderized Medicaid managed care federal regulations. These revised regulations were shared with the federal Centers for Medicare & Medicaid Services in the spring of 2014. This cover memo explained the rationale behind those recommended changes.
- 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…